Exam 2-Benign Neoplasms (excluding salivary gland) Flashcards
TERM: Pathologic new growth of tissue in which growth is not controlled by normal regulatory functions and which does not regress after removal of the stimulus which produced it.
Neoplasm
Neoplasm: Pathologic new ______ of tissue in which growth is not controlled by normal regulatory functions and which does not ______ after removal of the stimulus which produced it.
Growth…regress
Clinically can usually tell if a tumor (neoplasm) is of ________ or mesenchymal origin and whether it is benign or malignant.
epithelial
What are the two types of Epithelial neoplasms?
HPV, and KA(Kerato-acanth-oma)
What are the three types of neoplasms seen that have HPV origin?
1.Papilloma 2.Verruca Vulgaris (common wart) 3.Condyloma Acuminatum (vernerial warts)
ALL EPITHELIAL neoplasms, of EPITHELIAL origin, caused by HPV……are _______ tumors and are treated by removal
benign
What type of EPITHELIAL neoplasm has clinical and histological features similar to SKIN CANCER (squamous cell carcinoma), but are considered reactive, not neoplastic.
Kerato-A-Canthoma (KA)
Since these often resemble skin cancer, _________’s are usually at sun exposed areas of the head and neck
kerato-a-canthoma’s
Kerato-a-canthoma’s are typically in ______ aged patients, and only ___% are on or in the oral cavity.
older…10%
hmmmm what is this describing? Rapid growth, often UMBILICATE with ROLLED borders…Natural history: Involution and healing.
kerato-a-canthoma
How do you clinically tell if a benign neoplasm is mesenchymal? most look IDENTICAL clinically and present as asymptomatic, slowly growing ________ masses
SUBMUCOSAL
What are the 3 types (what tissue types?) of benign neoplasms?
Connective, Muscle, Nervous
What are the 3 types of Connective Tissue mesenchymal benign neoplasms?
1.Fibroma 2.Lipoma 3.Verru-ci-form Xanthoma
What is the most common benign, mesenchymal, connective tissue neoplasm?
A fibroma
What is a benign neoplasm of FAT, may appear yellowish, very common in skin, less so ORALLY?
Lipoma
WTF!??! What is a reactive lesion with predilection for the HARD PALATE or GINGIVA?? Most common ORALLY but reported on skin and genitals….
VX….Verru-ciform Xanthoma
(verrucous, “verruciform”) is just a fancy way of saying something has a WHAT?
surface irregularity
A verrucifom xanthoma will change color from pink to _______
white
Who’s histology?? Epithelium displays papillary hyperplasia. Connective tissue papillae contain phagocytic cells which have engulfed lipid (xanthoma cells)
Verrucifom Xanthoma
What are the four types of benign neoplasms of the MUSCLE?
1.Leiomyoma (smooth muscle) 2.Rhabdomyoma (skeletal muscle) 3.Granular cell tumor 4. Congenital Epilus of the newborn
Where is the most common site of a liomyoma?
the uterus
What is the frequency of leiomyoma in the oral cavity? They can be reddish to ______…
rare….purple
Where is the most common site of a rhabdomyoma?…Its RARE in the oral cavity, but if it does occur there…WHERE does it show up?
the heart….the tongue
Originally thought to arise from muscle (granular cell myoblastoma) now thought to be of nerve origin, possibly sheath….WHAT THE F?
Granular Cell Tumor (benign)
A granular cell tumor is most likely from nerve origin, esp the _______
sheath
What is the most common site for a granular cell tumor?
tongue
Is a granular cell tumor freely movable or fixed?
fixed
Histology of a Granular Cell Tumor: Large WHAT SHAPE? cells with granular cytoplasm, about 1/2 cause overlying epithelium to react in a pattern that simulates ________ called pseudoepitheliomatous hyperplasia (PEH)
polygonal… carcinoma
What is the name for a congenital tumor of the anterior alveolar ridge?
Congenital Epilus of the Newborn
Which arch is more likely to see Congenital Epilus of the Newborn? Which sex?
Maxilla (2:1)….Females (freggin 8:1)
Histo of Congenital Epilus of the Newborn-Identical cells to granular cell tumor but cells don’t react to WHAT TYPE OF markers for nerve, No PEH (WHAT DOES THIS MEAN AGAIN??!)….May regress if incompletely “excised”
Immunohistochemical…(PEH..pseudo-epithiomatis-hyperplasia)
TERM: not neoplasm but aberration of healing following trauma…..Mass of tangled regenerating nerve in scar tissue
Traumatic Neuroma
Where are the two most common locations for a Traumatic Neuroma?
1.borders of the tongue 2.lower lip at mental foramen (PAIN ON PALPATION)
Is there pain associated with Traumatic Neuroma?
YES, on PALPATION
What is a Benign neoplasm occurring in a nerve and composed of Schwann cells, axons and fibrous tissue?
A NeuroFibroma
A Neurofibroma Can occur in most tissues and organs of body, including ________, soft tissue and bone, most HAVE WHAT SYMPTOMS?
oral cavity…asymptomatic
Neurofibromatosis is also called…
Von Recklinghausens Disease of Skin
What is condition of neuroectoderm ranging from simple skin pigmentation to widespread involvement of central and peripheral nervous system. 1/2 inherited as autosound dominant trait, other 1/2 somatic mutations. (Gene for most on chromosome #17)
Neurofibromatosis: Von Recklinghausens Disease of Skin
What is a nearfibromatosis of the eye? (Axillary freckling, pigmentary defects of iris)
LISCH Spots
___-___% of patients develop malignancy in their neurofibromas.
1-5%
Benign encapsulated neural neoplasm arising WITHIN the sheath or neurilemma of a peripheral nerve
Neurilemmoma (Schwannoma)
Antoni A Schwannoma = _______ areas of replicated basement membrane material surrounded by Schwann cell nuclei
Acellular
Haphazardly arranged spindled Schwann cells in
loose stroma =
Antoni B Nerilemmoma (Schwannoma)
Melanotic _________ tumor of infancy: Neural crest tumor occurring almost exclusively in _____ but does occur in
extragnathic sites.
neuroectodermal…jaws
Melanotic neuroectodermal tumor of infancy: which age range and area are most affected?
1 year old, maxillary
What is the immunohistochem marker found in neuroectodermalMelanotic neuroectodermal tumor of infancy???
VMA (VanilyMandelic Acid) found in blood and urine
Even with aggressive cutarage, Melanotic neuroectodermal tumor of infancy has a recurrence rate of __-___%
10-20%
Multiple Endocrine Neoplasia Type 3 (MEN 3): 95% of patients with mutation of _____ gene, a proto-oncogene on chromosome ___.
RET…10
Multiple Endocrine Neoplasia Type 3 (MEN 3): 50% - inherited as WHAT KIND OF GENETIC problem?
autosomal dominant
If half of Multiple Endocrine Neoplasia Type 3 (MEN 3)’s are inherited as AD- how do the other half occur? (hint 3 ways)
somatic mutations…a. Mucosal neuromas (predates other tumors) b.Medullary carcinoma of thyroid c. Pheochromocytoma of adrenal medulla
Treatment of most benign mesenchymal tumors is _______.
excision
