CT lesions

Question 1

Which of the histological findings align with that of fibrosarcoma?

Histological findings shows encapsulated fibrous tissue
Histological findings comprised of cellular fibroblastic granulation tissue and interlacing collagen bundles with variable inflammatory cell infiltration,plasma cells, and calcifications
Histological findings shows anaplastic spindle-shaped cell with eosinophilic cytoplasm in delicate collagenous stroma arranged in a herringbone pattern
Histological findings comprised of mitotic figures but scant, with no evidence of pleomorphism.

Answer 1

Histological findings shows anaplastic spindle-shaped cell with eosinophilic cytoplasm in delicate collagenous stroma arranged in a herringbone pattern

Question 2

A 40 year old man came into your dental clinic due to pain and swelling associated with a rapidly enlarging mass on the body of the mandible. DPT results showed a large diffuse radio-opacity with a sunburst pattern. Which condition is most likely?

Lymphoma
Multiple Myeloma
Ossifying fibroma
Osteosarcoma

Answer 2

Osteosarcoma

Question 3

A 60yo female comes into your clinic complaining of a lump on her left cheek. Upon clinical examination, you notice a yellowish soft to doughy lump on her left cheek. How will you manage this patient?

Excision of lesion
Give oral health instruction and education, prophylaxis
Prescription of corticosteroids, monitor signs and symptoms
Will spontaneously resolve, do not do anything

Answer 3

Excision of lesion

Question 4

Fibrosarcoma is a malignant neoplasm of fibroblasts which can metastasise to distant sites. How does fibrosarcoma spread?

Via haematogenous route
Via lymphatic route
Via transcoelomic spread
Via canalicular spread

Answer 4

Via haematogenous route

Question 5

25 year old patient presents with a a pinkish red sessile lesion (2cm in size) at canine region of her gingiva, which of the following is true about her condition?
Occurs more commonly during pregnancy
May be covered by yellow fibrinous exudate
Has a 14% risk of recurrance
It has a soft consistency and blanches on pressure

Answer 5

May be covered by yellow fibrinous exudate

Question 6

What does this histology slide depict?

https://pasteboard.co/oZzgOIyZ4D8c.png

Fibroma
Peripheral giant cell granuloma
Peripheral ossifying fibroma
Pseudomembranous candidiasis

Answer 6

Peripheral giant cell granuloma

Question 7

A 70 year old female patient with a history of hypertension presents with dark red and oedematous inflamed gums which bleed easily and complains of ulcerations occasionally. As a result, she finds it difficult and painful to wear her dentures. Which of the following is most likely true?

The tumour-like hyperplastic gingiva is due to hyperplasia of fibrous connective tissue that developed in association with the flange of her ill-fitting denture.
The tumour-like hyperplastic gingiva is due to the abnormal growth of gingival tissues secondary to the use of Nifedipine.
The tumour-like hyperplastic gingiva is red as it contains proliferation of multinucleated giant cells with a background of spindle-shaped mesenchymal cells and abundant haemorrhage characteristically found throughout the mass.
The tumour-like hyperplastic gingiva is a developmental problem that spontaneously resolves with time and does not require intervention.

Answer 7

The tumour-like hyperplastic gingiva is due to the abnormal growth of gingival tissues secondary to the use of Nifedipine.

Question 8

A patient with HIV presents with Kaposi sarcoma. What would you expect to see histologically?

Intramucosal nodule with prominent vascular channels lined by atypical endothelial cells and areas of extravasated red blood cells with haemosiderin
Comprised of cellular fibroblastic granulation tissue and interlacing collagen bundles with variable inflammatory cell infiltration, plasma cells and calcifications
Comprised of vascular proliferation, solid sheets of endothelial cells or numerous small vessels and large, thin-walled vascular spaces supported by a delicate and oedematous cellular fibrous stroma infiltrated by mixed inflammatory cells
Very cellular neoplasm composing of anaplastic spindle-shaped nuclei with eosinophilic cytoplasm in delicate collagenous stroma

Answer 8

Intramucosal nodule with prominent vascular channels lined by atypical endothelial cells and areas of extravasated red blood cells with haemosiderin

Question 9

Which of the following is true about Fibrosarcoma?

It is a benign condition.
It occurs more comonly in females.
It tends to occur in children & in late adulthood.
It arises commonly in the bone.

Answer 9

It tends to occur in children & in late adulthood.

Question 10

Which of the following is true of a pyogenic granuloma?

Involves a neoplastic proliferation of endothelial cells and capillaries
More common in males than females
Occurs most commonly on the gingiva
Ulcerated white lesion accompanied by pain

Answer 10

Occurs most commonly on the gingiva

Question 11

Which is most common site of involvement for pyogenic granuloma?

Gingiva
labial mucosa
buccal mucosa
floor of mouth

Answer 11

Gingiva

Question 12

What is true regarding hemangiomas?

Hemangiomas are commonly associated with phleboliths
Hemangiomas are raised lesions that have a hard consistency
Hemangiomas present as isolated solitary lesions only
Patients with hemangiomas frequently complain of pain

Answer 12

Hemangiomas are commonly associated with phleboliths

Question 13

What tumour is this histology slide showing?

https://pasteboard.co/Zv55en3snrC9.png

Fibrosarcoma
Pyogenic granuloma
Plasmacytoma
Osteosarcoma

Answer 13

Plasmacytoma

Question 14

Which of the following is a feature of osteosarcoma?

Early features of osteosarcoma are ulceration of skin or mucosa.
It is associated with Rendu-Osler-Weber disease
It is more common in the maxilla
It is the most common primary malignant tumour of bone

Answer 14

It is the most common primary malignant tumour of bone

Question 15

A heavily pregnant lady stumbles into your clinic, anxiously complaining that there is a lump on her gums that bleeds easily. Upon examination, you discover an erythematous, pedunculated, ulcerated and lobular mass on her maxillary gingiva. She informs you that it was growing rapidly but was painless and is not affecting her function. Which of the following are true of the particular soft tissue lesion that should be at the top of your differential diagnosis?

A. Frequently develops in pregnant woman due to an increase in placental growth factor (PIGF)
B. It is a non- neoplastic proliferation of endothelial cells and capillaries in response to local injury
C. You should immediately refer her for surgical excision due to its malignant transformation potential
D. A potential aetiology includes bacterial infection by Staphylococcus

Answer 15

B. It is a non- neoplastic proliferation of endothelial cells and capillaries in response to local injury

Question 16

Which of the following benign connective tissue tumours is treated by conservative local excision?

a) Lymphangioma
b) Rhabdomyoma
c) Leiomyoma
d) Lipoma

Answer 16

d) Lipoma

Question 17

A 35 year old man presents to your clinic with a large 5x6cm swelling on the right mandible. He complains that his lips feel numb and his teeth are shaky. He had no recent dental extraction history and mentions that the swelling has gotten bigger in the past 1-2 months. Which of the following is not a clinical/radiological sign of his condition?

Nasal obstruction and diplopia
destruction of the body of the right side of the mandible.
“sun-ray” appearance on radiograph
widening of PDL space

Answer 17

Nasal obstruction and diplopia

Question 18

A 26/yo female comes into your clinic complaining of a lump at the interdental gingiva of her upper central incisors. As an aspiring aesthetic dentist you decided to remove the excess gums. However, after a few weeks, the patient complains that the lump came back. Which of the following is not true?

https://pasteboard.co/RzKAHUuYvERu.png

The lump is neoplastic, should have sent for biopsy
You didn’t excise completely
You didn’t remove precipitating factors such as subgingival plaque/calculus
The lesion tends to recur

Answer 18

The lump is neoplastic, should have sent for biopsy

Question 19

Which lymphoma best fits the following histological description :”starry sky macrophage pattern”?

Hodgkin lymphoma
Non-hodgkin lymphoma
Burkitt’s lymphoma
T cell lymphoma

Answer 19

Burkitt’s lymphoma

Question 20

A 30 year old pregnant woman enters your clinic, presenting with a soft, haemorrhagic deep reddish- purplish swellings on her buccal and labial mucosa. Upon clinical examination, what is the most likely diagnosis?

Fibroma
Fibrous epulis
Lipoma
Pyogenic Granuloma

Answer 20

Pyogenic Granuloma

Question 21

Lesion blanches on pressure and is asymptomatic, which of the following lesions is this?

https://pasteboard.co/vbgtxLxAXqCy.png

Pyogenic Granuloma
Giant Cell Fibroma
Oral Haemangioma
Fibrous epulis

Answer 21

Oral Haemangioma

Question 22

A male patient presents with a reddish-purple lesion. The lesion shows positive immunostaining for Factor VIII. What is the origin of this lesion?

https://pasteboard.co/AUN2uLLlaJdT.png

Autoimmune
Metabolic
Trauma
Vascular

Answer 22

Vascular

Question 23

Which of the following clinical features do not corresond to the identification of a pyogenic granuloma found on the labial mucosa?

A well-define pedunculated swelling of soft to firm consisteny.
A soft, hemorrhagic, ulcerated and deep reddish-purplish swelling.
A pedunculated tumour with a papillary surface
Dark red-purplish raised lesion of soft consistency

Answer 23

A pedunculated tumour with a papillary surface

Question 24

Mr Bo walks comes for a check up and you notice that there are well defined pedunculated/sessile yellowish soft to doughy lumps on his cheek and tongue. What do you expect to see on the histology slide?

Circumscribed mass of mature fatty tissue supported by fibrous stroma
Encapsulated mass of cellular fibrous tissue
Solid sheets of endothelial cells
Cellular fibroblastic granulation tissue and interlacing collagen bundles

Answer 24

Circumscribed mass of mature fatty tissue supported by fibrous stroma

Question 25

A patient comes in with red, purple patches in the oral cavity that later become nodular and ulcerative. Identify this connective tissue tumour.

Kaposi Sarcoma
Melanoma
Pyogenic granuloma
Fibrosarcoma

Answer 25

Kaposi Sarcoma

Question 26

Which of the following about fibrosarcoma is false

It is a common malignant neoplasm amongst the asian population
It is most often as soft tissue sarcoma in the neck with good prognosis
Intraorally, it involves the gingiva, tongue and cheek
there is no gender predilection

Answer 26

It is a common malignant neoplasm amongst the asian population

Question 27

What is not true about the lesion shown in the photo?

https://pasteboard.co/L5n9KSGjJq5b.png

It is a vascular neoplasm of endothelial cells
It is associated with HHV-8
It is commonly found on the hard palate, gingiva and dorsal tongue
The lesion is self-limiting

Answer 27

The lesion is self-limiting

Question 28

Which of the following is true about FIbrous epulis?

Has a gender predilection for males, occurs mostly anterior to molar teeth, on the maxilla.
Histological presentation includes cellular fibroblastic granulation tissue & interlacing collagen bundles with variable inflammatory cell infiltration, plasma cells & calcifications.
May be ulcerated and covered by yellow fibrinous exudate presenting as a pedunculated or sessile firm swelling that can be found on gingiva or mucosa.
Occurs commonly after 4th decade of life.

Answer 28

Histological presentation includes cellular fibroblastic granulation tissue & interlacing collagen bundles with variable inflammatory cell infiltration, plasma cells & calcifications.

Question 29

Which of the following conditions does not have a gender predilection?

Burkitt lymphoma
Fibrosarcoma
Fibrous epulis
Pyogenic granuloma

Answer 29

Fibrosarcoma

Question 30

A patient presents at your clinic with dark red-purplish smooth flat lesions on the gums. The lesions are of soft consistency and blanch on pressure. He complains about bleeding on brushing. What could be a possible diagnosis of his condition?

ANUG
Aggressive periodontitis
Hemangioma
Haematoma

Answer 30

Hemangioma

Question 31

A 40 year-old male patient presents with a painless, dark reddish-purplish, painless mass on his gingiva. Biopsy is carried out for diagnosis. There is proliferation of blood vessels. The endothelial cells lining these vascular spaces are flattened and form thin-walled vessels. The vascular spaces are not supported by granulation tissue. What is the most likely diagnosis?

Angiosarcoma
Hemangioma
Peripheral giant cell granuloma
Pyogenic granuloma

Answer 31

Hemangioma