Epithelial Pathology II Flashcards
What is the definition for a leukoplakia?
An intraoral white plaque that does not rub off and cannot be identified as any well known entity
What are 5 lesions that may appear like a leukoplakia but do rub off?
1-Materia Alba 2-White coated tongue 3-Burn (thermal, chemical, cotton roll, etc.) 4-Pseudomembranous candidiasis 5-Sloughing from toothpaste
What are 6 possible cause of a leukoplakia?
1-Tobacco 2-Alcohol (Synergistic with Tobacco) 3-Sanguinaria (Max vestibule, herbal toothpaste) 4-UV radiation (lower lip) 5-Microorganisms 6-Trauma
What 3 places are 70% of leukoplakias found?
1-Lip vermilion
2-Buccal mucosa
3-Gingiva
What 3 places are 90% of dysplastic or carcinoma leukoplakia found?
1-Lip vermilion
2-Lateral/ventral tongue
3-Floor of mouth
Red patch that cannot be diagnosed as any other condition is called what?
Erythroplakia
*True erythroplakias are never completely benign
A mixed Red and white plaque is called what?
Erythroleukoplakia
What high-risk form of leukoplakia is characterized by multiple keratotic plaques with roughened surface projections?
Proliferative verrucous leukoplakia (PVL)
*No association with tobacco use
What is the first step in arriving to a definitive diagnosis for a leukoplakia?
Biopsy
when alterations are limited to the lower 1/3 of the biopsy it is?
Mild dysplasia
When alterations are limited to the lower ½ of the biopsy it is?
Moderate dysplasia
When alterations are present above the lower ½ of the biopsy it is?
Severe dysplasia
When alterations are present throughout the epithelium it is called?
Carcinoma in situ
What are the 3 most common locations for an erythroplakia?
1-Floor of mouth
2-Ventral tongue
3-Soft palate
When the Lesion appears as a thin, gray or white plaque with a border that blends into surrounding mucosa (wavy looking texture) it is likely?
Smokeless tobacco Keratosis
*if lesions remain 6 weeks after habit is stopped, biopsy required
A chronic, progressive, scarring, high-risk precancerous condition of the oral mucosa linked to chronic placement of betel quid or paan is called?
Oral Submucous Fibrosis
*Typically in indian culture. On buccal mucosa, retromolar areas and soft palate
A white keratotic change on the palate due to heat, is not premalignant and has Punctate red centers are because of minor salivary glands is likely what?
Nicotine Stomatitis
*Reverse Smoking looks similar and is potentially malignant
What common cutaneous premalignant lesion caused by cumulative UV radiation results in scaly, irregular plaques?
Actinic Keratosis
*Usually over 40 yrs old, approx. 10% will progress to SCCA in 2 yrs
What common premalignant alteration of the lower lip vermilion results from long-term exposure to UV light?
Actinic Cheilosis
*Usually Induration (firm to the touch), Thickening (leukoplakia), and Ulceration
What syndrome is associated with iron-deficiency and has an increased risk for SCC?
Plummer-Vinson Syndrome
What are the 4 most common sites of intraoral SCC?
1-Tongue (Posterior lateral or ventral)
2-Floor of mouth
3-Soft palate
4-Gingiva
How does metastatic SCC typically spread?
Lymphatics
What are 4 descriptors for the way involved cervical lymph nodes will present?
1-Firm to stony hard
2-Painless
3-Enlarged
4-Fixed
What staging system is used as the best indicator of patient prognosis?
TNM system
*guides treatment for intraoral carcinoma
