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Oral Pathology > Class: Exam 2 Reactive Tumors > Flashcards

Class: Exam 2 Reactive Tumors Flashcards

1
Q

Most common “tumor” of the oral cavity

A

fibroma

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2
Q

What is a Fibroma

A

A reactive hyperplasia of fibrous connective tissue in response to local irritation or trauma

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3
Q

Where is the most common location for a fibroma?

A

the buccal mucosa along the bite line

*However, it occurs almost anywhere…

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4
Q

Name the clinical features of Fibromas

A

Usually sessile (immobile), Smooth surfaced, normal color, and Asymptomatic

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5
Q

Treatment of irritation fibroma

A

Treated by conservative surgical excision

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6
Q

Define Giant Cell Fibroma

A

A “papillary” fibrous tumor of connective tissue comparable to an irritation fibroma but not associated with chronic irritation.

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7
Q

What other lesion may a giant cell fibroma be clinically mistaken for?

A

A papilloma

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8
Q

What is the hallmark of a giant cell fibroma

A

Presence of numerous large, stellate fibroblasts within the superficial connective tissue.
Also, often bi or trinucleated fibroblasts.

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9
Q

Other than the major hallmark, what other feature/features distinguish giant cell fibromas from irritation fibromas

A

The lesion usually occurs a a younger age, usually diagnosed during the first 3 years of life. (a.ka. –>more in children)

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10
Q

Clinical features of giant cell fibroma?

A

Asymptomatic
Sessile (immobile) or pedunculate nodule
Less than 1 cm in size
Surface often appears papillary

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11
Q

What is the major location in which giant cell fibroma’s are found

A

Approx. 50% cases found on gingiva

Tongue also common site

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12
Q

Define Peripheral Ossifying Fibroma

A

Reactive fibroblastic lesion of PDL

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13
Q

Describe the location/s where peripheral ossifying fibromas may be found

A

Exclusively on the gingiva

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14
Q

Describe the clinical features of a Peripheral Ossifying fibroma

A 
Asymptomatic
Sessile or Pedunculated mass (usually emanates from interdental papilla)
Color: red to pink
Sometimes ulcerated
Most are less than 2 cm in size
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15
Q

What age is common for peripheral ossifying fibroma

A

1-3 decades

predominantly a lesion of teenagers and young adults with peak prevalence between 10-19 yrs.

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16
Q

Histologic features of peripheral ossifying fibromas

A

Cellular fibroblastic lesion with bone and/or cementum and/or dystrophic calcification

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17
Q

Treatment for peripheral ossifying fibromas

A

Excision including superficial PDL
Submission of specimen for exam (biopsy)
Recurrence rate of 15-20% –> Highest of any reactive gingival lesions

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18
Q

Define Inflammatory Fibrous Hyperplasia (Epulis Fissuratum)

A

Reactive folds of hyper plastic fibrous connective tissue along border of ill-fitting, over extended denture

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19
Q

Histologic features of Epulis Fissuratum

A

Fibrous hyperplasia +- inflammation

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20
Q

Treatment of Epulis Fissuratum

A

Excision and remake/reline denture

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21
Q

Define Inflammatory Papillary Hyperplasia (Papillomatosis)

A

Reactive tissue growth of hyper plastic palatal mucosa usually developing beneath a denture.

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22
Q

Histologic features of Inflammatory Papillary Hyperplasia

A

Papillary Hyperplasia +- Inflammation +- Pseudoepitheliomatous Hyperplasia (PEH)

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23
Q

Treatment options for Inflammatory Papillary Hyperplasia

A

Early lesions - removal of denture may allow erythema and edema to subside and tissues may resume normal appearance

Advanced lesions - excision and remake/reline denture.

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24
Q

Define Peripheral Giant Cell Granuloma

A

Tumor of well vascularized fibrous connective tissue containing numerous multinucleated giant cells

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25
Q

Where does Peripheral Giant Cell Granuloma occur?

A

Occurs exclusively on the gingiva or edentulous alveolar ridge

26
Q

Clinical features of Peripheral Giant Cell Granuloma

A 
Reddish-brown-purple-blue color
Pedunculate or sessile mass
Asymptomatic
Any age
Female:male --> 2:1
27
Q

Pyogenic granulomas and Peripheral giant cell granulomas are similar but can be distinguished by color. What color denotes which?

A

Peripheral GC Granuloma –> Blue-Purple

Pyogenic granuloma –> Bright red

28
Q

Does the Peripheral Giant Cell Granuloma only occur on soft tissue?

A

It develops within the soft tissue but may produce cupping respiration of underlying bone.

29
Q

Treatment of Peripheral Giant Cell Granuloma

A

Excision and removal of irritants, may recur

30
Q

Define Pyogenic Granuloma

A

Reactive lesion representing hyperplasia of body’s basic reparative tissue - granulation tissue
- thought to represent an exuberant tissue response to local irritation or trauma

31
Q

Clinical Features of Pyogenic Granuloma

A

Reddish
Ulcerated
Pedunculate or sessile mass
Asymptomatic but may bleed easily

32
Q

Where is a pyogenic granuloma most likely to occur?

A

75% of cases on gingiva

Can occur anywhere including the skin

33
Q

What age is a pyogenic granuloma most common?

A

2-4 decades

- Children and young adults

34
Q

What sex is pyogenic granulomas most common?

A

Females, often in pregnancy “pregnancy tumor”

35
Q

True or False, pyogenic granuloma are uncommon to be found in extraction sockets/

A

False, Not uncommon in extraction sockets - epulis granulomatosa

36
Q

Histologic features of Pyogenic granuloma

A

Hyperplastic granulation tissue, fibroblasts with delicate collagen
Endothelial cells + capillaries and dilated larger vessels

37
Q

Treatment for Pyogenic granuloma

A

Excision and removal of irritants

May recur

38
Q

Parulis “Gum Boil” description

A

Represents draining from a source of odontogenic infection of either pulpal or periodontal origin

  • Pus (purulence, suppuration) = Bacterial infection
39
Q

Define Localized Juvenile Spongiotic gingival hyperplasia

A

Localized hyperplasia presumably from externalized sulcular epithelium on gingiva

40
Q

At what age does LJ Spongiotic gingival hyperplasia occur?

A

Almost exclusively 1-2 decades

41
Q

What sex is Localized Juvenile Spongiotic gingival hyperplasia normally found in?

A

Female 2:1

42
Q

What location is Localized Juvenile Spongiotic gingival hyperplasia normally found?

A

Almost all anterior gingiva

Maxillary 5:1

43
Q

Clinical features of Localized Juvenile Spongiotic gingival hyperplasia

A

Red often papillary gingival lesions

44
Q

Histology features of Localized Juvenile Spongiotic gingival hyperplasia

A

Papillary proliferation of inflamed epithelium with intercellular edema (Spongiosis)

45
Q

Treatment of Localized Juvenile Spongiotic gingival hyperplasia

A

Excision

46
Q

Define Hemangioma

A

Overgrowth of blood vessels

- Hamartoma –> localized overgrowth of tissues native to the part, often developmental

47
Q

Clinical characteristics of Hemangioma

A
  • Rapid proliferation of endothelial cells at birth or shortly thereafter, Characteristically involute
  • Reddish to purple mass lesions that tend to blanch with pressure
  • can occur in bone, often multilocular or soap bubble appearance (why you aspirate before bone biopsy)
  • Oral ones often later and don’t involute
48
Q

Most common tumor of infancy

A

Hemangioma

49
Q

What gender is hemangioma more common?

A

Females 3:1

50
Q

What percent of hemangioma are found in the H&N?

A

60%

51
Q

What age is Hemangioma more common?

A

0-5 years
rarely congenital
90% complete but slow involution by age 10

52
Q

Histologic features of Hemangioma

A

Endothelial cell proliferation with formation of small capillaries (capillary) or larger dilated vascular spaces (cavernous)

53
Q

Treatment of Hemangioma

A

Natural history is involution

Laser pulse, excision, sclerosing agents, steroids both intralesional and systemic propanolol

54
Q

Define Sturge-Weber Angiomatosis

A

Nonhereditary developmental, congenital condition characterized by vascular proliferation of brain and face usually along distribution of ophthalmic branch of the trigeminal nerve

55
Q

Clinical features of Sturge-Weber Angiomatosis

A

Large purplish lesions - identical clinically to port-wine stains.
Ipsilateral oral mucosal involvement common
Leptomingeal angiomas of cerebral cortex

56
Q

Define Lymphangiomas

A

Developmental overgrowth of lymphatic vessels

57
Q

What age are Lymphangiomas most common

A

0-5 years of age

58
Q

Where are lymphangiomas most commonly found

A

H&N

Orally –> Tongue (may produce macroglossia)

59
Q

Difference between Superficial and Deeper lymphangiomas

A

Superficial –> Pebbly surface covered by translucent vesicles
Deeper –> More diffuse

60
Q

Cystic Hygroma

A

Variant of Lymphangiomas that infiltrates and becomes very large (>neck)

61
Q

Histologic features of Lymphangiomas

A

Proliferation of thin walled lymphatic vessels capillary sized
Dilated (cavernous) or mystically dilated (cystic hygroma)

62
Q

Treatment of Lymphangiomas

A

Lesions dont involute
Excision
Deeper ones often recur
Sclerosing agents

Oral Pathology (4 decks)

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