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5th Oral Disease -Histology Lectures > Benign Swellings and Reactive Lesion > Flashcards

Benign Swellings and Reactive Lesion Flashcards

1
Q

What is a congenital/ developmental harmartoma of the epithelium?

A

Pigemental naevus

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2
Q

What is a congenital/ developmental harmartoma of the gingiva?

A

Gingival fibromatosis

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3
Q

What is an inflammatory lesion of fibrous tissue/ gingiva?

A

Gingival hyperplasia

Periodontal/ PA abscess

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4
Q

What is a reactive lesion of the epithelium?

A

Mucoceles

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5
Q

What is a reactive lesion seen in gingiva?

A

Pyogenic granuloma
Fibrous hyperplasia
Giant cell granuloma

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6
Q

What is neoplastic lesion of epithelium?

A

SCC

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7
Q

Neoplastic lesion if fibrous tissue?

A

Fibroma

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8
Q

Neoplastic lesion of the blood vessel

A

Angiosarcoma

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9
Q

Neoplastic lesion of fat?

A

Lipoma

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10
Q

What is epulis?

A

Gingival swelling

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11
Q

What is a fibrous epulis?

A

Fibro-epithelial polyps or fibrous hyperplasia

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12
Q

Features of fibrous epulis?

A

Pedunculated or sessile
Same colour as normal mucosa
Firm
Painless unless traumatised

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13
Q

Difference between pedunculated and sessile?

A

Pedunculated - stalk

Sessile - flat base

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14
Q

Cause of fibrous epulis?

A

Caused by trauma e.g dentures, teeth, ortho appliance

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15
Q

What would you see histologically of fibrous epulis?

A

Overgrowth fibrous connective tissue

Covered hyperkeratinised stratified squamous eputhelium

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16
Q

Management of fibrous epulis?

A

Excision
Removal of cause
Send histopathological exam

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17
Q

What are the clinical features of pyogenic granuloma?

A

Red/blue/purple vascular growth
Rapid growth
Soft, easily bleeds
Can be ulcerated

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18
Q

When is common to see pyogenic granuloma?

A

Usually <40yrs

Common pregnancy/ puberty - hormones exacerbate

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19
Q

What can pyogenic granuloma mature into?

A

Fibrous epulis

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20
Q

Cause of pyogenic granuloma?

A

Trauma - plaque/ appliances

Pregnancy - hormone exacerbate response to trauma

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21
Q

Why of pyogenic granulomas red?

A

Lots of blood vessels filled RBCs

Overgrowth of vascular granulation tissue

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22
Q

Management of pyogenic granuloma?

A

Excision and removal of cause

Pt pregnant - can remove but can reoccur - improve OH

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23
Q

Clinical appearance of peripheral giant cell granuloma

A

Soft red/blue swelling
Sessile or pedunculated
Similar pyogenic granuloma
Usually anterior teeth

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24
Q

Examples of localised epulides?

A 
Fibrous epulis
Pyogenic granuloma
Peripheral giant cell granuloma 
Bohn's nodules
Epstein pearls
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25
Difference pyogenic granuloma and peripheral giant cell granuloma
PGCG - only found gingiva | Pyogenic g - can be found sites elsewhere
26
What problems can peripheral giant cell granuloma cause?
Superficial bone resorption
27
What histology would you see with peripheral giant cell granuloma?
Vascular fibrous tissue Multinucleate giant cells in fibrous strome Haemorrhage
28
Problem w/ histology of peripheral giant cell granuloma?
Same as giant cell lesions arising in bone e/g central giant cell granuloma
29
Management of peripheral giant cell granuloma?
Determine where lesion has arose If peripheral - excision w/ curettage
30
What is Bohn's nodule?
Keratin filled cyst on the gingival crest | Fused w/ overlying gingival mucosa
31
What are Epstein pearls?
Midline of palate - epithelium filled w/ keratin | Seen in babies
32
How to exclude abscess from differential of epulide?
Access will be red/ yellow/ soft/ fluctuant
33
If the epulide is firm and mucosal coloured what is likely diagnosis?
Fibrous epulis
34
If epulide is soft red/blue what is likely diagnosis?
Pyogenic granuloma | Giant cell granuloma
35
What are examples of generalised gingival swellings?
``` Chronic hyperplastic gingivitis Gingival fibromatosis Hormonal related gingival hyperplasia Diet related gingival hyperplasia Neoplastic related gingival hyperplasia Drug induced gingival hyperplasia Crohn's related gingival hyperplasia ```
36
What is gingival fibromatosis?
Hereditary generalised gingival swelling - lifelong | Pale pink, firm overgrowths which may cover and submerge teeth
37
Tx of gingival fibromatosis?
Gingivectomy - may reoccur | Superior plaque control
38
What is chronic hyperplastic gingivitis?
Generalised gingival swelling Associated w/ poor OH Erythematous gingiva w/ inflammatory overgrowth
39
Features of hormonal related gingival hyperplasia?
Often seen in puberty/ pregnancy Exuberent response to plaque Red, erythematous
40
What is a type of dietary related gingival hyperplasia?
Scurvy related - lack of vitamin C = failure to synthesis collagen
41
Why is tooth loss related w/ dietary gingival hyperplasia?
Lack of collagen = loss of teeth due to lack of support PDL
42
What would you see in gigival hyperplasia associated w/ leukaemia?
Red, swollen gingiva May exclude pus Ulceration Other: petechial haemorrhage, tiredness
43
What drugs can cause gingival hyperplasia?
Cyclosporin - immunosuppressant Nifedipine - antihypertensive Phenytoin - anticonvulsant
44
What histology see in gingival hyperplasia?
Dense fibrous tissue - lots collagen Little inflammation Hyperplastic epithelium w/ long rete ridge
45
Management of drug induced gingival hyperplasia?
Alterative med - GO Gingivectomy Improved OH
46
How would Crohn's related gingival hyperplasia present?
``` Labial swelling Apthous ulcers Mucosal tags Cobblestoning Generalised gingival hyperplasia ```
47
What would see on histology of Crohn's related gingival hyperplasia?
Granulomatous inflammation
48
Examples of swellings of oral mucosa?
``` Squamous cell papilloma Heck's disease Fibrous hyperplasia Pyogenic granuloma Traumatic neuroma Lipoma Haemangioma Sturge-Weber syndrome Mucocele ```
49
What is clinical features squamous cell papilloma?
White cauliflower like growth Common on palate Pedunculated or sessile
50
What is squamous cell papilloma related w/?
Benign neoplasm which is HPV derived (not oncogenic) | HPV 6 and 11
51
What is histology of squamous cell papilloma?
Overgrowth of hyperkeratinised epithelium Surface thrown into fronds Vascular connective tissue core
52
Tx of squamous cell papilloma?
Excision w/ margins
53
What is heck's disease caused by?
HPV 13 and 32
54
What would see clinically in Heck's disease?
Multiple papillomas Multiple flat viral warts - typically on lips Can coalesce to form bigger warms
55
Other name for Heck's disease?
Focal epithelial hyperplasia
56
Where would see fibrous hyperplasia?
Cheeks, tongue and lips - from continued trauma
57
What would see in fibrous hyperplasia?
Mucosal coloured, firm nodule | Matured fibrous tissue covering normal epithelium
58
Can pyogenic granuloma affect mucosa?
Yes from continued trauma | Overgrowth of vascular granulation tissue - usually ulcerated
59
What is traumatic neuroma?
Haphazard overgrowth of nerve fibres - usually caused by trauma (e.g traumatic XLA)
60
What is lipoma?
Benign neoplasm composed of fat | Appear yellow/ pink w/ smooth surface
61
Where is common to see lipoma?
Common on cheek and tongue | Buccal mucosa - large amount adipose/ submucosa
62
What is a malignant form of lipoma?
Liposarcoma very rarely seen in oral cavity
63
What histology would you see in lipoma?
Overgrowth of benign adipose tissue w/ well defined edges
64
What is harmartoma?
Overgrowth of tissue found in location
65
What is choristoma?
Overgrowth of tissue not native to site
66
What would see in haemangioma?
Excess blood vessels = blue/ blue-purple colour May bleed excessively Will blanch on pressure
67
What is Sturge-Weber syndrome?
Congenital - present from birth Port wine stain w/ varying degree of mental retardation Port wine stain - follow division of trigeminal nerve
68
What are the two types of mucocele?
Mucous retention cyst | Mucous extravasation cyst
69
What causes mucocele?
Salivary duct becomes damaged - saliva spills into tissue which is then surrounded by granulation tissue
70
Most common sit of mucocele?
Lower lip
71
Treatment of mucocele?
Excision along w/ damaged duct
72
What is associated w/ lymphatic vessels but similar to haemangioma?
Lymphangioma
73
What is granular cell tumour?
Of neural origin | Common on tongue
74
If lesion is cauliflower like and white what is it?
Squamous cell papilloma
75
If lesion is smooth, mucosal coloured and related to trauma what is it?
Fibrous hyperplasia
76
If lesion is smooth and yellow what is it?
Lipoma
77
If lesion is red/ red-blue and related to trauma?
Pyogenic granuloma

5th Oral Disease -Histology Lectures (11 decks)

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