Extra Histology/Pathology Flashcards
what is a fibrous epulis
pedunculated mass which may be ulcerated
what is histology of fibrous epulis
ulceration
granulation tissue
metaplastic bone formation
name a type of vascular epulides
pyogenic granuloma
what does histology of pyogenic granulomas show
vascular proliferation
oedematous cellular fibrous stroma
what is a peripheral giant cell lesion
pedunculated swelling which is dark red and ulcerated and often arises in interdental area with swellings on both buccal and lingual surfaces
what does a peripheral giant cell lesion show on histology
multi-nucleated osteoclast-like giant cells lying in a richly vascular and cellular stroma
fused macrophages make up the giant cells
what are peripheral giant cell lesions caused by
unphagocytosable material
what is a fibroepithelial polyp
firm, pink, painless, pedunculated swelling
what is a fibroepithelial polyp like on histology
dense
avascular
acellular fibrous tissue which resembles a scar with thick interlacing bundles of collagen
what is papillary hyperplasia
minor denture trauma with chronic candidiasis
pebbled palate
what is the histology of papillary hyperplasia
papillary projections with a core of hyperplastic, chronically inflamed granulation tissue
pseudo-epitheliomatous hyperplasia
proliferation and branching of rete ridges into underlying connective tissue
what does drug induced fibrous overgrowth look like on histology
collagen fibres
chronic inflammatory cell infiltration
hyperplastic epithelium and long rete ridges
what are haemangiomas
tumours (hamartoma)
what is sturge weber syndrome
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
treatment for chronic hyperplastic candidosis
systemic fluconazole once daily 14 days
what type of leukoplakia has the highest malignant transformation
proliferative verrucous leukoplakia
what are the hallmarks of cancer
self sufficiency in growth signals
evading apoptosis
insensitivity to anti-growth signals
sustained angiogenesis
limitless replicative potential
tissue invasion and metastasis
what is histology of pleomorphic adenoma
duct epithelium
myoepithelial cells, myxoid and chondroid areas
what is the capsule like with pleomorphic adenoma
variable and may/may not be complete
what is histology of warthins tumour
cystic, distinctive epithelium and lymphoid tissue
2 types of malignant salivary carcinomas
adenoid cystic carcinoma
mucoepidermoid carcinoma
what is a cyst
pathological cavity having fluid, semi-fluid or gaseous contents and which is not created by the accumulation of pus
what are the characteristic signs of a cyst
mobility
numbness
increasing in size
discolouration
loss of vitality
swelling
absence of tooth
egg shell crackling
what radiographs would be taken for a cyst
PA
occlusal
OPT
then CBCT, PA mandible and occipitomental
where do odontogenic cysts occur
tooth bearing areas
what lines odontogenic cysts
epithelium
what are the sources of epithelium for odontogenic cysts
rests of malassez
rests of seres
reduced enamel epithelium
most common cysts
radicular cyst = 60%
dentigerous cyst = 18%
OKC = 12%
what type of cyst is a radicular cyst
inflammatory odontogenic
cause of radicular cyst
non-vital tooth and chronic inflammation and pulp necrosis
where are radicular cysts more common
maxilla
radiological appearance of radicular cysts
well defined corticated margins continuous with the lamina dura of a non-vital tooth
can displace structures and cause external root resorption
histology of radicular cysts including cells
epithelial lined with connective tissue capsule inside which is filled with inflammatory infiltrate
cells include mucous metaplasia, rushton bodies, cholesterol clefts
what are inflammatory collateral cysts and what are the 2 types
inflammatory odontogenic cysts associated with vital tooth
paradental cyst and buccal bifurcation cyst
what type of cysts are dentigerous cysts
developmental odontogenic
what are dentigerous cysts associated with
crown of unerupted tooth due to cystic change of the dental follicle
where are dentigerous cysts more commonly seen
mandible in males
radiological appearance of dentigerous cyst
corticated margins attached to CEJ and are symmetrical
displace tooth and cortical bone
histology of dentigerous cyst
thin non-keratinised stratified squamous epithelium with fibrous connective tissue capsule but no inflammation
what type of cyst is an odontogenic keratocyst
developmental odontogenic
where is OKC normally seen
mandible of males
radiological appearance of OKC
scalloped margins
may be multilocular
displacement of adjacent teeth
grows mesio-distally
what is in a cyst aspirate biopsy of an OKC
low soluble protein content
squames
histology of an OKC
thinly lined epithelial wall
palisading cells in basal cell layer
parakeratosis
daughter/satellite cysts
no rete pegs - easily separated
characteristics of basal cell naevus syndrom
multiple OKC
multiple basal cell carcinomas
frontal and temporoparietal bossing
palmar and plantar pitting
calcification of intracranial dura mater
what type of cyst is a nasopalatine duct cyst
non-odontogenic
signs of nasopalatine duct cyst
salty discharge
displace teeth or cause swellings
histology of nasoplatine duct cyst
variable lining with either stratified squamous of pseudostratified ciliated columnar cells
connective tissue capsule
prominent neurovascular bundles, mucous glands and inflammatory infiltrate
radiological appearance of nasopalatine duct cyst
corticated margins between roots of centrals, unilocular and heart shaped
advantages of enucleation
get whole lining
primary closure
not much aftercare
disadvantages of enucleation
risk of mandibular fracture
old age
clot cavity can get infected
incomplete removal means recurrence
damages structure
advantages of marsupialisation
not damages structures
harder to access
elderly
prevent jaw fracture
disadvantages of marsupialisation
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
types of tissues that odontogenic tumours can form from
epithelial
mesenchymal
mixed
type of tumour that ameloblastoma is
benign epithelial tumour
radiological appearance of ameloblastoma
multicystic
well defined corticated margins
potentially scalloped
thick curved septa = soap bubble
displacement, thinning of bony cortices, knife edge external root resorption
histological types of ameloblastoma
plexiform or follicular
histology of follicular ameloblastoma
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
histology of plexiform ameloblastoma
tangled pattern made of the same ameloblast and stellate reticulum like cells and forming irregular masses
management of ameloblastoma
surgical resection with margin
malignant risk of ameloblastoma
<1% to ameloblastic carcinoma
type of tumour that adenomatoid odontogenic tumour is
benign epithelial tumour
radiographic appearance of adenomatoid odontogenic tumour
unilocular radiolucency with internal calcifications around crown of unerupted maxillary canine attached apical to the CEJ
histology of adenomatoid odontogenic tumour
well encapsulated
columnar cells forming duct or tubule like structures
patchy calcification
management of adenomatoid odontogenic tumour
enucleated
where is calcifying epithelial odontogenic tumour usually situated
posterior mandible with unerupted tooth
radiographic appearance of calcifying epithelial odontogenic tumour
internal radiopacities
histology of calcifying epithelial odontogenic tumour
amyloid like material within epithelial sheets
type of tumour that odontogenic myxoma is
benign mesenchymal tumour
radiographic appearance of odontogenic myxoma
well defined thin corticated margins
multilocular with soap bubble appearance (tennis racket)
mesio-distally and scallops between teeth
histology of odontogenic myxoma
stellate fibroblast like cells
separated by connective tissue (myxoid tissue)
no capsule
type of tumour that an odontoma is
benign mixed tumour made of malformed dental tissue
types of odontoma
compound
complex
what leukoplakias have higher chance of malignant change
chronic hyperplastic candidosis
proliferated verrucous leukoplakia
histology of chronic hyperplastic leukoplakia
parakeratinised
hyperplastic
acanthotic
cells separated by oedema and neutrophils
hyphae invade parakeratin
inflammatory cell infiltrate
what is the WHO classification 2005 for grading epithelial dysplasia
hyperplasia
mild
moderate
severe
carcinoma in situ
what is seen with basal hyperplasia (WHO)
increased basal cell numbers
regular stratification
basal compartment is larger
no cellular atypia
what is seen with mild dysplasia (WHO)
architectural changes in lower third
mild atypia - pleomorphism and hyperchromatism
what is seen with moderate dysplasia (WHO)
architectural changes in middle third
moderate atypia
what is seen with severe dysplasia (WHO)
architectural disturbance in upper third
sever atypia
numerous mitoses which are abnormally high
what is seen with carcinoma in situ
full thickness abnormal architecture
pronounced cytological atypia
malignant but not invasive
what genes play a role in oncogenesis
Tp53
oncogenes
tumour suppressor genes
DNA repair genes
hallmarks of cancer
self sufficiency in growth signals
evading apoptosis
insensitive to anti-growth signals
sustained angiogenesis
tissue invasion and metastasis
limitless replicative potential
how does cancer spread to bone
edentulous = gaps in cortex
dentate = via PDL
what predicts nodal spread of cancer
involving small nerves at the advancing edge
