Connective Tissue Lesions

Question 1

What does lymphangioma look like?

Answer 1

Vesicle like if superficial Can appear submucosal when deeper.

Question 2

Leiomyoma Characteristics

Answer 2

Benign tumor of smooth muscles Rare in oral cavity Any age and slow growing

Question 3

Congenital Epulis predilection

Answer 3

BIG female predilection

Question 4

Neurofibroma DDx

Answer 4

Submucosal nodules Traumatic fibroma Granular cell tumor Lipoma Macroglossia Lymphangioma Amyloidosis Myxedema Acromegaly

Question 5

Granular Cell Tumors Histo

Answer 5

Sheet of large cells with granular eosinophilc cytoplasm Pseudoepitheliomatous hyperplasia Granular cells stain with S-100

Question 6

Schwannoma Appearance

Answer 6

Slow growing and submucosal Common locations → tongue, palate, lips NO PAIN, unless compressing a nerve

Question 7

Schwannoma Histo

Answer 7

Interestingly, no nerve tissue in the lesion. As lesion grows, nerve is pushed aside. Antoni Type A and Type B patterns Type A: LOOOOONG spindle shaped cells; paralleling and palisading Type B: MIcrocystic arrangement of cells

Question 8

Traumatic neuromas are associated with pain what percentage

Answer 8

50% Tenderness to severe pain.

Question 9

MEN characteristics

Answer 9

Autosomal dominant MEN 1 and MEN 2A/B MEN 2B has mucosal neuromas (only one with ORAL manifestations) and medullary carcinoma of thyroid gland

Question 10

Cause of traumatic neuroma

Answer 10

Injury to a peripheral nerve that causes inflammation and scarring to the area.

Question 11

DDx Congenital Epulis

Answer 11

Gingival cyst Neuroectodermal tumor of infancy Rhabdomyosarcoma

Question 12

Origin of neurofibroma

Answer 12

Benign tumor of nerve tissue origin

Question 13

Rhabdomyosarcoma Characteristics

Answer 13

Most common malignant neoplasm of skeletal muscles origin 40% occur in the head and neck Common in children (1st decade)

Question 14

Traumatic Neuroma Characteristics

Answer 14

Not a TRUE neoplasm Occurs with trauma, but also cases without trauma present

Question 15

Myositis Ossificans histo

Answer 15

Central proliferating osteoblasts Maturation and organized osseous structures

Question 16

What is this

Answer 16

Granular cell tumor

Question 17

Cause of MEN

Answer 17

Mutation on RET oncogene Leads to neoplasms arising in endocrine tissues

Question 18

TX Congenital Epulis

Answer 18

Excision

Question 19

What neoplasms involved with MEN

Answer 19

Parathyroid hyperplasia or
adenoma

Multiple pheochromocytomas

Medullary carcinomas of the thyroid

Question 20

Neurofibromatosis histo

Answer 20

Composed of Schwann cells, fibroblasts, perineural cells Positive for S-100

Question 21

DDx Granular Cell Tumors

Answer 21

Neurofibroma Schwannoma Fibroma Lipoma

Question 22

Traumatic Neuroma TX

Answer 22

Excision

Question 23

When do mucosal neuromas of MEN occur

Answer 23

Usually early in life

Question 24

Traumatic Neuroma Histo

Answer 24

Nerve fibers in discrete bundles

Question 25

What is cystic hygroma

Answer 25

Lymphangioma of the neck. Large swelling that can be life threatening

Question 26

Neurofibromatosis Appearance

Answer 26

Multiple nodules on skin. 25% of NF will have nodules in the mouth

Question 27

Where lymphangioma occur

Answer 27

The tongue most commonly

Question 28

Schwannoma etiology

Answer 28

Benign neoplasm of Schwann cells of the neural sheath

Question 29

Congenital Epulis Appearance

Answer 29

Usually present at birth Present on the anterior maxilla alveolar crest commonly, Also on mandible (alveolar crest)

Question 30

What bone changes are involved with neurofibromatosis?

Answer 30

Blunderbuss IA canal Cortical erosion or intrameduallary erosion

Question 31

Granular Cell Tumors Appearance

Answer 31

Can have a yellowish surface color Usually a single, submucosal mass

Question 32

Location of neurofibroma

Answer 32

tongue, buccal mucosa, palate, vestibule If on tongue, macroglossia possible

Question 33

Myositis Ossificans Characteristics

Answer 33

Reaction lesion of skeletal muscles with intramuscular inflammation with ossification Two forms: progressive systemic and focal single `

Question 34

what is this

Answer 34

congenital epulis

Question 35

Congenital Epulis Histo

Answer 35

Similar to granular cell tumor, but NO pseudoepitheliomatous hyperplasia

Question 36

Lipoma Characteristics

Answer 36

Benign tumor of mature fat

Question 37

Appearance of neurofibroma

Answer 37

Firm nodule that will be color of normal mucosa

Question 38

Oral involvement of MEN 2B

Answer 38

Mucosal neuromas Appear as small, discrete nodules on the labia, larynx, and tongue, BM

Question 39

Another name for congenital epulis

Answer 39

congenital gingival granular cell tumor

Question 40

Cause if neurofibromatosis

Answer 40

An autosomal dominant inherited disease

Question 41

What enlargements can occur with lymphangioma

Answer 41

Macroglossia and macrocheilia

Question 42

Leiomyoma appearance

Answer 42

Firm nodule with normal mucosa

Question 43

Characteristics of neurofibromatosis

Answer 43

Cafe-au-lait spots Well-defined border (Coast of California) Multiple neurofibromas Lisch nodules in eyes Axillary frecking Skeletal deformities