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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
Q

Difference pyogenic granuloma and peripheral giant cell granuloma

A

PGCG - only found gingiva

Pyogenic g - can be found sites elsewhere

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26
Q

What problems can peripheral giant cell granuloma cause?

A

Superficial bone resorption

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27
Q

What histology would you see with peripheral giant cell granuloma?

A

Vascular fibrous tissue
Multinucleate giant cells in fibrous strome
Haemorrhage

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28
Q

Problem w/ histology of peripheral giant cell granuloma?

A

Same as giant cell lesions arising in bone e/g central giant cell granuloma

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29
Q

Management of peripheral giant cell granuloma?

A

Determine where lesion has arose

If peripheral - excision w/ curettage

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30
Q

What is Bohn’s nodule?

A

Keratin filled cyst on the gingival crest

Fused w/ overlying gingival mucosa

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31
Q

What are Epstein pearls?

A

Midline of palate - epithelium filled w/ keratin

Seen in babies

32
Q

How to exclude abscess from differential of epulide?

A

Access will be red/ yellow/ soft/ fluctuant

33
Q

If the epulide is firm and mucosal coloured what is likely diagnosis?

A

Fibrous epulis

34
Q

If epulide is soft red/blue what is likely diagnosis?

A

Pyogenic granuloma

Giant cell granuloma

35
Q

What are examples of generalised gingival swellings?

A 
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
Q

What is gingival fibromatosis?

A

Hereditary generalised gingival swelling - lifelong

Pale pink, firm overgrowths which may cover and submerge teeth

37
Q

Tx of gingival fibromatosis?

A

Gingivectomy - may reoccur

Superior plaque control

38
Q

What is chronic hyperplastic gingivitis?

A

Generalised gingival swelling
Associated w/ poor OH

Erythematous gingiva w/ inflammatory overgrowth

39
Q

Features of hormonal related gingival hyperplasia?

A

Often seen in puberty/ pregnancy

Exuberent response to plaque

Red, erythematous

40
Q

What is a type of dietary related gingival hyperplasia?

A

Scurvy related - lack of vitamin C = failure to synthesis collagen

41
Q

Why is tooth loss related w/ dietary gingival hyperplasia?

A

Lack of collagen = loss of teeth due to lack of support PDL

42
Q

What would you see in gigival hyperplasia associated w/ leukaemia?

A

Red, swollen gingiva
May exclude pus
Ulceration

Other: petechial haemorrhage, tiredness

43
Q

What drugs can cause gingival hyperplasia?

A

Cyclosporin - immunosuppressant
Nifedipine - antihypertensive
Phenytoin - anticonvulsant

44
Q

What histology see in gingival hyperplasia?

A

Dense fibrous tissue - lots collagen
Little inflammation
Hyperplastic epithelium w/ long rete ridge

45
Q

Management of drug induced gingival hyperplasia?

A

Alterative med - GO
Gingivectomy
Improved OH

46
Q

How would Crohn’s related gingival hyperplasia present?

A 
Labial swelling
Apthous ulcers
Mucosal tags
Cobblestoning 
Generalised gingival hyperplasia
47
Q

What would see on histology of Crohn’s related gingival hyperplasia?

A

Granulomatous inflammation

48
Q

Examples of swellings of oral mucosa?

A 
Squamous cell papilloma
Heck's disease 
Fibrous hyperplasia 
Pyogenic granuloma
Traumatic neuroma
Lipoma
Haemangioma 
Sturge-Weber syndrome
Mucocele
49
Q

What is clinical features squamous cell papilloma?

A

White cauliflower like growth
Common on palate
Pedunculated or sessile

50
Q

What is squamous cell papilloma related w/?

A

Benign neoplasm which is HPV derived (not oncogenic)

HPV 6 and 11

51
Q

What is histology of squamous cell papilloma?

A

Overgrowth of hyperkeratinised epithelium
Surface thrown into fronds
Vascular connective tissue core

52
Q

Tx of squamous cell papilloma?

A

Excision w/ margins

53
Q

What is heck’s disease caused by?

A

HPV 13 and 32

54
Q

What would see clinically in Heck’s disease?

A

Multiple papillomas
Multiple flat viral warts - typically on lips
Can coalesce to form bigger warms

55
Q

Other name for Heck’s disease?

A

Focal epithelial hyperplasia

56
Q

Where would see fibrous hyperplasia?

A

Cheeks, tongue and lips - from continued trauma

57
Q

What would see in fibrous hyperplasia?

A

Mucosal coloured, firm nodule

Matured fibrous tissue covering normal epithelium

58
Q

Can pyogenic granuloma affect mucosa?

A

Yes from continued trauma

Overgrowth of vascular granulation tissue - usually ulcerated

59
Q

What is traumatic neuroma?

A

Haphazard overgrowth of nerve fibres - usually caused by trauma (e.g traumatic XLA)

60
Q

What is lipoma?

A

Benign neoplasm composed of fat

Appear yellow/ pink w/ smooth surface

61
Q

Where is common to see lipoma?

A

Common on cheek and tongue

Buccal mucosa - large amount adipose/ submucosa

62
Q

What is a malignant form of lipoma?

A

Liposarcoma very rarely seen in oral cavity

63
Q

What histology would you see in lipoma?

A

Overgrowth of benign adipose tissue w/ well defined edges

64
Q

What is harmartoma?

A

Overgrowth of tissue found in location

65
Q

What is choristoma?

A

Overgrowth of tissue not native to site

66
Q

What would see in haemangioma?

A

Excess blood vessels = blue/ blue-purple colour
May bleed excessively
Will blanch on pressure

67
Q

What is Sturge-Weber syndrome?

A

Congenital - present from birth
Port wine stain w/ varying degree of mental retardation

Port wine stain - follow division of trigeminal nerve

68
Q

What are the two types of mucocele?

A

Mucous retention cyst

Mucous extravasation cyst

69
Q

What causes mucocele?

A

Salivary duct becomes damaged - saliva spills into tissue which is then surrounded by granulation tissue

70
Q

Most common sit of mucocele?

A

Lower lip

71
Q

Treatment of mucocele?

A

Excision along w/ damaged duct

72
Q

What is associated w/ lymphatic vessels but similar to haemangioma?

A

Lymphangioma

73
Q

What is granular cell tumour?

A

Of neural origin

Common on tongue

74
Q

If lesion is cauliflower like and white what is it?

A

Squamous cell papilloma

75
Q

If lesion is smooth, mucosal coloured and related to trauma what is it?

A

Fibrous hyperplasia

76
Q

If lesion is smooth and yellow what is it?

A

Lipoma

77
Q

If lesion is red/ red-blue and related to trauma?

A

Pyogenic granuloma

5th Oral Disease -Histology Lectures (11 decks)

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