Connective Tissue Conditions

Question 1

Two overarching categories of CT conditions:

Answer 1

Reactive- result of trauma
Neoplastic- new and abnormal growth

Question 2

Why do CT conditions often appear as lumps and bumps in the mouth?

Answer 2

because CT is deep to mucosal membrane

Question 3

3 types of benign CT tumors

Answer 3

Leiomyoma- neoplasm of smooth muscle cells
Lipoma- neoplasm of fat cells
Rhabdomyoma- neoplasm of skeletal muscle cells

Question 4

benign CT tumor that is a neoplasm (new or abnormal growth) of smooth muscle cells

Answer 4

leiomyoma

Question 5

benign CT tumor that is a neoplasm of fat cells, most common on the buccal mucosa

Answer 5

lipoma

Question 6

benign CT tumor that is a neoplasm of skeletal muscle cells

Answer 6

rhabdomyoma

Question 7

lesions that result due to a poorly fitting denture

Answer 7

denture-induced fibrous hyperplasia

Question 8

Two main types of denture-induced fibrous hyperplasia:

Answer 8

Epulis fissuratum- occurs at the base of the vestibule
Papillary hyperplasia- occurs on palate, more likely due to poorly cleaned dentures

Question 9

a benign fibroid tumor caused by chronic trauma or irritation, are among the most common benign CT tumors

Answer 9

fibroma

Question 10

other names for a fibroma (3)

Answer 10

hyperplastic scar, irritation fibroma, traumatic fibroma

*the tumor is specifically known as fibrous hyperplasia of oral mucosa

Question 11

neoplasm of fibroblasts, a difficult to eradicate condition that often recurs even after treatment

Answer 11

fibromatosis

Question 12

a difficult to eradicate condition that often recurs even after treatment

Answer 12

fibromatosis

Question 13

the enlargement of the gingiva

Answer 13

gingival hyperplasia

Question 14

medications that cause gingival hyperplasia (3)

Answer 14

Dilantin (anticonvulsant)
Calcium channel blockers
Cyclosporine (immunosuppressant)

Question 15

tx of gingival hyperplasia

Answer 15

gingivectomy, discontinued drug use if possible

Question 16

neoplasm of Schwann cells, the cells forming the myelin sheath in the PNS

Answer 16

granular cell tumor

Question 17

most common location of a granular cell tumor

Answer 17

anterior dorsal tongue

Question 18

How did the granular cell tumor get its name?

Answer 18

granular cytoplasm of the tumor cells

Question 19

PEH (pseudoepitheliumatous hyperplasia) in this tumor results in a highly proliferative appearance, mimics SCC

Answer 19

granular cell tumor

Question 20

What in a granular cell tumor causes it to have a highly proliferative appearance and mimic SCC?

Answer 20

pseudoepitheliumatous hyperplasia

Question 21

tumor variant of a granular cell tumor that occurs on the gingiva

Answer 21

congenital epulis of newborn (no PEH, but everything else is similar to granular cell tumor)

Question 22

neoplasm of Schwann cells and fibroblasts

Answer 22

neurofibroma

Question 23

Characteristics of neurofibromatosis type I (or Von Recklinghausen’s disease):

Answer 23

• multiple neruofibromas (that can transform into neurofibrosarcomas)
• multiple skin freckles (cafe au lait spots)
• axillary freckles (Crowe’s sign)
• iris freckles (Lisch spots)

*think Von Frecklinghausen’s disease

Question 24

neoplasm of fibroblasts, the lesion is easy to eradicate and rarely recurs after surgical excision

Answer 24

nodular fasciitis

Question 25

hyperplasia of capillaries resulting in a bright red lesion, common found in gingiva of patients with elevated hormone levels (pregnancy or puberty)

Answer 25

pyogenic granuloma

Question 26

neoplasm of Schwann cells, acellular verocay bodies are observed microscopically in Antoni A tissue, the bodies form a characteristic “line of scrimmage” pattern

Answer 26

Schwannoma (neurilemmoma)

Question 27

microscopic appearance of a schwannoma (neurilemmoma)

Answer 27

acellular verocay bodies observed microscopically in Antoni A tissue, these bodies form a characteristic “line of scrimmage” pattern

Question 28

a tangle of neural fibers and CT that develops following nerve injury, usually in the mental foramen

Answer 28

traumatic neuroma

Question 29

disease associated with traumatic neuroma

Answer 29

multiple endocrine neoplasia (MEN 2B)

Question 30

Characteristics of MEN 2B:

Answer 30

• multiple neuromas
• medullary thyroid cancer
• pheochromocytoma of the adrenal gland

Question 31

malignant proliferation of Schwann cells

Answer 31

neurofibrosarcoma (aka malignant peripheral nerve sheath tumor)

Question 32

another name for neurofibrosarcoma

Answer 32

malignant peripheral nerve sheath tumor

Question 33

the malignant proliferation of fibroblasts, these tumors are rarely cured by surgical removal and recurrence and metastasis are common

Answer 33

fibrosarcoma

Question 34

malignant proliferation of endothelial cells

Answer 34

Kaposi’s sarcoma

Question 35

cause of Kaposi’s sarcoma and a complication

Answer 35

HHV 8, complication of AIDS

Question 36

Unlike the other sarcomas that can vary in their oral appearances, this has a very characteristic appearance: a purple lesion.

Answer 36

Kaposi’s sarcoma

Question 37

3 malignant CT tumors

Answer 37

Leiomyosarcoma- malignant proliferation of smooth muscle cells
Liposarcoma- malignant proliferation of fat cells
Rhabdomyosarcoma- malignant proliferation of skeletal muscle cells