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Oral Path > Bone Lesions > Flashcards

Bone Lesions Flashcards

1
Q

occurring between the premolar and molar regions of the mandible, this lesion is composed of fibroblastic stroma (CT) in which foci of mineralized products are formed

A

central ossifying fibroma

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2
Q

3 forms of central ossifying fibroma:

A

Central- lesion occurs in bone, and has well-circumscribed radiolucency with ossification product in center –> looks similar to cementifying fibroma

Peripheral- lesion occurs in gum with no radiolucency or radiopacity

Also has a juvenile variant with aggressive and rapid growth

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3
Q

tx of central ossifying fibroma

A

surgical excision

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4
Q

condition in which scar-like fibrous tissue grows in place of normal bone, and usually does not stop growing until puberty

A

fibrous dysplasia

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5
Q

radiographically, this has a ground-glass appearance with soft RO areas throughout the lesion

A

fibrous dysplasia

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6
Q

syndrome characterized by polyostic fibrous dysplasia (affecting multiple bones), as well as cutaneous cafe au lait spots, and endocrine abnormalities (such as precocious puberty)

A

McCune-Albright syndrome (MAS)

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7
Q

tx of fibrous dysplasia

A

surgical re-contouring, preferably after puberty when the lesion stops growing

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8
Q

a circumscribed RO mass of osteoblasts and bone

A

osteoblastoma

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9
Q

tx of osteoblastoma

A

surgical excision

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10
Q

this reactive process with unknown origin is characterized by fibrous tissue replacing normal bone tissue, commonly at the apices of mandibular anterior teeth

A

periapical cemento-osseous dysplasia

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11
Q

While the pulps may radiographically look necrotic, the affected teeth are vital.

A

periapical cemento-osseous dysplasia

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12
Q

PCOD: Are teeth vital or non-vital?

A

vital

While the pulps may radiographically look necrotic, the affected teeth are vital.

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13
Q

This is more prevalent in middle-aged black females.

A

PCOD

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14
Q

This condition starts out looking RL, but transitions to having a more RO border.

A

PCOD

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15
Q

tx of PCOD

A

none

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16
Q

a benign blood-filled pseudocyst that tends to expand or grow, this lesion has a multilocular radiolucency and is commonly found in the posterior mandible

A

aneurysmal bone cyst

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17
Q

first step of diagnosing a condition like aneurysmal bone cyst

A

an aspiration biopsy to determine if it in fact a vascular bone cavity filled with blood

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18
Q

tx of an aneurysmal bone cyst

A

surgical excision

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19
Q

an osteolytic neoplasm composed of fibroblasts and multinucleated giant cells

A

central giant cell granuloma

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20
Q

common location of central giant cell granulomas

A

anterior mandible

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21
Q

Two forms of central giant cell granulomas:

A

Central: occurs in bone, and has radiolucency with thin wispy separations

Peripheral: occurs in gum, and presents as red/purple gingival mass

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22
Q

tx of central giant cell granuloma

A

surgical excision

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23
Q

an autosomal dominant disorder characterized by enlargement and prominence of the mandible and maxilla as bone is replaced by a fibrous granuloma that contains multinucleated giant cells

A

cherubism

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24
Q

this condition has symmetrical bilateral swelling, and expansile bilateral multilocular radiolucencies that stop growing after puberty (unlike fibrous dysplasia that has unilateral swelling)

A

cherubism

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25
Q

excessive levels of PTH result in multiple bone lesions that look similar to CGCGs

A

hyperparathyroidism

26
Q

name of the lesion associated with hyperparathyroidism, which forms due to excess osteoclast activity

A

Brown tumor

27
Q

What is elevated with a Brown tumor? Why?

A

alkaline phosphatase levels due to excess osteoclast activity

28
Q

Brown tumor can lead to…?

A

Von Recklinghausen’s disease of bone

29
Q

this rare type of cancer involves the abnormal buildup of Langerhans cells (histiocytes) in certain parts of the body

A

Langerhans cell disease (aka idiopathic histiocytosis)

30
Q

this condition has discrete punched/scooped out radiolucencies that cause a floating teeth appearance

A

Langerhans cell disease

31
Q

another name for Langerhans cell disease

A

idiopathic histiocytosis

32
Q

tx of Langerhans cells disease

A

surgical excision, radiation, and chemotherapy

33
Q

a progressive metabolic disturbance of different bones (skull, jaw, spine, femur) resulting in symmetrical enlargement with a cotton wool appearance

A

Paget’s disease

34
Q

similar to hyperparathyroidism, elevated alkaline phosphatase levels are observed due to increased breakdown of bone

A

Paget’s disease

35
Q

Because of enlargement, dentures or even hats become too tight.

A

Paget’s disease

36
Q

tx of Paget’s disease

A

bisphosphonates, calcitonin

37
Q

a clinical term for a new infection in bone

A

acute osteomyelitis

38
Q

MC causes of acute osteomyelitis (2)

A

odontogenic infection and trauma

39
Q

progression of acute osteomyelitis

A

Infection and inflammation first start in the medullary space, involving cancellous (spongey) bone. To observe radiolucency, the infection needs to have spread to cortical bone, periosteum, and soft tissues. Otherwise, we won’t see much radiographically.

40
Q

noteworthy symptoms include pain, high or intermittent fever, and paresthesia or anesthesia of IAN (teeth do NOT become loose –> this is caused by periodontitis)

A

acute osteomyelitis

41
Q

tx of acute osteomyelitis

A

antibiotics and drainage

42
Q

current or previous treatment of bisphosphonates that leads to exposed bone that does not heal quickly

A

bisphosphonate-related osteonecrosis of the jaws (BRONJ)

43
Q

puts pt at a higher risk of developing BRONJ

A

IV administered bisphosphonates (drugs that end in -dronate)

44
Q

tx of BRONJ

A

CHX rinse, antibiotics, conservative surgery

45
Q

a bone infection that doesn’t go away despite treatments, resulting in recurring drainage and intense pain, has diffuse mottled radiolucency since it has now been able to impact cortical bone

A

chronic osteomyelitis

46
Q

condition that involves chronic osteomyelitis and proliferative periostitis as the body tries to heal

A

Garre’s osteomyelitis

47
Q

tx of chronic osteomyelitis

A

antibiotics and debridement

48
Q

a periapical lesion resulting from low-grade inflammation such as chronic pulpitis, a wall of diffuse dense bone forms to “wall off” the infection

A

focal sclerosing osteomyelitis (condensing osteitis)

49
Q

tx of focal sclerosing osteomyelitis (condensing osteitis)

A

none, other than addressing the cause of infection (such as performing a root canal)

50
Q

similar to condensing osteitis, but on a wider scale, this condition may lead to jaw fracture and osteomyelitis

A

diffuse sclerosing osteomyelitis

51
Q

tx of diffuse sclerosing osteomyelitis

A

none, other than addressing the cause of infection

52
Q

most common symptom of bone malignant lesions

A

paresthesia

53
Q

sarcoma of the jaws when tumor cells produce new cartilage, commonly involves the condyle due to its cartilaginous origin

A

chondrosarcoma

54
Q

has a sunburst pattern radiographically

A

chondrosarcoma

55
Q

sarcoma of long bones involving round cells, or undifferentiated mesenchymal cells

A

Ewing’s sarcoma

56
Q

rarely affects the jaws, most commonly affects children with intense swelling as the primary symptom

A

Ewing’s sarcoma

57
Q
  • orally, this condition involves pain, swelling, and most importantly paresthesia (lip numbness)
  • diffuse and ill-defined changes such as eroding bone are observed radiographically
A

metastatic carcinoma

58
Q

Rank from most to least likely the places of origin of metastatic carcinoma:

A

breast > lung > kidney > colon > prostate

59
Q

sarcoma of the jaws when tumor cells produce new bone

A

osteosarcoma

60
Q

the deposition of new bone creates a sunburst pattern radiopacity

A

osteosarcoma

61
Q

tx of osteosarcoma

A

resection and chemotherapy

Oral Path (13 decks)

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