Epithelial

Question 1

Probably caused by HPV; over 100 types identified; 6 and 11 are most commonly associated

Answer 1

squamous papilloma

Question 2

any site, with the tongue and soft palate most frequently involved; typically solitary; usually pedunculated; variable color

Answer 2

squamous papilloma

Question 3

papillary proliferation of hyperkeratotic stratified squamous epithelium; supported by finger like projections of fibrovascular connective tissue

Answer 3

squamous papilloma

Question 4

squamous papillomas of the _ may behave differently

Answer 4

larynx

Question 5

typically a benign skin lesion induced by HPV 2, 4, 6 and 40; relatively contagious with potential for autoinoculation

Answer 5

verruca vulgaris (common wart)

Question 6

most commonly in children; skin of hands; more commonly sessile; variable color

Answer 6

verruca vulgaris

Question 7

oral lesions uncommon; often indistinguishable from squamous papilloma; oral lesions typically appear white

Answer 7

verruca vulgaris

Question 8

papillary, hyperkeratotic proliferation of epithelium; rete ridges appear to converge toward the center of the lesion; course keratohyaline granules and koilocytosis

Answer 8

verruca vulgaris

Question 9

also known as “venereal warts”; caused by several strains of HPV, including types 2, 6, 11, 16, 18

Answer 9

condyloma acuminatum

Question 10

typically a genital lesion; oral lesions -multiple, sessile, cauliflower surface

Answer 10

condyloma acuminatum

Question 11

common lesion of the elderly; unknown etiology but correlated with sun exposure; may be hereditary

Answer 11

seborrheic keratosis

Question 12

exclusively a skin lesion; face, trunk, extremities; tan to brown, roughened plaques; “stuck on” appearance

Answer 12

seborrheic keratosis

Question 13

seborrheic keratosis; 30% blacks; multiple brown to black papules

Answer 13

dermatosis papulosa nigra

Question 14

exophytic, papillary proliferation of basaloid cells; horn cysts and pseudo-horn cysts

Answer 14

seborrheic keratosis

Question 15

multiple seborrheic keratoses may be an indicator of internal malignancy- _ sign

Answer 15

Leser-Trelat sign

Question 16

common lesion of facial skin; unknown etiology; significance based upon the clinical resemblance to the more serious basal cell carcinoma

Answer 16

sebaceous hyperplasia

Question 17

> 40 yrs; white, yellow or normal color umbilicated papule, usually

Answer 17

sebaceous hyperplasia

Question 18

fordyce granules have same histo as _

Answer 18

sebaceous hyperplasia

Question 19

benign lesion secondary to chronic sun exposure; no intraoral counterpart; patients who have facial ephelides (freckles) are more likely to develop later in life

Answer 19

actinic lentigo

Question 20

elderly whites; facial skin, dorsum of hands and arms; brown to tan, well demarcated macules; no change on sun exposure (unlike ephelis)

Answer 20

actinic lentigo

Question 21

common oral mucosal lesion of unknown etiology; lip lesions may be associated with actinic exposure; F>M; commonly affects the lower lip vermilion zone

Answer 21

oral melanotic macule

Question 22

tan to dark brown macule usually less than 7mm; no change with sun exposure; oral

Answer 22

oral melanotic macule

Question 23

Oral melanotic macule- histo may be necessary to rule out _

Answer 23

melanoma

Question 24

benign proliferation of nevus cells, which are derived from neural crest and are related to melanocytes; acquired or congenital; intraoral lesions are uncommon

Answer 24

acquired melanocytic nevus (mole)

Question 25

F>M; begin to occur in childhood; 10-40 may be present in the average adult

Answer 25

acquired melanocytic nevus

Question 26

3 stages of acquired melanocytic nevus?

Answer 26

junctional, compound, intradermal

Question 27

intraoral; palate, gingiva; less papillomatous; may never show pigmentation

Answer 27

acquired melanocytic nevus

Question 28

proliferation of nevus cells that vary in morphology depending upon their depth; superficially arranged in theques

Answer 28

acquired melanocytic nevus

Question 29

1% of newborns, 15% in the head and neck area; small (20 cm)

Answer 29

congenital melanocytic nevus

Question 30

proliferation of melanocytes within the subepithelial connective tissue; 2nd most common intraoral; Tyndall effect; any cutaneous site; F>M; macular or dome-shaped,

Answer 30

blue nevus

Question 31

Congenital melanocytic nevus- _ to _ % risk of malignant transformation

Answer 31

3 to 15%

Question 32

a white patch or plaque which cannot be characterized clinically or pathologically as any other disease; most common precancerous oral lesion

Answer 32

leukoplakia

Question 33

worrisome sites- tongue, floor of mouth, soft palate, homogenous, speckled

Answer 33

leukoplakia

Question 34

architectural features of _: bulbous or drop-shaped rete ridges; acantholysis

Answer 34

dysplasia

Question 35

architectural features of _: invasion through the basement membrane; perineural invasion; vascular invasion

Answer 35

malignancy

Question 36

keratin pearl formation associated with _

Answer 36

malignancy

Question 37

leukoplakia with warty surface architecture

Answer 37

proliferative verrucous leukoplakia

Question 38

leukoplakia -biopsy is _

Answer 38

mandatory

Question 39

leukoplakia: _% risk of transformation to SCC

Answer 39

4%

Question 40

_ associated leukoplakia is classically located on the maxillary gingiva/vestibule

Answer 40

sanguinaria

Question 41

red patch that cannon be clinically or pathologically diagnosed as any other condition; greater presence of dysplasia than leukoplakia; same etiology as SCC

Answer 41

erythroplakia

Question 42

older males; floor of mouth, tongue, soft palate; well-demarcated velvety, red plaque; may be adjacent to areas of leukoplakia

Answer 42

erythroplakia

Question 43

erythroplakia: _% will show severe dysplasia or CIS

Answer 43

90%

Question 44

gray or gray-white plaque in the area of placement; diffuse borders; corrugated surface texture

Answer 44

tobacco pouch keratosis

Question 45

hyperkeratosis and acanthosis with/without intracellular edema; chevron surface architecture; may see connective tissue hyalinization

Answer 45

tobacco pouch keratosis

Question 46

benign hyperkeratotic change to the palatal mucosa secondary to tobacco smoking; most common in pipe and cigar smokers; similar changes may be induced by drinking hot beverages

Answer 46

nicotine stomatitis

Question 47

M>F;>45 yrs; grey-white mucosa, multiple papules with erythematous center

Answer 47

nicotine stomatitis

Question 48

hyperkeratosis and acanthosis; chronic inflammation; squamous metaplasia of the excretory ducts

Answer 48

nicotine stomatitis

Question 49

common premalignant lesion of skin; secondary to cumulative sun exposure (UV radiation)

Answer 49

actinic keratosis

Question 50

>40 yrs; face, dorsum of hands, scalp; irregular scaly plaques of variable color; rough "sandpaper" feel

Answer 50

actinic keratosis

Question 51

common premalignant lesion of the lip (typically the lower lip vermilion); secondary to chronic sun exposure; equivalent to actinic keratosis of skin

Answer 51

actinic cheilosis

Question 52

>45 yrs; M>F; early atrophy that progresses to scaly plaque; may show ulceration

Answer 52

actinic cheilitis

Question 53

Oral SCC: _ most common cancer in males

Answer 53

7th

Question 54

etiology of oral SCC: _ syndrome (iron deficiency anemia, glossitis, dysphagia)

Answer 54

Plummer-Vinson syndrome

Question 55

Normal gene that is transformed in some manner to alter its activity

Answer 55

oncogenes

Question 56

genes that normally function to protect damaged cells from proliferating; alterations allow for the accumulation of genetic damage

Answer 56

tumor suppressor genes

Question 57

tongue (ventral and lateral), floor of mouth, soft palate are most common sites; usually minimal pain; underlying bone may be altered

Answer 57

Oral SCC

Question 58

_ at diagnosis is the most important prognostic indicator

Answer 58

stage

Question 59

persons with one carcinoma are at increased risk of developing a second mucosal tumor

Answer 59

field cancerization

Question 60

rare low grade tumor first reported by Ackerman as a smokeless tobacco related lesion; even among smokeless tobacco users, squamous cell carcinoma is much more common

Answer 60

verrucous carcinoma

Question 61

males; >55; mandibular vestibule, buccal mucosa, hard palate; typically a white, warty plaque

Answer 61

verrucous carcinoma

Question 62

malignancy of the _ mucosa that is more common in parts of asia; associated with EBV infection, vitamin C deficient diets, and diets high in salted fish (nitrosamines)

Answer 62

nasopharyngeal carcinoma

Question 63

M>F; 40-60 yrs; primary lesion is usually undetected; enlarged cervical nodes typically the first sign; other presenting signs include unilateral serous otitis media and hearing loss

Answer 63

nasopharyngeal carcinoma

Question 64

extremely common low-grade cutaneous malignancy secondary to chronic sun exposure; tumor cells arise from the _ cell layer of skin and appendages; especially common in fair complected patients

Answer 64

basal cell carcinoma

Question 65

fair complected, >40; most common location is the middle third of the face; associated with nevoid _ syndrome

Answer 65

basal cell carcinoma

Question 66

most common form of BCC is _

Answer 66

noduloulcerative

Question 67

distinct peripheral palisading and stromal retraction

Answer 67

BCC

Question 68

may arise from preexisting benign melanocytic lesions or from skin subject to a history of acute solar damage; 3rd most common cancer but number one cause of death among skin cancers

Answer 68

melanoma

Question 69

most common melanoma

Answer 69

superficial spreading

Question 70

most oral melanoma

Answer 70

acral lentiginous

Question 71

rare; maxillary gingiva, palate; brown to black macule that extends laterally and thickens with vertical growth phase

Answer 71

oral melanoma

Question 72

melanocytic distribution throughout the epithelium

Answer 72

pagetoid spread