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Neville and Damm > Ch12 Soft Tissue Tumors > Flashcards

Ch12 Soft Tissue Tumors Flashcards

Pg 473 - 526

1
Q

Most common location for a fibroma

A

buccal mucosa bite line

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2
Q

Likely that many fibromas represent fibrous maturation of a pre-existing _______

A

pyogenic granuloma

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3
Q

Fibroma: age and gender

A

4th-6th decades, 2:1 female

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4
Q

Recurrence for fibroma?

A

extremely rare

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5
Q

Which type of fibroma clinically resembles a papilloma?

A

giant cell fibroma

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6
Q

Giant cell fibroma: age, gender, location

A

young, slight female, mandibular gingiva

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7
Q

What entitiy occurs on the lingual gingiva of the mandibular cuspid? 25-__% of children and young adults have them

A

retrocuspid papilla 25-99% lol

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8
Q

What lesion? *numerous large, stellate fibroblasts with several nuclei *pebbly surface

A

Giant cell fibroma

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9
Q

______ is a generic term that can be applied to any tumor of the gingiva or alveolar mucosa

A

epulis

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10
Q

What are the 4 epulides? (lol - the four entities with the word epulis in them)

A
  1. Epulis fissuratum 2.giant cell epulis (peripheral giant cell granuloma) 3.ossifying fibroid epulis 4.Congenital epulis
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11
Q

Epulis fissuratum: classically HOW many folds of tissue?

A

2..the denture flange fits inside the two folds

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12
Q

Occasional examples of epulis fissuratum demonstrate surface areas of inflammatory _________

A

papillary hyperplasia

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13
Q

The epulis fissuratum usually develops on the ________…with the Anterior/posterior portions more often?? Gender?

A

facial aspect of the alveolar ridge…Anterior more affected than posterior…FEMALE predilection (2/3 to 3/4 of cases)

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14
Q

The edge of WHAT lesion (2 names) often is serrated and resembles a leaf

A

Fibroepithelial polyp / leaflike denture fibroma

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15
Q

Some instances of epulis fissuratum the epithelium shows what two distinct features?

A
  1. inflammatory papillary hyperplasia 2.pseudoepitheliomatous hyperplasia
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16
Q

What specific type of immune cell likes to show up in epulis fissuratum? If minor salivary glands are included in the specimen, what do they like to show?

A

eosinophils…chronic sialadenitis

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17
Q

What is the RARE phenomenon caused by an ill fitting denture that can be seen microscopically in epulis fissuratum?

A

osseous and chondromatous metaplasia.. so DON’T mistake it for a freaking sarcoma

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18
Q

What is the alternate name for inflammatory papillary hyperplasia?

A

Denture Papillomatosis

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19
Q

What are the 4 possible causes for denture papillomatosis? What % of patients who wear their denture 24hrs/day develop inflammatory papillary hyperplasia?

A

1.ill-fitting denture 2.poor denture hygiene 3.wearing the denture 24 hours a day 4. POSSIBLY candida infection (but role is uncertain)…..20% of 24hr denture wearers dev denture papillomatosis

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20
Q

Where does inflammatory papillary hyperplasia typically occur FIRST? What other 2 locations can it also show up?

A

palatal vault…less common edentulous ridge of mandible or surface of an epulis fissuratum

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21
Q

Denture papillomatosis (inflammatory papillary hyperplasia) CAN occur in pts without a denture…what 3 situations make you susceptible?

A
  1. habitual mouth breathing 2. vaulted palate 3.HIV infected pts
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22
Q

inflammatory papillary hyperplasia is usually asymptomatic/symptomatic? the mucosa is erythematous and _______ and in many cases is associated with ________

A

Asymptomatic…pebbly/papillary…denture stomatitis

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23
Q

_________ are a diverse group of tumors that

exhibit fibroblastic and histiocytic differentiation

A

Fibrous histiocytomas

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24
Q

What are the 4 names used for Fibrous histiocytomas?

A
  1. dermatofibroma 2.sclerosing hemangioma 3.fibroxanthoma 4.nodular subepidermal fibrosis
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25
Q

A Fibrous histiocytoma is called a _______ when it presents on the skin

A

dermatofibroma

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26
Q

Fibrous histiocytomas of the oral cavity and perioral cavity are rare and its likely that many of the reports are ACTUALLY what entity?

A

Solitary fibrous tumor (hemangiopericytoma)

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27
Q

Can you get a Fibrous histiocytoma in the bone?

A

yes. rare. but yes.

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28
Q

Oral Fibrous histiocytomas happen in old/young pts? What about DFs?

A

oral Fibrous histiocytomas = older pts (middle aged to older) vs DFs = young adults

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29
Q

fibrous histiocytoma is characterized by a cellular proliferation of _______-shaped fibroblastic cells with _____ nuclei

A

spindle…vesicular

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30
Q

The margins of a fibrous histiocytoma often are not _______.

A

sharply defined

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31
Q

fibrous histiocytoma cells are arranged in short, intersecting fascicles, known as a ______ pattern

A

storiform

32
Q

fibrous histiocytoma: Rounded histiocyte-like cells, lipid-containing ________ cells, or multinucleated giant cells can be seen occasionally, as may scattered lymphocytes.

A

xanthoma

33
Q

fibrous histiocytoma: The stroma may demonstrate areas of _____ change or focal ________.

A

myxoid…hyalinization

34
Q

fibrous histiocytoma: tx? recurrance?

A

excision..recurrance rare for superficial tumors, still rare but less so for deep tumors

35
Q

Where was the solitary fibrous tumor (hemangiopericytoma) first discovered?

A

pleura so from mesothelial cells or submesothelial fibroblasts

36
Q

A pericytic origin appears doubtful, for hemangiopericytomas, they propably represent cellular variants within the spectrum of __________.

A

solitary fibrous tumor

37
Q

LOL what are the 3 names for a hemangiopericytoma in the sinonasal tract? (why the fuck are there 3 names for this?)

A

1.sinonasal-type hemangiopericytoma 2.glomangiopericytoma 3.myopericytoma

38
Q

Solitary fibrous tumors have been reported primarily in
age? and are rare in age?. The tumor often is described as a ____-growing, painless/painful?, submucosal, or deep soft tissue mass that is ______removed from the surrounding tissues.

A

primarily in adults, rare in children…slow-growing, painless, easily removed

39
Q

Solitary fibrous tumors of the head and neck region are
most common in the ________, which accounts for
approximately one-third of such cases.

A

buccal mucosa

40
Q

Sinonasal-type hemangiopericytoma occurs primarily in

_____ and _____ adults.

A

middle-aged and older

41
Q

What lesion? At one end of the spectrum, the lesional cells appear as tightly packed cells and surround endothelium-lined vascular channels

A

solitary fibrous tumor

42
Q

Name that lesion: The cells are haphazardly arranged and demonstrate round to ovoid nuclei and indistinct cytoplasmic borders

A

solitary fibrous tumor

43
Q

Name that lesion: The blood vessels often show irregular branching, which results in a characteristic “staghorn” and “antlerlike” appearance

A

solitary fibrous tumor

44
Q

Name that lesion: At the other end of the spectrum, the cells are more spindled and arranged in either short fascicles or in a disorganized fashion (“patternless pattern”)

A

solitary fibrous tumor

45
Q

Immunohistochemical studies show the lesional cells in solitary fibrous tumors to be positive for ____ and ____ in nearly all cases.

A

CD34 and bcl-2

46
Q

Solitary fibrous tumor The identification of ____ or more mitoses per ten highpower fields suggests a rapidly growing tumor that is capable of metastasis…The presence of _______ also suggests malignancy.

A

4 or more….necrosis

47
Q

Sinonasal-type hemangiopericytomas have a more prominent _______ pattern, with the cells arranged in a more orderly fashion.

A

spindle cell

48
Q

In contrast to a solitary fibrous tumor, the cells of a sinionasal-type hemangiopericytoma are usually NEGATIVE for _____ and _____

A

CD34 and bcl-2

49
Q

Most sinionasal-type hemangiopericytoma are positive for what IHC marker? What is the recurrence?

A

SMA…17%

50
Q

What group of lesions is intermediate (histo and behavior) between those of benign fibrous lesions and fibrosarcoma?

A

fibromatosis

51
Q

What are the two most common forms of fibromatosis in the head and neck?

A

juvenile aggressive fibromatoses and extraabdominal desmoids

52
Q

Similar histological lesions as Fibromatosis but located in the bone are called _______

A

desmoplastic fibromas

53
Q

People with FAP/Gardner syndrome have an increased risk for WHAT soft tissue lesions?

A

aggressive fibromatosis

54
Q

The most common oral site for fibromatosis is the ________ region, although the lesion can occur almost anywhere.

A

paramandibular soft tissue

55
Q

Soft tissue ________ is characterized by a cellular proliferation of spindle-shaped cells that are arranged in
streaming fascicles and are associated with a variable amount of collagen

A

fibromatosis

56
Q

Along with spindle cells in streaming fascicles, this lesion is usually poorly circumscribed and infiltrates the adjacent tissues and this is excised with generous margins

A

fibromatosis

57
Q

Recurrence of fibromatosis of the head and neck? Does it met?

A

30% (wow, thats high)..no mets

58
Q

What is an alternate name for myofibroma?

A

myofibromatosis

59
Q

________ is a rare spindle cell neoplasm that consists of cells with both smooth muscle and fibroblastic features

A

myofibroma (myofibroblasts)

60
Q

Solitary myofibromas develop most frequently in the first ____ decades of life, with a mean age of ___ years.

A

first 4 decades…22 years

61
Q

The most common oral location for a myofibroma is the ______, followed by the tongue and buccal mucosa….what are some radiographic characteristics?

A

mandible…RL defects poorly defined (can be well defined or multilocular)

62
Q

_________ primarily affects neonates and infants who may have tumors of the skin, subcutaneous tissue, muscle, bone, and viscera. The number of tumors can vary from several to more than 100.

A

Multicentric myofibromatosis

63
Q

What entity? - interlacing bundles of
spindle cells with tapered or blunt-ended nuclei -BIPHASIC (nodular fascicles + cellular zones) - scattered mitoses - centrally vascular (like a SFT)

A

Myofibromas

64
Q

Myofibromas are positive for ______ and _____, negative for _______

A

positive: SMA, MSA(muscle specific actin)….NEGATIVE for desmin

65
Q

What is the recurrence for solitary myofibromas? Multifocal myofibromas?

A

“small percentage” of solitary myofibromas recur…multifocal RARELY recur (some spontaneously regress)

66
Q

_________ involving the viscera or vital organs in infants can act more aggressively and sometimes proves to be fatal within a few days after birth.

A

myofibromatosis (multifocal myofibromas)

67
Q

Oral focal mucinosis is an uncommon tumorlike mass that is believed to represent the oral counterpart of __________ or a __________.

A

cutaneous focal mucinosis or a cutaneous myxoid cyst

68
Q

The cause of focal melanosis is unknown, although the lesion may result from overproduction of _______ by fibroblasts.

A

hyaluronic acid

69
Q

Oral focal mucinosis is most common in what age range? and shows a 2 : 1 _______ predilection.

A

young adults….2:1 female-to-male

70
Q

What is the most common site of oral focal mucinosis? Whats the second most common?

A

gingiva…hard palate

71
Q

What lesion usually presents as sessile or pedunculated and as a painless nodular mass that is the same color as the surrounding mucosa?

A

Oral focal mucinosis

72
Q

Recurrence of oral focal mucinosis?

A

does not tend to recur

73
Q

Sino-nasal hemangiopericytoma compared to but differentiated from ________

A

solitary fibrous tumor

74
Q

What does sinonasal type hemangiopericytoma stain positive for

A

SMA and muscle specific actin

UNLIKE solitary fibrous tumor which it is compared to for some unknown reason it is NEGATIVE for CD34 and BCL2

75
Q

What two syndromes have an increased risk for developing aggressive fibromatosis?

A

FAP (familial adenomatous polyposis) and Gardner syndrome

76
Q

Soft tissue fibromatosis of the head and neck most frequently occurs in what age group?

A

children / young adults hence: juvenile fibromatosis

Neville and Damm (72 decks)

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