Chapter 16 images

Question 1

Answer 1

apthous ulcer

Question 2

Answer 2

fibroma

Question 3

Answer 3

pyogenic granuloma

Question 4

Answer 4

Erythroplakia

Question 5

Answer 5

leukoplakia

Question 6

Answer 6

hyperkeratosis in the development of squmous cell carcinoma (earliest stage, no genetic causes known)

Question 7

Answer 7

mild moderate dysplasia in the development of SCC, genetic mutations associated with this stage: p16 mutations on genes 9p21, 3p (9 and 3)

Question 8

genes and diagnosis

Answer 8

Squamous cell carcinoma, mutations associated with this malignancy include gene translocation (11; 13) (Cyclin D mutation), and mutations on chroms 4, 6, 8, 13, 14.

Question 9

Answer 9

severe displasia CIS, gene mutations associated with this condition include gene mutations 17p13 mutation effecting TP53

Question 10

Answer 10

erythroplakia, almost always associated with severe dysplasia and/or invasive carcinoma (90%)

Question 11

Answer 11

squamous cell carcinoma, 95% of head/neck tumors are SCCs. in the west, tobacco and alcohol are the most highly associated. genetic mutations (simplified):

Hyperplasia/Hyperkeratosis: 9 (p16; cyclin D inhibitor) + 3 –>

Moderate dysplasia: 17 (TP3: codes for p53) –>

Severe dysplasia CIS: 4, 6 ,8, 11 (cyclin D itself), 13, 14 —>

Squamosu Cell carcinoma

Question 12

Answer 12

SCC: histo nests/islands of malignant keratinocytes invade underlying CT stroma and Skeletal muscle

Question 13

Answer 13

mucocele, inflammatory sialadenitis, blocks salviary gland, lower lip common, xerostomia

Question 14

Answer 14

mucocele, cystlike cavity filled with mucinous material and granulation tissue

Question 16

Answer 16

pleom adenoma, high fraction ass with chrom rearrangements involving PLAG1, mostly no dysplasia or mitotic activity.

Question 17

Answer 17

Pleo A, dominant histo is heterogeneity ductal cells myoepi cells, acini, tubules, stand, myxoid tissue, cartilage

Question 18

Answer 18

Warthin, narrow cyst like spaces lined by double layer of neeoplas resting on dense lymphoid stroma with germinal centers

Question 19

Answer 19

papillary cystadenoma lymphmatosum (warthin tumor): epithelial and lymphoid elements, germinal centers beneat the epithelium.

warthins arises exclusive in the parotid gland

10% multifocal, 10% bilateral

5th-7th decades of life, usually women

smokers 8x times the risk

Question 20

Answer 20

Mucoepidermoid carcinoma

cricumscribed but not well defined all the same

MECT1 and MAML2 translocation via 11; 19

Noth signaling PW effected–> cAMP dependent signaling

most common form of primary malignant tumor of salivary gland

histo: cords, sheets, cystic config of squamous cells, mucous filled vacuoles. can appear both benign and malig. subclassified into low, intermediate, or high grade.

Dinstinguished from adenoid cystic carcinoma: ACC are smaller, have hyaline between the cells, take on a cribriform pattern, and often form around nerve endings “perineural invasion”

Question 21

Where do these largely occur? How would you distinguish it from the “other” most common tumor?

Answer 21

adenoid cystic acarcinoma (distinct from muco carcin):

50% occur in the minor salivary glands (palatine especially), the biggers ones include parotid and and submandiblar. appear in nose, sinuses, upper airwaysm breast, elsewhere. “cribriform pattern enclosing secretions” and “perineural invasion” (invades around a nerve)

small, poorly encapsulated, infiltrative, compact nucleu, scan cyto, tubular, solid, or cribriform patterns spaces between cells filled with hyaline material (excess basement membrane)

Question 22

Answer 22

adenoid cystic carcinoma: perineural invasion