Epithelial Dysplasia + Potentially Malignant Flashcards
what is dysplasia
abnormal growth
NOT PRE-CANCER
red flags
> 3 weeks, >50y/o
smoke, drink, previous
non healing ulcer + no cause
induration, exophytic
tissue tethering
difficulty speaking/swallowing
lymphadenopathy
weight/appetite loss
numbness, altered sensation
architectural signs of epithelial dysplasia
- irregular epithelial stratification
- basal cell loss of polarity
- drop-shaped rate ridges w keratin pearls
- increased mitotic figures
- abnormal superficial mitoses
- loss of epithelial cell cohesion
- premature keratinisation
cytological signs of epithelial dysplasia
- abnormal variation of nuclear size/shape, cell size/shape
- increased nuclear cytoplasmic ratio
- atypical number + size nuclei
- hyperchromasia
SCC histological features
- invasion beyond basement membrane
- keratin pearls
- pleomorphism
- loss of cell differentiation
- high mitotic acitivty
- disorganised growth pattern _ keratinisation
describe
1- basal hyperplasia
2 - mild hyperplasia
3 - mod dysplasia
4 - severe dysplasia
5 - carcinoma in situ
1 - increased basal cells, regular stratification
2 - arc changes lower 1/3, mild atypia
3 -arc changes mid 1/3, mod atypia, pleomorphism, hyperchromatism
4 - arc changes upper 1/3, severe atypia, abnormal high numerous mitoses, hyperchromatism, loss of polarity
5 - theoretic, arc abnormal, full thickness/all cells, pronounced atypia, mitotic abnormalities
what is the difference in management for
- mild-low dysplasia
- mod-severe dysplasia
mild - monitor 5 years
mod-severe - remove
what is an oral potentially malignant disorder
give examples
any mucosal abnormality associated with increased risk of developing cancer, increased susceptibility in mouth where cancer more likely than clinical normal mucosa
leukoplakia [esp verrucous]
oral submucous fibrosis
erytho(leuko)plakia
OLP
