Chapter 10 Flashcards
What is a benign proliferation of stratified squamous epithelium, and results in a papillary mass? What is it caused by?
- Squamous Papilloma
2. Caused by human papillomavirus (HPV), type 6 and 11
What is a common wart in the mouth that is contagious? What is it caused by?
- Verruca Vulgaris
2. Caused by HPV: 2, 4, 6, 40
What is also known as a Venereal wart that is considered an STD? What is it caused by?
- Condyloma Acuminatum
2. Many forms of HPV, mostly type 6, 11 and 16, 18, 31
What is also known as Heck’s disease, usually appears in childhood and has multiple lesions? Caused by?
- Multifocal Epithelial Hyperplasia
2. HPV 13 & 32
What is a benign, localized proliferations of respiratory mucosa that usually arise from the lateral nasal wall? There are three different forms of this (Fungiform, Inverted and Cylindrical cell), what makes them different?
- Sinonasal Papillomas
- Fungiform: Arises almost exclusively on the nasal septum.
- Inverted: Most common, occurs on the lateral nasal wall or sinus.
- Cylindrical cell: Most rare, occurs on lateral wall.
- Fungiform: Arises almost exclusively on the nasal septum.
Virally-induced epithelial hyperplasia, and more prevalent among immunocompromised patients? What virus causes this? How do you diagnose this histologically?
- Molluscum Contagiosum
- DNA poxvirus
- Molluscum bodies
What is a hyperplastic condition which is largely an oral disease of unknown cause (likely trauma) and characterized by lipid-laden histiocytes in the epithelium?
Verruciform Xanthoma
What are extremely common skin lesion of older people, which is an acquired benign proliferation of epidermal basal cells of unknown etiology and does not occur in the mouth? What form of this is common in African-Americans? When a sudden appearance of numerous seborrheic keratoses with pruritus has been associated with internal malignancy?
- Seborrheic Keratosis
- Dermatosis papulosa nigra
- Leser-Trélat Sign
What is a localized proliferation of sebaceous glands of the skin and is clinically similar to more serious facial tumors, such as basal cell carcinoma (BCCA)?
Sebaceous Hyperplasia
What is increased melanin production without increase in number of melanocytes, changes in color intensity with UV light exposure and are also known as a Freckle?
Ephelis
What is a benign brown macule resulting from chronic UV light damage to the skin, and has NO change in color intensity with UV light exposure?
Lentigo Simplex
What is an acquired, symmetrical, hormonally-driven hyperpigmentation of the sun-exposed skin of the face and classically associated with pregnancy?
Melasma
What is a brown asymptomatic macule produced by a focal increased in melanin deposition that is not dependent on sun exposure, the most common site is the vermilion zone of the lower lip, and a biopsy is mandatory to distinguish from early melanoma?
Oral Melanotic Macule
What is an acquired pigmentation of the oral mucosa, that appears to be a reactive process due to trauma, characterized by dendritic melanocytes throughout the epithelium, and seen almost exclusively in African Americans?
Oral Melanoacanthoma
What is the most commonly recognized nevus that is the acquired melanocytic nevus AKA mole and is the most common of all adult tumors? This has 3 stages (Junctional, Compound, and Intradermal), what makes them different?
- Acquired Melanocytic Nevus
- o Junctional – Earliest presentation; appears as a dark macule less than 6 mm.
o Compound – Occurs as the nevus cells proliferate. It is a slightly elevated, soft papule with a smooth surface. The degree of pigmentation decreases.
o Intradermal (intramucosal in oral cavity) – The surface becomes somewhat papillomatous; hairs may grow from the center. Loses most or all of its pigmentation.
What affects 1% of newborns, divided into small (less than 20 cm) and large (greater than 20 cm), and a common feature in the large type is hypertrichosis (excess hair)? **(Form of birthmark)
Congenital Melanocytic Nevus
What is a melanocytic nevus with a surrounding pale hypopigmented border (“halo”) and thought to be nevus cell destruction by the immune system?
Halo Nevus
What shares histopathologic features with melanoma, but is completely benign and occurs in childhood on the skin of the extremities or face?
Spitz Nevus
What is an uncommon, benign proliferation of dermal (or intramucosal) melanocytes and causes a blue color? What is the reason for this blue color? It has two forms (common and cellular), what makes them different?
- Blue Nevus
- Tyndall effect
- Common: Occurs on hands and feet, scalp, face. Orally is almost always on palate and less than 1 cm.
- Cellular: 50% are seen on the buttock and can reach up to 2 cm in size.
- Common: Occurs on hands and feet, scalp, face. Orally is almost always on palate and less than 1 cm.
What is an intraoral white plaque that can’t be rubbed off and it cannot be identified well, where 80% is benign hyperkeratosis and etiology comes from tobacco, alcohol, UV radiation, trauma and sanguinaria? What are the lesions that can then demonstrate scattered red patches? Red and white intermixed lesions are termed?
- Leukoplakia
- Erythroplakia
- Erythroplakia and erythroleukoplakia
What is a special high-risk form of leukoplakia characterized by multiple keratotic plaques with roughened surface projections?
Proliferative verrucous leukoplakia (PVL)
What is defined as a red patch that cannot be diagnosed as any other condition, where a biopsy is mandatory and is red in color due to lack of keratin and epithelial thinness?
Erythroplakia
What is characteristic white plaque is produced on the mucosa in direct contact – termed smokeless tobacco keratosis with lesions that develop shortly after heavy tobacco use begins; new lesions seldom arise in persons with long history of use, and lesion appears as a thin, gray or white plaque with a border that blends into surrounding mucosa?
Smokeless Tobacco Keratosis
What is chronic, progressive, scarring, high-risk precancerous condition of the oral mucosa and linked to chronic placement of betel quid or paan?
Oral Submucous Fibrosis
What is a white keratotic change on the palate, due to heat, which is seen as a diffusely gray or white palate and usually caused by cigarettes?
Nicotine Stomatitis
What is a common cutaneous premalignant lesion caused by cumulative UV radiation and develops in over half of white adults with significant lifetime sun exposure?
Actinic Keratosis
What is a common premalignant alteration of the lower lip vermilion and results from long-term exposure to UV light usually on a farmers or sailers lip?
Actinic Cheilosis
What is a self-limiting, epithelial proliferation, where patients with Muir-Torre syndrome have a hereditary predisposition for multiple lesions and appears as a firm, well-demarcated, painless, sessile, dome-shaped nodule with a central plug of keratin?
Keratoacanthoma
What is cancer of the mouth that is usually caused by alcohol, tobacco, radiation, iron deficiency, phenolic agents (phenoxyacetic acids of wood workers), immunosuppression (HIV), Vitamin-A Deficiency (excessive keratinization), Syphilis (tertiary stage), Oncogenic Viruses (HPV 16, 18, 31, 33), and Oncogenes?
Squamous Cell Carcinoma (SCC)
What is a low-grade variant of oral SCC, can be caused by smokeless tobacco, is also known as Snuff Dipper’s cancer, and appears as a diffuse, well-demarcated, painless, thick plaque with papillary or verruciform surface projections and benign microscopic appearance?
Verrucous Carcinoma
What refers to a group of malignancies that arise from the lining epithelium of the nasopharynx, most prevalent in Chinese men and possibly caused by EBC, Vit. C deficiency, salt fish and tobacco?
Nasopharyngeal Carcinoma
What is the MOST common of all cancers, locally invasive & slowly spreading epithelial malignancy, usually results from UV radiation and contains telangiectatic blood vessels? What is the most common form?
- Basal Cell Carcinoma
2. Nodular
What is a malignant neoplasm of melanocytic origin, arises from a benign melanocytic lesion or de novo from melanocytes within otherwise normal skin or mucosa? ______ most common skin cancer, and accounts for the _____ deaths. This causes two directional growth patterns, what are they?
- Melanoma
- Third
- Most
- Radical (horizontally/flat), Vertical (invade underlying connective tissue/tumor)
To distinguish between melanoma and its benign counterpart (melanocytic nevus), the ABCDE system has been developed to describe the clinical features of melanoma, what are the ABCDEs?
o Asymmetry o Border irregularity o Color variation o Diameter greater than 6 mm (roughly the end of an eraser) o Evolving lesions
What is the TNM system used for? What does each stand for? There are 4 Stages of TNM Classification, what are they?
- Used to determine tumor size and metastatic spread.
- T: Tumor Size (Tis, T1, T2, T3, T4a,T4b)
- N: Node Involvement (N1,N2,N3)
- M: Metastases (M0,M1)
- Stage:
I. T1, N0, M0
II. T2, N0, M0
III. T3, N0, M0 -OR- ANY T with N1, M0
IV. T4, N3 and any M
In the TNM system of tumors, how do you differentiate the different levels of T, N and M?
Tumor size: Tis: In Situ, T1: 2 cm or less, T2: 3-4 cm, T3: 5+ cm, T4a: Resectable and doesn’t involve major anatomy. T4b: Unresectable tumor that involves major anatomy.
Node: N1: Single ipsilateral node (3 cm or less), N2: Ipsilateral or contra lateral node(s), (6 cm or less), N3: Metastasis (more than 6 cm).
Metastases: M0: Not present, M1: Present
With melanoma, there are areas on the body which have a higher risk/worse prognosis than others. These areas are known as BANS. Where are they?
o Interscapular area of the Back
o Posterior upper Arm
o Posterior & lateral Neck
o Scalp
