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Oral Path 2 Finals > Connective Tissue Lesions (fibrous) > Flashcards

Connective Tissue Lesions (fibrous) Flashcards

1
Q

Reactive conditions are derived from ___ cells and are represented by fibrous hyperplasia or exuberant proliferations of granulation tissue

A

Mesenchymal

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2
Q

Reactive conditions are derived from ___ cells and are represented by fibrous hyperplasia or exuberant proliferations of granulation tissue

A

Mesenchymal

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3
Q

____ hyperplasias comprise a group of fibrous connective tissue lesion that commonly occur in the oral mucosa secondary to injury

A

Reactive

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4
Q

A reactive hyperplastic mass that occurs on the gingiva and is believed to be derived from connective tissue of the submucosa or PDL

A

Peripheral fibroma

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5
Q

Any age

Males > females

Gingiva anterior to to permanent molars is most often affected

A

Peripheral fibroma

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6
Q

Presents clinically as a stalk (pedunculated) or a broad-based (sessile) mass that is similar in color to surrounding connective tissue

A

Peripheral fibroma

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7
Q

Hyperplastic scar

Highly collagenous and relatively avascular. Contains mild to moderate chronic inflammatory cell infiltrate

A

Peripheral fibroma

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8
Q

Gingival counterpart of peripheral fibroma

A

Traumatic fibroma (oral mucosa)

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9
Q

A subtype of peripheral fibroma that is a gingival mass in which islands of women (immature)bone and osteoid are seen.

A

Peripheral ossifying fibroma

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10
Q

A subtype of peripheral fibroma that is a gingival mass composed of well-vascularized, non encapsulated fibrous connective tissue.

Strands of odontogenic epithelium are often abundant

Amorphous hard tissue resembling tertiary dentin

A

Peripheral odontogenic fibroma

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11
Q

A subtype of peripheral fibroma that is a fibrous hyperplasia in which many of the mesenchymal cells are relatively larger than normal fibroblasts and assumes a stellate shape

A

Giant cell fibroma

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12
Q

DD of peripheral fibroma

A

Peirpheral giant cell granuloma
Pyogenic granuloma

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13
Q

Treatment of peripheral fibroma

A

Local excision, which should include the PDL

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14
Q

Reactive lesion usually caused by chronic trauma to oral mucous membrane

Overexuberant fibrous connective tissue repair results in a clinically evident submucosal mass

These are misnomers because there lesions are not benign tumor of fibroblasts

A

Focal fibrous hyperplasia

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15
Q

No gender and racial predilection

Very common reactive hyperplasia - typically found in buccal mucosa, lateral border of the tongue, and lower lip.

Painless, broad-based swelling that is pale in color, due to lack of vascular channels

A

Focal fibrous hyperplasia

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16
Q

These lesion have limited growth potential and do not exceed by 1-2 cm in diameter

A

Focal fibrous hyperplasia

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17
Q

If multiple focal fibrous hyperplasia, what are the syndrome that is commonly associated with?

A

Cowden’s syndrome or multiple hamartoma syndrome

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18
Q

Organ system associated with focal fibrous hyperplasia

A

Skin
Breast
Mucosa
Throid
Colon

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19
Q

Frequently encountered abnormalities in focal fibrous hyperplasia

A

Numerous fibromas and papillomas:
Cutaneous papules
Keratosses
Trichilemmomas
Benign and malignant neoplasms of the breast and thyroid
Colonic polyps

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20
Q

Underlying genetic problem appears to be related to germline mutation of the tumor suppressor gene in focal fibrous hyperplasia

A

PTEN found on chromosome 10q23

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21
Q

Histopath of focal fibrous hyperplasia

A

Collagen overproduction

Hyperkeratotic epithelium

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22
Q

DD of focal fibrous hyperplasia

A

IF TONGUE
Neurofibroma
Schwannoma
Granular cell tumor

LOWER LIP AND BUCCAL MUCOSA
Lipoma
Mucocele
Salivary gland tumor

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23
Q

Treatment of focal fibrous hypeplasia

A

Simple surgical excision

24
Q

Benign proliferation of spindle cells of disrupted but probable Fibroblastic origin

Was first described as a tumor of the pleura

Buccal mucosa

A

Solitary fibrous tumor

25
Q

Rare case of these lesion cause hyperglycemia due to tumor production of insulin like growth factors

A

Solitary fibrous tumor

26
Q

Pattern less proliferation of spindle cells

A

Solitary fibrous tumor

27
Q

IHC of solitary fibrous tumor

A

STAT-6 - 100%
CD34 - 90-95%
CD99. - 70%
Bcl-2. - 20-25%

Factor XIIIa- positive cells may be found

28
Q

Treatment for solitary fibrous tumor

A

Surgical excision

29
Q

Oral Fibroblastic proliferations

Very common oral lesions
Uncommon to rare tumor
Rare oral tumor

A

VCOL - fibrous hyperplasia
UTRT - solitary fibrous tumor, myofibroma, benign fibrous histiocytoma
ROT - Nodular fasciitis, fibromatosis, fibrosarcoma, malignant fibrous histiocytoma

30
Q

Gene associated with solitary fibrous tumor

A

NAB2-STAT6 gene

31
Q

What are the reactive hyperplasias? (PPT NI DOC)

A

Pyogenic granuloma
Peripheral giant cell granuloma
Peripheral fibroma
Focal fibrous hyperplasia

32
Q

Location: gingiva
Color: red lesions
Histopath: high vasularity, fibroblastic

A

Pyogenic granuloma
Periapical giant cell granuloma

33
Q

Color: same with gingival/surrounding tisues
Histopath: avascular, fibroblastic

A

Peripheral fibroma
Focal fibrous hyperplasia

34
Q

Hyperplastic granulation tissue predominantly on the gingiva

A

Pyogenic granuloma

35
Q

Exuberant connective tissue proliferation to a known stimulus or injury

A

Pyogenic granuloma

36
Q

Appears as red mass because it is composed of hyperplastic granulation tissue in which capillaries are very prominent

A

Pyogenic granuloma

37
Q

2nd decade of life

Commonly seen on the attached gingiva

Tongue, lower lip, buccal mucosa are most common

A

Pyogenic granuloma

38
Q

Histopath of pyogenic granuloma

A

Lobular mass of hyperplastic granulation tissue

Vascularization

Neutrophils, ulceration ay be present

39
Q

DD of pyogrnic granuloma

A

Peirpheral GCG
Peripheral dontogenic fibroma
Peripheral ossifying fiboma
Kasposi sarcoma
Metastatic cancer

40
Q

Treatment of pyogenic granuloma

A

Surgical excision
Removal of local etiologic factor

41
Q

Reactive localized proliferation of mononuclear cels and osteoclasts (multinucleated giant cells) in a vascular stroma located in the soft tissue soft gingiva or alveolar ridge mucosa

A

Peripheral giant cell granuloma

42
Q

Scattered fibrblasts are the basic element

Non0functional osteoclast like multinucleated giant cells

A

Peripheral giant cell granuloma

43
Q

Essential diagnostic criteria of peripheral giant cell granuloma

A

Located on gingiva/alveolar ridge
cellular mononuclear stroma clustered osteoclasts
Hermorrhage
No origin from underlying intraosseous giant cell granuloma

44
Q

DD of peripheral giant cell granuloma

A

Pyogenic granuloma

Bone resorption in PGCG than PG

45
Q

Treatment for PGCG

A

Surgical excision m underlying bone may be reduced to minimize recurrence

Removal of local etiologic factors

46
Q

IHC for nerve sheath tumor

A

S-100
Neurofilament

47
Q

IHC for myofibroma

A

Muscle actin

48
Q

IHC for leiomyoma/saarcoma

A

Muscle actin
Desmin

49
Q

Rhabdomyoma/sarcoma

A

Muscle actin
Desmin

50
Q

IHC for fibrous histiocytoma and malignant counterpart

A

All negative

51
Q

IHC for solitary fibrous tumor

A

CD34
CD99

52
Q

IHC for kaposi sarcoma

A

CD31

Tumor is also positive for HHV-8

53
Q

Most common soft tissue sarcoma

A

Fibrosarcoma

54
Q

Considered now as rare malignant spindle cell tumor represented a range of spindle cell malignancies

A

Fibrosarcoma

55
Q

Soft tissue and bone malignancy of the head and neck

Proloferstion of malignant mesencymal cells

Secondary ulceration

Young adults are commonly affected

A

Fibrosarcoma

56
Q

exhibits malignant-appearing fibroblasts, typically in a herringbone or interlacing fascicular pattern

Collagen may be sparse, and mitotic figures frequent.

Atypical spindle cells

A

Fibrosarcoma

Oral Path 2 Finals (3 decks)

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