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BDS4 Exam Revision > Extra Histology/Pathology > Flashcards

Extra Histology/Pathology Flashcards

1
Q

what is a fibrous epulis

A

pedunculated mass which may be ulcerated

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2
Q

what is histology of fibrous epulis

A

ulceration
granulation tissue
metaplastic bone formation

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3
Q

name a type of vascular epulides

A

pyogenic granuloma

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4
Q

what does histology of pyogenic granulomas show

A

vascular proliferation
oedematous cellular fibrous stroma

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5
Q

what is a peripheral giant cell lesion

A

pedunculated swelling which is dark red and ulcerated and often arises in interdental area with swellings on both buccal and lingual surfaces

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6
Q

what does a peripheral giant cell lesion show on histology

A

multi-nucleated osteoclast-like giant cells lying in a richly vascular and cellular stroma
fused macrophages make up the giant cells

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7
Q

what are peripheral giant cell lesions caused by

A

unphagocytosable material

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8
Q

what is a fibroepithelial polyp

A

firm, pink, painless, pedunculated swelling

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9
Q

what is a fibroepithelial polyp like on histology

A

dense
avascular
acellular fibrous tissue which resembles a scar with thick interlacing bundles of collagen

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10
Q

what is papillary hyperplasia

A

minor denture trauma with chronic candidiasis
pebbled palate

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11
Q

what is the histology of papillary hyperplasia

A

papillary projections with a core of hyperplastic, chronically inflamed granulation tissue
pseudo-epitheliomatous hyperplasia
proliferation and branching of rete ridges into underlying connective tissue

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12
Q

what does drug induced fibrous overgrowth look like on histology

A

collagen fibres
chronic inflammatory cell infiltration
hyperplastic epithelium and long rete ridges

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13
Q

what are haemangiomas

A

tumours (hamartoma)

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14
Q

what is sturge weber syndrome

A

congenital disorder with combination of haemangiomatous lesions of the face over one or more branches of the trigeminal nerve with convulsions affecting limbs on opposite side of body

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15
Q

treatment for chronic hyperplastic candidosis

A

systemic fluconazole once daily 14 days

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16
Q

what type of leukoplakia has the highest malignant transformation

A

proliferative verrucous leukoplakia

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17
Q

what are the hallmarks of cancer

A

self sufficiency in growth signals
evading apoptosis
insensitivity to anti-growth signals
sustained angiogenesis
limitless replicative potential
tissue invasion and metastasis

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18
Q

what is histology of pleomorphic adenoma

A

duct epithelium
myoepithelial cells, myxoid and chondroid areas

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19
Q

what is the capsule like with pleomorphic adenoma

A

variable and may/may not be complete

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20
Q

what is histology of warthins tumour

A

cystic, distinctive epithelium and lymphoid tissue

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21
Q

2 types of malignant salivary carcinomas

A

adenoid cystic carcinoma
mucoepidermoid carcinoma

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22
Q

what is a cyst

A

pathological cavity having fluid, semi-fluid or gaseous contents and which is not created by the accumulation of pus

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23
Q

what are the characteristic signs of a cyst

A

mobility
numbness
increasing in size
discolouration
loss of vitality
swelling
absence of tooth
egg shell crackling

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24
Q

what radiographs would be taken for a cyst

A

PA
occlusal
OPT
then CBCT, PA mandible and occipitomental

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25
Q

where do odontogenic cysts occur

A

tooth bearing areas

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26
Q

what lines odontogenic cysts

A

epithelium

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27
Q

what are the sources of epithelium for odontogenic cysts

A

rests of malassez
rests of seres
reduced enamel epithelium

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28
Q

most common cysts

A

radicular cyst = 60%
dentigerous cyst = 18%
OKC = 12%

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29
Q

what type of cyst is a radicular cyst

A

inflammatory odontogenic

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30
Q

cause of radicular cyst

A

non-vital tooth and chronic inflammation and pulp necrosis

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31
Q

where are radicular cysts more common

A

maxilla

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32
Q

radiological appearance of radicular cysts

A

well defined corticated margins continuous with the lamina dura of a non-vital tooth
can displace structures and cause external root resorption

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33
Q

histology of radicular cysts including cells

A

epithelial lined with connective tissue capsule inside which is filled with inflammatory infiltrate
cells include mucous metaplasia, rushton bodies, cholesterol clefts

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34
Q

what are inflammatory collateral cysts and what are the 2 types

A

inflammatory odontogenic cysts associated with vital tooth
paradental cyst and buccal bifurcation cyst

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35
Q

what type of cysts are dentigerous cysts

A

developmental odontogenic

36
Q

what are dentigerous cysts associated with

A

crown of unerupted tooth due to cystic change of the dental follicle

37
Q

where are dentigerous cysts more commonly seen

A

mandible in males

38
Q

radiological appearance of dentigerous cyst

A

corticated margins attached to CEJ and are symmetrical
displace tooth and cortical bone

39
Q

histology of dentigerous cyst

A

thin non-keratinised stratified squamous epithelium with fibrous connective tissue capsule but no inflammation

40
Q

what type of cyst is an odontogenic keratocyst

A

developmental odontogenic

41
Q

where is OKC normally seen

A

mandible of males

42
Q

radiological appearance of OKC

A

scalloped margins
may be multilocular
displacement of adjacent teeth
grows mesio-distally

43
Q

what is in a cyst aspirate biopsy of an OKC

A

low soluble protein content
squames

44
Q

histology of an OKC

A

thinly lined epithelial wall
palisading cells in basal cell layer
parakeratosis
daughter/satellite cysts
no rete pegs - easily separated

45
Q

characteristics of basal cell naevus syndrom

A

multiple OKC
multiple basal cell carcinomas
frontal and temporoparietal bossing
palmar and plantar pitting
calcification of intracranial dura mater

46
Q

what type of cyst is a nasopalatine duct cyst

A

non-odontogenic

47
Q

signs of nasopalatine duct cyst

A

salty discharge
displace teeth or cause swellings

48
Q

histology of nasoplatine duct cyst

A

variable lining with either stratified squamous of pseudostratified ciliated columnar cells
connective tissue capsule
prominent neurovascular bundles, mucous glands and inflammatory infiltrate

49
Q

radiological appearance of nasopalatine duct cyst

A

corticated margins between roots of centrals, unilocular and heart shaped

50
Q

advantages of enucleation

A

get whole lining
primary closure
not much aftercare

51
Q

disadvantages of enucleation

A

risk of mandibular fracture
old age
clot cavity can get infected
incomplete removal means recurrence
damages structure

52
Q

advantages of marsupialisation

A

not damages structures
harder to access
elderly
prevent jaw fracture

53
Q

disadvantages of marsupialisation

A

dont get the lining
opening can close
cyst reforms
hard to keep clean
takes a long time to heal
obturator needed to keep window open

54
Q

types of tissues that odontogenic tumours can form from

A

epithelial
mesenchymal
mixed

55
Q

type of tumour that ameloblastoma is

A

benign epithelial tumour

56
Q

radiological appearance of ameloblastoma

A

multicystic
well defined corticated margins
potentially scalloped
thick curved septa = soap bubble
displacement, thinning of bony cortices, knife edge external root resorption

57
Q

histological types of ameloblastoma

A

plexiform or follicular

58
Q

histology of follicular ameloblastoma

A

discrete rounded islands consisting of loosely connected angular cells resembling the stellate reticulum
surrounded by columnar/cuboidal cells resembling ameloblasts
cystic change and squamous metaplasia in stellate reticulum
fibrous tissue between cyst islands

59
Q

histology of plexiform ameloblastoma

A

tangled pattern made of the same ameloblast and stellate reticulum like cells and forming irregular masses

60
Q

management of ameloblastoma

A

surgical resection with margin

61
Q

malignant risk of ameloblastoma

A

<1% to ameloblastic carcinoma

62
Q

type of tumour that adenomatoid odontogenic tumour is

A

benign epithelial tumour

63
Q

radiographic appearance of adenomatoid odontogenic tumour

A

unilocular radiolucency with internal calcifications around crown of unerupted maxillary canine attached apical to the CEJ

64
Q

histology of adenomatoid odontogenic tumour

A

well encapsulated
columnar cells forming duct or tubule like structures
patchy calcification

65
Q

management of adenomatoid odontogenic tumour

A

enucleated

66
Q

where is calcifying epithelial odontogenic tumour usually situated

A

posterior mandible with unerupted tooth

67
Q

radiographic appearance of calcifying epithelial odontogenic tumour

A

internal radiopacities

68
Q

histology of calcifying epithelial odontogenic tumour

A

amyloid like material within epithelial sheets

69
Q

type of tumour that odontogenic myxoma is

A

benign mesenchymal tumour

70
Q

radiographic appearance of odontogenic myxoma

A

well defined thin corticated margins
multilocular with soap bubble appearance (tennis racket)
mesio-distally and scallops between teeth

71
Q

histology of odontogenic myxoma

A

stellate fibroblast like cells
separated by connective tissue (myxoid tissue)
no capsule

72
Q

type of tumour that an odontoma is

A

benign mixed tumour made of malformed dental tissue

73
Q

types of odontoma

A

compound
complex

74
Q

what leukoplakias have higher chance of malignant change

A

chronic hyperplastic candidosis
proliferated verrucous leukoplakia

75
Q

histology of chronic hyperplastic leukoplakia

A

parakeratinised
hyperplastic
acanthotic
cells separated by oedema and neutrophils
hyphae invade parakeratin
inflammatory cell infiltrate

76
Q

what is the WHO classification 2005 for grading epithelial dysplasia

A

hyperplasia
mild
moderate
severe
carcinoma in situ

77
Q

what is seen with basal hyperplasia (WHO)

A

increased basal cell numbers
regular stratification
basal compartment is larger
no cellular atypia

78
Q

what is seen with mild dysplasia (WHO)

A

architectural changes in lower third
mild atypia - pleomorphism and hyperchromatism

79
Q

what is seen with moderate dysplasia (WHO)

A

architectural changes in middle third
moderate atypia

80
Q

what is seen with severe dysplasia (WHO)

A

architectural disturbance in upper third
sever atypia
numerous mitoses which are abnormally high

81
Q

what is seen with carcinoma in situ

A

full thickness abnormal architecture
pronounced cytological atypia
malignant but not invasive

82
Q

what genes play a role in oncogenesis

A

Tp53
oncogenes
tumour suppressor genes
DNA repair genes

83
Q

hallmarks of cancer

A

self sufficiency in growth signals
evading apoptosis
insensitive to anti-growth signals
sustained angiogenesis
tissue invasion and metastasis
limitless replicative potential

84
Q

how does cancer spread to bone

A

edentulous = gaps in cortex
dentate = via PDL

85
Q

what predicts nodal spread of cancer

A

involving small nerves at the advancing edge

BDS4 Exam Revision (6 decks)

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