Benign Tumors

Question 1

Describe a squamous papilloma in terms of color, size, sessile vs pedunculated

Answer 1

White or pink, less than 5mm, sessile most often

Question 2

What tissues are contained in a squamous papilloma lesion?

Answer 2

SSE that is keratinized or parakeratinized. There is a core of vascular connective tissue

Question 3

Describe the clinical features of verruca vulgaris, color, type of lesion, sessile vs. pedunculated, solitary or multiple

Answer 3

White but occasionally pink, nodule or papule, sessile or pedunculated, multiple

Question 4

Where do most cases of verruca vulgaris occur?

Answer 4

In the anterior part of the mouth

Question 5

Describe the histologic appearance of verruca vulgaris

Answer 5

Multiple projections composed of keratinized SSE. Long rete ridges with kilobytes in the outer spinous layer

Question 6

What types of HPV are associated with verruca vulgaris?

Answer 6

2, 4, 6, 40

Question 7

Describe condyloma acuminatum in terms of color, texture, sessile vs pedunculated, solitary or multiple

Answer 7

White or pink, warty, sessile, multiple nodules

Question 8

How does the size of a condyloma acuminatum lesion compare to papilloma?

Answer 8

Tend to be larger

Question 9

Condyloma acuminatum represents what other disease?

Answer 9

A sexually transmitted one

Question 10

What tissue and cells are seen in condyloma acuminatum?

Answer 10

Acanthotic SSE and koilocytes. The broad projections have a core of vascular connective tissue

Question 11

What do lesions look like in Heck’s disease?

Answer 11

Pale plaques or papule which tend to cluster

Question 12

Where do lesions most often occur in Heck’s disease?

Answer 12

Labial or buccal mucosa

Question 13

Keratoacanthoma is often mistaken for? What does it arise from?

Answer 13

Cancer, arises from pilosebaceous units

Question 14

Describe the lesions in keratoacanthoma

Answer 14

Well-defined, umbilicated nodules up to 1.5cm in diameter

Question 15

Describe the growth pattern of keratoacanthoma

Answer 15

Grows rapidly, reaching full size in 6 weeks and then regresses

Question 16

What are the most common sites for a melanotic macule?

Answer 16

Vermilion of the lower lip, buccal mucosa, gingiva, and palate

Question 17

Are melanotic macules solitary or in clusters?

Answer 17

Solitary most of the time

Question 18

What causes lentigo?

Answer 18

Hyperplasia of melanocytes

Question 19

Which type of lentigo is unrelated to sun exposure?

Answer 19

Lentigo simplex

Question 20

What is lentigo senile?

Answer 20

Benign condition that usually occurs on the face, sun-exposed areas

Question 21

What is lentigo maligna?

Answer 21

Melanoma in situ, the purely radial growth phase. Grows for up to 15 years

Question 22

Describe the epithelium in lentigo maligna

Answer 22

Atrophic with loss of rate ridges and hyper plastic melanocytes are atypical

Question 23

Most nevomelanocytic nevi occur in men or women?

Answer 23

Women

Question 24

What are the most common sites for nevomelanocytic nevi?

Answer 24

Hard palate, buccal mucosa, lip, gingiva

Question 25

Most oral nevi are of which type?

Answer 25

Intramucosal

Question 26

What is the 2nd most common type of melanocytic nevus?

Answer 26

Blue nevus

Question 27

Where do most blue nevi occur?

Answer 27

On the palate

Question 28

Junctional nevi have nevus cells in what layers?

Answer 28

bulging down from the basal layer

Question 29

In compound nevi and intramucosal nevi, where are the nevus cells?

Answer 29

In compound they extend from the junction into the lamina propria. Intramucosal, the cells are confined to the lamina propria

Question 30

Melanoacanthosis most often occurs in who?

Answer 30

African-American females

Question 31

How does melanoacanthosis present itself?

Answer 31

Dark brown macules or patches in the buccal mucosa. They can be more intensely pigmented centrally

Question 32

How large can melanoacanthosis lesions get?

Answer 32

Several centimeters

Question 33

What tissues and cells are seen in melanoacanthosis?

Answer 33

Acanthotic SSE with spongiosis. Dendritic melanocytes scattered throughout tissue Eosinophils are seen in the epithelium and lamina propr.

Question 34

Verruciform xanthoma presents as?

Answer 34

A solitary, red or white, sessile lesion

Question 35

What causes verruciform xanthoma?

Answer 35

Usually trauma

Question 36

Who gets verruciform xanthoma and where do they occur?

Answer 36

Middle aged or elder people on the gingiva or alveolar ridge

Question 37

What are xanthoma cells?

Answer 37

Lipid filled macrophages

Question 38

Xanthomas are seen in what two illnesses?

Answer 38

Diabetes mellitus and familial disturbances in lipid metabolism

Question 39

Is a lipoma encapsulated?

Answer 39

Yes

Question 40

What can cause a herniated buccal fat pad?

Answer 40

herniation of the buccal fat pad through the buccinator muscle

Question 41

How do you distinguish a buccal fat pad from a lipoma?

Answer 41

Skeletal muscle fibers within the adipose tissue

Question 42

When do oral lymphangiomas appear

Answer 42

At birth or in the first 2 years of life

Question 43

Where do oral lymphangiomas appear?

Answer 43

On the anterior dorsal surface of the tongue

Question 44

What is pathagnomic for oral lymphangioma?

Answer 44

Irregular, grey or pink fluid filled papillations on the anterior dorsal tongue

Question 45

The papillations of oral lymphangioma are lined by?

Answer 45

Endothelium

Question 46

What is cystic hygroma?

Answer 46

Large, multicystic lymphangioma of the neck

Question 47

What symptoms can cystic hygroma cause?

Answer 47

Dysphagia and dyspnea

Question 48

Are leiomyomas freely movable or fixed?

Answer 48

Freely movable

Question 49

Are leiomyomas encapsulated? What cells are they composed of?

Answer 49

Encapsulated. Composed of spindle cells with cigar shaped nuclei

Question 50

How do you definitely diagnosis leiomyoma?

Answer 50

IHC identification of antigenic actin filaments

Question 51

What do most oral leiomyomas arise from?

Answer 51

Vascular smooth muscle

Question 52

Are traumatic neuromas freely movable or attached?

Answer 52

Attached

Question 53

What symptoms may a patient experience with a traumatic neuroma?

Answer 53

Pain or tenderness

Question 54

In what case is a neurofibroma free movable?

Answer 54

If it arises within the perineurium

Question 55

Can a neurofibroma be encapsulated?

Answer 55

Yes, if the proliferation occurs within the perineurium otherwise it blends into the surrounding CT

Question 56

Neurofibromas are composed mostly of what kind of cell?

Answer 56

Schwann cells