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Oral Pathology, Stephen > ch 10 epithelial pathology > Flashcards

ch 10 epithelial pathology Flashcards

1
Q

5 papillomas

A

Squamous papilloma Verruca vulgaris Condyloma accuminatum Verruciform Xanthoma Focal Epithelial hyperplasia

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2
Q

benign proliferation of stratified squamous epithelium thought to be virally induced (HPV), but not as infective

A

Squamous papilloma

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3
Q

Squamous papilloma character

A

soft painless usually pedunculated exophytic nodule with numerous fingerlike surface projections giving a cauliflower or wartlike look

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4
Q

Squamous papilloma treatment

A

Surgery. May remain same if untre

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5
Q

This is a benign, virus induced (HPV), focal hyperplasia of stratified squamous epithelium

A

Verruca Vulgaris (common wart)

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6
Q

Is verruca vulgaris contagious

A

Yes, can spread around person by autoinoculation

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7
Q

Age Verruca vulgaris common in, and where is it rarely found

A

children, rare in mouth

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8
Q

Verruca Vulgaris treatment

A

Liquid nitrogen
Cryotherapy
Salicylic or lactic acid (topical keratinolytic agents)

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9
Q

If untreated, how long will it take for Verruca Vulgaris to resolve

A

2 yrs

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10
Q

Extreme accumulation of compact keratin resulting in hard surface projection several millimeters in height found in Verruca Vulgaris

A

Cutaneous horn/Keratin horn

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11
Q

Virus induced (HPV) proliferation of stratified squamous epithelium of genitalia, perianal region, mouth, larynx

A

condyloma accuminatum (Venereal wart)

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12
Q

Condyloma acuminatum is considered what type of disease

A

STD

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13
Q

Condyloma acuminatum age normally diagnosed

A

Teenagers/young adults

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14
Q

Condyloma acuminatum occur orally where

A

labial mucosa, soft palate, lingual frenum

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15
Q

Histologic indication of Condyloma acuminatum

A

acanthotic stratified squamous epithelium w/ cover having pynknotic nuclei surrounded by clear zone = KOILOCYTES

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16
Q

Which 2 HPV are associated with Cancer

A

HPV 16, HPV 18. Present in urogenital condyloma acuminatum

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17
Q

Hyperplastic condition of epithelium of mouth, skin, and genitalia with a characteristic accumulation of lipid-laden histiocytes beneath the epithelium

A

Verruciform Xanthoma

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18
Q

Is Verruciform Xanthoma an HPV papilloma

A

no

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19
Q

Gender, Age, race for Verruciform Xanthoma

A

Females
40-70
white

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20
Q

What is the histology looking for when differentiating for a Verruciform Xanthoma

A

lipid laden histiocytes under the epithelium

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21
Q

HPV 13 and HPV 32 induced localized proliferation of oral squamous epithelium

A

Focal Epithelial Hyperplasia

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22
Q

Age Focal Epithelial Hyperplasia found

A

Childhood

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23
Q

Clinical appearance of Focal Epithelial Hyperplasia

A

multiple flat or rounded papules which are clustered with normal color (not white)

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24
Q

What is the hallmark histo for Focal Epithelial Hyperplasia

A

acanthosis

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25
Q

What is acanthosis (

A

diffuse epidermal hyperplasia, increases thickness of stratum spinosum (and possibly bm?)

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26
Q

Treatment for Focal Epithelial Hyperplasia

A

conservative surgical for diagnosis or esthetics, but will regress spontaneously

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27
Q

Common skin condition of elderly representing axquired benign proliferation of epidermal basal cells, associated with chronic sun exposure.

A

Seborrheic Keratosis

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28
Q

Clinical appearance of Seborrheic Keratosis

A

Brown plaque that grows up and appears to be stuck on skin

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29
Q

What is sebhorrheic keratosis identical to when it is a small macule (early stages)

A

actinic lentigenes

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30
Q

Form of Sebhorrheic keratosis in African Americans

A

Dermatosis papulosa nigra

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31
Q

Sudden appearance of numerous seborrheic keratoses with pruritis that is associated with internal malignancy

A

Laser-Trelat sign

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32
Q

Histo feature of Seborrheic Keratosis

A

deep keratin filled invaginations that look cystic = horn cyst/pseudo-horn cysts

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33
Q

common small hyperpigmented macule of skin that represents a region of increased melanin production

A

Ephelis (Freckle)

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34
Q

What is the predilection for Ephelis

A

Blond and red heads

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35
Q

benign brown macule that results from chronic UV light damge to skin. Not seen in mouth, but common on face

A

Actinic Lentigo

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36
Q

Layman’s term for Actinic Lentigo

A

Age spots/liver spots

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37
Q

Demographics for Actinic Lentigo

A

Older whites >70

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38
Q

Does Actinic Lentigo undergo malignant transformation

A

no

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39
Q

diffuse hyperpigmentation of the facial skin in pregnant women

A

Melasma

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40
Q

flat brown mucosal discoloration produced by focal increase in melanin deposition and possibly concomitant increase in number of melanocytes

A

Oral Melanotic Macule

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41
Q

Is the oral melanotic macule related to the sun

A

no

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42
Q

Demographics for Melanotic macule

A

2:1 Females, can be on vermillion border

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43
Q

Causes/syndromes/demographics associated w/ melanin pigmentation

A

Racial Peutz-jaghers

Addison’s disease Neurofibromatosis Chronic trauma Smoker’s Melanosis

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44
Q

What drugs can cause melanin pigmentation

A

Chloroquine/quinine derivatives Phenolphthalein
Estrogen
AIDS medications

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45
Q

Benign acquired pigmentation characterized by dendritic macrophages dispersed throughout epitherlium

A

Oral Melanoacanthoma

46
Q

Oral Melanoacanthoma is found exclusively in what race, common site, and age

A

Blacks w/ female predilection Buccal mucosa

3rd-4th decade

47
Q

Freckle like lesions of the hands, perioral skin, oral mucosa, in conjunction with intestinal polyps

A

Peutz-Jeghers syndrome

48
Q

Treatment of Oral Melanoacanthoma

A

incisional biopsy to rule out melanoma but not treatment indicated

49
Q

benign, localized proliferation of cells from the neural crest called nevus cells. Represent the most commonly recognized nevus

A

Acquired melanocytic nevus

50
Q

Other name for Acquired Melanocytic Nevus

A

mole

51
Q

Most common places to have an acquired

melanocytic nevus intraorally

A

Palate Gingival

52
Q

Melanoma transformation risk for Acquired melanocytic nevus

A

1 in 1 million

53
Q

White lesion that does not rub off and cannot be characterized as any other disease

A

Leukoplakia

54
Q

What type of lesion is Leukoplakia considered

A

PREMALIGNANT

55
Q

3 areas high risk for Leukoplakia

A

Floor of mouth, ventral tongue, soft palate

56
Q

1/3 of oral cancers have this in close proximity

A

Leukoplakia

57
Q

Most common oral precancer

A

Leukoplakia

58
Q

Most common etiology for Leukoplakia

A

tobacco

59
Q

If patient had UV radiation induced Leukoplakia, where would it appear orally

A

Lower lip

60
Q

With Leukoplakia, which is worse: thick or thin

A

thick=bad

61
Q

Leukoplakia that is red, representing sites in which epithelial cells are so immature or atrophic they no longer produce keratin

A

Eryhtroplakia

62
Q

If have a mixed Leukoplakia/erythroplakia lesion, where do you biopsy

A

Biopsy the red

63
Q

4 grades of dysplasia

A

Mild Moderate

Severe Carcinoma-in-situ

64
Q

What is carcinoma-in-situ

A

entire thickness of epithelium involved. At basement membrane but not through

65
Q

What must be breached to diagnose cancer

A

Basement membrane

66
Q

What is the histology of leukoplakia

A

Hyperkeratosis (thickened keratin layer of surface epithelium), which can be hyperparakeratinized or hyperorthokeratinized. May or may not have thickened spinous layer (acanthosis)

67
Q

What is orthokeratin versus parakeratin

A

Parakeratin has nuclei in top layer

68
Q 
Diffuse, gray white milky opalescent appearance of the mucosa looking folded or whitish occurring bilaterally that is diagnosed because white appearance disappears when cheek is stretched. African Americans
Siversky lecture & book)
51.) Palate Gingival
52.) 1 in 1 million 53.) Leukoplakia
Page 4 of 7
A

Leukoedema

69
Q

What is the malignant/premalignant risk for

Erythroplakia

A

)80-90%

70
Q

.)Soft fissured gray white lesion of lower labial mucosa located in the area of chronic snuff placement

A

Tobacco pouch keratosis

71
Q

What is first oral lesion get with dip versus first thing you get with chew

A

dip get recession, Chew get root caries

72
Q

What is the Indian form of dip or chew

A

Betel quic

73
Q

How long will tobacco pouch keratosis remain if dipping ceases

A

disappear in 2-6 weeks, >6 weeks biopsy

74
Q

Chronic, progressive, scarring high-risk precancerous oral condition seen primarily in India du to betel quid/paan

A

Oral Submucous Fibrosis

75
Q

Oral Submucous Fibrosis clinical appearance

A

Feel the fibrous bands with blotchy, marble-like pallor and progressive stiffness of subepithelial tissues. Can be brownish red

76
Q

Does oral submucous fibrosis have a high malignant transformation rate

A

yes

77
Q

Common premalignant alteration of the lower lip vermillion that results from long-term or excessive exposure to UV component of sunlight

A

Actinic Cheilosis (Actinic Cheilitis)

78
Q

Gender predilection for Actinic Cheilosis

A

Males 10:1

79
Q

Approximately 94% of all oral malignancies are…

A

Squamous Cell Carcinoma

80
Q

When are white men at greatest risk for squamous cell carcinoma

A

> 65 years old

81
Q

In middle age, what race is at greatest risk for squamous cell carcinoma

A

Blacks

82
Q

Smoking increases lung cancer, but smoking + _____ increases oral cancer

A

Smoking + alcohol

83
Q

Most common site for intraoral carcinoma

A

tongue, posterior lateral and ventral surfaces most common

84
Q

What human papilloma virus is associated with intraoral cancers

A

HPV 16

85
Q

Is there a link between Herpes Type I and oral cancer

A

no

86
Q

What is the most common site for Squamous Cell

Carcinoma on the floor of the mouth

A

Midline near frenum. Usually had a leukoplakia or

erythroplakia in the region prior

87
Q

Location of 2/3 Oropharyngeal carcinomas

A

tonsillar area of soft palate

88
Q

How stage oral cancer

A 
T = size of primary tumor N= nodal involvement
M = distant metastasis
89
Q

If you see a lesion on the the lateral border of the tongue, then feel it and it is not indurated (hard), but soft, what is it likely

A

Normal Folliate papillae

90
Q

Carcinoma lesion, frequently associated with snuff, appearing as a well demarcated, painless, thick plaque with papillary or verruciform surface projections

A

Verrucous Carcinoma

91
Q

What leukoplakia is a risk for Verrucous Carcinoma

A

Proliferative Verrucous Leukoplakia

92
Q

Is verrucous carcinoma more or less aggressive than squamous cell carcinoma

A

less aggressive

93
Q

Maxillary sinus carcinomas are classified as

A

Squamous Cell Carcinoma

94
Q

Most common skin cancer and the most common of all cancers

A

Basal Cell Carcinoma

95
Q

Locally invasive, slowly spreading, primary epithelial malignancy that arises from the basal cell layer of the skin.

A

Basal Cell Carcinoma

96
Q

Basal cell carcinoma is a disease of who

A

white adults with fair complexion

97
Q

Does Basal Cell Carcinoma metastasize

A

no

98
Q

Malignant neoplasm of melanocytic origin that arises from a benign melanocytic lesion

A

Melanoma

99
Q

4 risks for melanoma

A

Red hair Fair skin

Blue eyes Sun

100
Q

Most common from of oral melanoma

A

Acral lentiginous melanoma

101
Q

Majority of oral melanomas are found where

A

hard palate or maxillary alveolu

102
Q

3 most common skin cancers in order

A

Basal Cell Squamous Cell

Melanoma

103
Q

4 melanoma types

A

Superficial spreading melanoma Nodular Melanoma

Lentigo Malignant melanoma Acral Lentiginous Melanoma

104
Q

Most common form of melanoma found on interscapular of males and back of legs females, and has satellite nodules around primary lesion

A

Superficial Spreading Melanoma

105
Q

Melanoma that begins almost immediately in vertical growth phase

A

Nodular Melanoma

106
Q

Develops from precursor lesion called Lentigo maligna/Hutchinson’s freckle arising in the midface region of older adults and is a melanoma in situ in purely radial growth phase

A

Lentigo Malignant Melanoma

107
Q

Most common form of melanoma in blacks and the overall most common form of oral melanoma

A

Acral Lentigerous Melanoma

108
Q

ABCD of Melanoma

A

A = Assymetry (from uncontrolled growth
B = Border (usually notched)
C = Color variegation (brown, black, red, blue,
none depending on amount of melanin
D= diameter >6 mm (size of pencil eraser)

109
Q

prognosis for oral melanoma

A

poor 20-45% 5 year survival

110
Q

Worse prognosis areas for Melanoma

A

BANS Back

posterior upper Arm posterior and lateral Necki Scalp

Oral Pathology, Stephen (13 decks)

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