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Pathology Final > Black and White > Flashcards

Black and White Flashcards

1
Q

Benign neoplasms of bone

A 
asymptomatic
grows slowly by expansion
displaces teeth and expands cortex
symmetrical 
doesn't metastasize
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2
Q

Malignant neoplasms of bone

A 
symptomatic
grows quickly
invades and destroys structures (cortex)
asymmetrical
ragged/poor defined margins
lays down bone outside of cortex
can metastasize
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3
Q

Focal osteoporotic marrow defect

A

hematopoietic marrow produces radiolucency
ill defined borders with fine trabeculations
not pathology
asymptomatic
diagnose with incisional biop
not associated with a hematological disorder

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4
Q

Focal osteoporotic marrow defect F

A

75% F

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5
Q

Focal osteoporotic marrow defect location

A

posterior mandible (no jaw expansion)

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6
Q

Idiopathic osteosclerosis

A

focal area radiopaque with unknown cause
diagnose with history, clinical feathers and radiograph
biop only if symptoms, growth, or cortical expansion

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7
Q

Idiopathic osteosclerosis differentials

A

condensing osteitis (associated with infection)
focal cemnto-osseous dysplasia (with radiolucent rim)
cemntoblastoma (fused with tooth)

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8
Q

Condensing osteitis

A

focal sclerosing osteomyelitis
local area of bone associated with apices of teeth with pulpitis
associated with inflammation is necessary for diagnosis

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9
Q

Central giant cell granuloma

A

non-neoplastic
before age 30
most asymptomatic, some have pain, paresthesia, and perforation of cortical plate

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10
Q

Central giant cell granuloma F/M

A

F>M

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11
Q

Central giant cell granuloma location

A

Mand > Max

common in anterior jaw and crosses midline

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12
Q

Central giant cell granuloma tx

A

curettage with 20% recurrence, > in young patient
more curettage if recurrence
long term prognosis is good without risk of metastasis

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13
Q

Traumatic bone cyst

A 
simple bone cyst
asymptomatic 
20% have swelling
ages 10-20
scalloping: doesnt involve roots
radiographic findings suggestive but not diagnostic (surgical exploration)
cyst but NOT epithelium lined
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14
Q

Traumatic bone cyst location

A

mand

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15
Q

Traumatic bone cyst tx

A

surgery
curette walls to rule out thin walled lesions
little/no tissue obtained
rapid obliteration of defect and bone fills in
radiographs until resolved
excellent prognosis

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16
Q

Aneurysmal bone cyst

A

intraosseous accumulation of blood filled spaces surrounded by connective tissue
not a true cyst!
etiology unclear
swelling that develops rapidly

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17
Q

Aneurysmal bone cyst location

A

mostly long bones, jaw rare

~20 years in posterior mand

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18
Q

Aneurysmal bone cyst F/M

A

F=M

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19
Q

Fibro-osseous lesions

A

diverse group of processes where normal bone is replaced by fibrous tissue containing mineralized product
microscopically similar, need clinical and radiographic findings to diagnose

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20
Q

Benign fibro-osseous lesions

A

fibrous dysplasia
cemnto-osseous dysplasia
ossifying fibroma

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21
Q

Cemento-osseous dysplasia types

A

in tooth bearing areas of jaw

focal (caucasians)
periapical (african americans)
florid (african americans)

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22
Q

Focal cemento-osseous dysplasia

A

single site of involvement
~ 40 yrs
asymptomatic lesions < 1.5 cm

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23
Q

Focal cemento-osseous dysplasia location

A

posterior mand (1st molar)

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24
Q

Periapical cemento-osseous dysplasia

A

multiple foci usually
~ 40 yrs
teeth vital

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25
Q

Periapical cemento-osseous dysplasia location

A

periapical of anterior mandible (canine to canine)

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26
Q

Periapical cemento-osseous dysplasia F/M

A

90% F > 70% african american

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27
Q

Florid cemento-osseous dysplasia

A

multiple foci not limited to anterior mand
middle-aged older adults
can be asymptomatic
usually bilateral and symmetrical

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28
Q

Focal cemento-osseous dysplasia F/M

A

90% F

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29
Q

Florid cemento-osseous dysplasia F/M

A

90% F > 90% african american

30
Q

Ossifying fibroma

A

true neoplasm with large growth potential
tumor of fibrous tissue with mix of bone and cementum
wide age range
small seen on x ray, no swelling or symptoms
large cause painless swelling
bowing downward of interior cortex of mand for large tumors
root divergence or resorption can occur or teeth displacement
well defined, unilocular radiolucent or radiolucent-radiopaque mix (depends on amount of calcified material)

31
Q

Cementoblastoma

A

odontogentic neoplasm of cementoblasts
75% < 30 yrs
2/3 have pain and swelling
radiopaque mass surrounded by radiolucent rim fused to tooth roots, outline of roots usually obscured

32
Q

Cementoblastoma tx

A

extract tooth and calcified mass

33
Q

Osteosarcoma

A

mesenchymal malignancy
cells able to produce osteoid/immature bone
most common type of neoplasm to originate in bone minus hematopoietic neoplasms
can be intramedullary, juxtacortical or extraskeletal

34
Q

Metastatic tumors to the jaws

A

poor prognosis (stage IV disease)
5 yr survival rare
pt succumbs to cancer within a year
most common type of cancer in the bone

35
Q

Dentigerous cyst

A

originates from separation of follicle from around the crown of unerupted tooth
most common developmental cyst
encloses crown of unerupted tooth and attaches at the CEJ

36
Q

Odontogenic keratocyst (OKC)

A

30% recurrence
associated with gorlins syndrome (nevoid basal cell carcinoma syndrome)
- PTCH gene
- WHO: keratocystic odontogenic tumor
thin friable wall unifrom 6-8 layers of epithelium thick
basal cell layer > palisading and hyperchromatic (picket fence)
epithelium surfaced with wavy parakeratin
small satellite (daughter cysts) cells away from primary lesion

37
Q

Orthokeratinized odontogenic cyst (OOC)

A

orthokeratinized lining not palisading
typically uniclocular - looks like dentigerous cyst
2% recurrence after enuculation and curettage

38
Q

Orthokeratinized odontogenic cyst location

A

posterior mandible (3rd molar)

39
Q

Calcifying odontogenic cyst (COC)

A

Gorlin cyst
WHO: calcifying cystic odontogenic tumor
~ 35 yrs
20% associated with odontomas

40
Q

Calcifying odontogenic cyst radiographically

A

unilocular, well defined radiolucency with radiopaque structures 50% of the time

41
Q

Calcifying odontogenic cyst location

A

65% incisor-canine area
max = mand
1/3rd associated with unerupted tooth (canine)

42
Q

Adenamatoid odontogenic tumor (AOT)

A

10-20 yrs
asymptomatic
discovered by radiograph when tooth hasnt erupted

43
Q

Adenamatoid odontogenic tumor location

A

almost always anterior jaw

max > mand

44
Q

Adenamatoid odontogenic tumor F/M

A

2F>M

45
Q

Adenamatoid odontogenic tumor radiographically

A

75% time tumor circumscribed, uniloculare radiolucency with crown of unerupted tooth (canine)
Radiolucency extends apically past CEJ (unlike dentigerous cyst)
fine, snowflake calcifications
thick fibrous capsule

46
Q

Calcifying epithelial odontogenic tumor (CEOT)

A

Pindborg tumor

painless slow growing swelling

47
Q

Calcifying epithelial odontogenic tumor location

A

mand > max

posterior > anterior

48
Q

Calcifying epithelial odontogenic tumor F/M

A

F=M

49
Q

Calcifying epithelial odontogenic tumor radiographically

A

uni/multilocular - unilocular more common in max
scalloped will defined margins - corticated or ill defined
associated with impacted tooth often (mand molar)
calcified structures varying size and density

50
Q

Calcifying epithelial odontogenic tumor histology

A

nuclear polymophism and atypia
amyloid like extracellular material
positive for congo red
green birefringence under polarized light
Liesegang rings: calcifications with concentric rings form in amyloid like areas

51
Q

Odontoma

A 
most common odontogenic tumor
developmental anomolies > haratomas (not true neoplasm)
~ 15 yrs 
asymptomatic
usually associated with unerupted tooth
52
Q

Odontoma types

A

Compound (multiple, small tooth like structures, > in anterior max)
Complex (mixed mass of enamel and dentin, > in molar area)

53
Q

Ameloblastic fibroma

A

true mixed tumor
epithelial and mesenchymal tissues neoplastic
younger, usually < 20 yrs
75% associated with unerupted tooth

54
Q

Ameloblastic fibroma location

A

70% posterior mandible

55
Q

Ameloblastic fibro-odontoma

A

like ameloblastic fibroma but with enamel and dentin

~ 10 yrs

56
Q

Ameloblastic fibro-odontoma location

A

posterior jaws

57
Q

Ameloblastic fibro-odontoma radiographically

A

well circumscribed unilocular radiolucency
varying amounts of calcified material
usually associated with unerupted tooth

58
Q

Ameloblastic fibro-odontoma tx

A

conservative curettage and rare recurrence

59
Q

Odontogenic keratocyst

A

arise from cell rests of dental lamina

60
Q

Nevoid basal cell carcinoma syndrome

A 
Gorlin syndrome
autosomal dominant
chromosome 9
PTCH gene abnormal of OKC
1. multiple nevoid basal cell carcinomas
2. OKCs 
3. calcification of faux cerebri
4. ribs splayed/bifid
61
Q

Carcinoma arising in odontogenic cysts

A

carcioma in bone rare and only in jaw (odontogenic carcinoma)
most arise from odontogenic cysts
older patients

62
Q

Carcinoma arising in odontogenic cysts F/M

A

2M > F

63
Q

Carcinoma arising in odontogenic cysts radiographically

A

like odontogenic cysts but margins irregular and ragged

64
Q

Ameloblastoma

A

most common clinically significant odontogenic tumors

typors of odontogenic epithelial origin

65
Q

Ameloblastoma types

A

conventional solid or multicystic (85%)
unicystic (15%)
peripheral (1%)

66
Q

Ameloblastoma patterns

A 
follicular (most common)
plexiform (second most common)
acanthomatous (has keratin)
granular cell
basal cell (very rare)
desmoplastic
67
Q

Desmoplastic ameloblastoma

A

mixed radiolucent-radiopaque (osseous metaplasia)

68
Q

Desmoplastic ameloblastoma histology

A

palisading-hyperchromatic basal layer
reversible polarity
apical vacuolization

69
Q

Peripheral ameloblastoma

A

painless nonulcerated, sessile gingival lesion
clinically on of the three Ps for bump on the gums
~ 50 yrs
innocuous clinical behavior

70
Q

Peripheral ameloblastoma tx

A

15% recurrence, further excision has 0% recurrence

71
Q

Peripheral ameloblastoma location

A

gingival mucosa

mand > max

Pathology Final (4 decks)

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