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ORAL PATHOLOGY! > Exam 3-Leukoplakia & Erythroplakia > Flashcards

Exam 3-Leukoplakia & Erythroplakia Flashcards

1
Q

What is a clinicaly descriptive term for a white patch or plaque that won’t rub off and which can’t be diagnosed as any specific condition

A

leukoplakia

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2
Q

Whats the term for REVERSIBLE hyperkeratosis from a physical irritant? *It is NOT a cause of leukoplakia!! * NOT pre-malignant

A

Frictional Keratosis

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3
Q

What is the MAJORITY of leukoplakia caused by?

A

TOBACCO

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4
Q

What is the name for WHITE coloration on the PALATE of a smoker with small red macules? IS it pre-malignant? WHAT are the small red macules from?

A

STOMATITIS NICOTINA…..NOT pre-malignant…red from inflamed ducts

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5
Q

Histologically, 80% of leukoplakia can be described as one of these three….

A

1.hyperPARAkeratosis 2.hyperORTHOkeratosis 3.A-canth-osis

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6
Q

Histo: what is an increased amount of “more nucleated” keratinized cells on the surface of the epithelium?

A

hyperPARAkeratosis

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7
Q

Histo: what is an increased amount of “more mature/non nucleated” keratinized cells on the surface of the epithelium?

A

hyperORTHOkeratosis

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8
Q

Histo: what is the term for an increase in thickness of epithelium?

A

A-Canth-osis (latin-thorny evergreen tree lol)

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9
Q

ummm how much of leukoplakia will display as hyperparakaratosis/hyperorthokeratosis/acanthosis again??

A

80%

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10
Q

What % of histologic samples of leukoplakia will show EPITHELIAL DYSPLASIA (carcinoma in situ)?

A

17%

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11
Q

What % of histologic samples of leukoplakia will show superficially INVASIVE squamous cell carcinoma?

A

3%

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12
Q

What is the process the epithelium goes through prior to becoming malignant?

A

epithelial dysplasia (carcinoma in situ)

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13
Q

WHAT IS THE HISTOLOGIAL HALLMARK of epithelial dysplasia?

A

PleoMorphism (cells have many different shapes)

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14
Q

Besides the hallmark of epithelial dysplasia in a histo sample, please name 3 other important markers…

A
  1. increased/abnormal mitosis 2. increased nuclear/cytoplasmic ratios 3.hyperChromatism
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15
Q

Interesting….A single incisional biopsy of leukoplakia will underdiagnose ___% of the time

A

30%

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16
Q

Interesting….if we take 2 biopsies from a leukoplakia lesion our % missed diagnosis goes to ___%

A

12%

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17
Q

Interesting….if we take 3 biopsies from a leukoplakia lesion our % missed diagnosis goes to ___%

A

2.4%

18
Q

What are the three areas of the oral cavity most at risk for leukoplakia? What are the % chance of dysplasia/invasion of each location?

A

1.Floor of Mouth/VENTRAL TONGUE (Freggin 50%) 2.Lateral border of the tongue (25%) 3.Lower Lip (actinic keratosis) (35%)

19
Q

What is the term for when the vermilion becomes atrophic and blends with skin, variably white ± erosion ± crusting?

A

Actinic Keratosis (or leukoplakia of the lower lip)

20
Q

NON-homogenous leukoplakia is __-__% dysplastic/invasive

A

50-80%

21
Q

Areas of redness, ulceration, pebbly or verrucous surface describe a leukoplakia lesion that is defined as:

A

NON-homogeneous

22
Q

What is the RARE form of PROGRESSIVE leukoplakia that is characterized by progression, multifocality, verrucous morphology, RECURRENCE after excision, progression to SCC and DEATH??

A

PVL-Proliferative Verrucous Leukoplakia

23
Q

OVERALL: What % of leukoplakia has a chance for malignant transformation???

A

4-6%

24
Q

OVERALL: What % of leukoplakia will transform to malignancy if DYSPLASTIC?

A

15%

25
Q

What % of leukoplakia will transform to malignancy if NOT dysplastic?

A

1-3.5%

26
Q

What is the recurrence rate for someone who has overcome oral cancer?

A

10-40%

27
Q

Hmm…what is a red patch which can’t be diagnosed as a specific condition….Its a clinically descriptive term considerably LESS common than leukoplakia

A

erythroplakia

28
Q

Where is erythroplakia most likely to show up in the oral cavity?

A

the high risk sites (1.FOM/VenTongue 2.LatTongue 3.LowerLip)

29
Q

Histologically, what % of erythroplakia shows dysplasia/carcinoma in situ?

A

100% of the time…HOLY SHIT

30
Q

Most early ASYMPTOMATIC oral carcinomas are ____ or ____ AND ______ lesions.

A

red or red AND white

31
Q

How do you treat a non-dysplastic erythroplakia lesion? (like 0% of the time)

A

modify the risk factors and watch it (happens like 0% of the time)

32
Q

If an erythroplakia lesion is considered have mild to moderate dysplasia, what is the treatment?

A

modify the risk factors and MAYBE or MAYBE NOT excise it

33
Q

If an erythroplakia lesion is considered have severe dysplasia, what is the treatment?

A

modify the risk factors AND EXCISE

34
Q

When we say tx for erythroplakia is modifying the risk factors….how much of it is resolved with SMOKING tobacco cessation?

A

50% of the time its resolved

35
Q

When we say tx for erythroplakia is modifying the risk factors….how much of it is resolved with SPIT/TOPICAL tobacco cessation?

A

95% of the time the lesion is resolved!

36
Q

He powered thru this in the lecture, not sure how important it is…premalignant conditions:

A

A. SIDE-RO-PENIC dysphasia B. subMucous Fibrosis C. LICHEN PLANUS (most likely NOT pre-malignant) D. Immunosupression

37
Q

Which “pre-malignant” condition is CONTROVERSIAL because the risk is debatable….many cases represent MISDIAGNOSED cases of dysplasia

A

Lichen Planus

38
Q

What are the 4 types of epithelium?

A

Squamous, cuboidal, pseudostratified, columnar

39
Q

Which contains nuclei: ortho or parakeratin

A

parakaratin (ortho no nuclei)

40
Q

white plaque that cannot be wiped off and cannot be characterized
clinically as any other disease

A

Leukoplakia

ORAL PATHOLOGY! (40 decks)

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