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Opath 2 Midterms > Fibro-osseous Lesions > Flashcards

Fibro-osseous Lesions Flashcards

1
Q

A diverse group of processes that are characterized by replacement of normal bone by fibrous tissue containing a newly formed mineralized product

A

Fibro-osseous lesions

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2
Q

Fibro-osseous lesions of the jaw: entities most commonly include

A

Ossifying fibroma
Fibrous dysplasia
Cemento osseous dysplasia
Periapical/focal
Florid

Chronic osteomyelitis

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3
Q

Composed of a fibrous connective tissue stroma in which new bone is formed, it is classified as one of the benign fibrous-osseous lesions of the jaw

A

Ossifying fibroma

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4
Q

Uncommon lesion that tends to occur during the 3rd and 4th decades of life.

Women > men

A

Ossifying fibroma

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5
Q

Generally a slow growing, asymptomatic and expansile lesion.

May be seen in jaws, anterior cranial fossa, craniofacial bones

A

Ossifying fibroma

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6
Q

An ossifying fibroma that occus in younger pstient (children)

A

Juvenile ossifying fibroma

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7
Q

Important radiographic features of ossifying fibroma

A

Well-circumscribed

Sharply defined borders

Generally expansile profile

Well-circumscribed radiolucency or mixed radiolucency

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8
Q

Two variants of ossifying fibroma that occur in younger patient

A

Juvenile trabecular ossifying fibroma (JTOF)

Juvenila psammomatoid ossifying fibroma (JPOF)

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9
Q

Ossifying fibroma variant that is characterized by progressive and sometimes rapid growth but rarely painful.

A

Juvenile trabecular ossifying fibroma

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10
Q

A variant of OF that radiographically, shows a defined border and can range from radiodense to radiolucent.

A

Juvenile trabecular ossifying fibroma

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11
Q

A variant if OF that microscopically, has a high cellular and contains trabeculae or spheroids of new bone

A

Juvenile trabecular ossifying fibroma

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12
Q

Extragnathic craniofacial bone location of juvenile psammomatoid ossifying fibroma

A

Paranasal sinuses
Periorbital bones

Where it can cause exophthalmos, proptosis, sinusitis and nasal symptoms

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13
Q

Juvenile psammomatoid ossifying fibroma occurs principally in ___ craniofacial bones

A

Extragnathic cranofacial bones

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14
Q

A variant form of OF that microscopically, is formed by cellular stroma containing small, rounded calcifications.

A

Juvenile psammomatoid ossifying fibroma

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15
Q

Treatment for ossifying fibroma

A

Surgical excision or curretage

Resection if shows an aggressive behavior

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16
Q

Dd of ossifying fibroma

A

Fibrous dysplasia
Osteoblastoma
- younger age, pain
- osteoblasts (++)
- central nidus

Periapical cemento osseous dysplasia
- (+) posterior teeth
- needs biospy confirmation

Focal osteomyelitis
- inflammation and pain

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17
Q

Ossifying fibroma is clinically, microscopically identical to ?

A

Cementifying fibroma aka cemento ossifying fibroma

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18
Q

Composed of fibrous connective tissue with well-differentiated, spindled fibroblasts.

A

Ossifying fibroma

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19
Q

Bone is immature and often surrounded by osteoblasts.

Osteoclasts are infrequently seen

A

Ossifying fibroma

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20
Q

Why does ossifying fibroma and fibrous dysplasia a primary diagnostic challenge in distinguishing them both?

A

They may exhibit similar clinical, radiographic and microscopic features.

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21
Q

The most helpful feature in distinguishing fibrous dysplasia and ossifying fibrous is?

A

OF is well-circumscribed. Well-defined appearance is evident.

And the ease with which it can be separated from normal bone

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22
Q

What gene does fibrous dysplasia have but ossifying fibroma doesn’t have?

A

GNAS 1a gene

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23
Q

Most commonly presents as an asymptomatic, slow enlargement of single/several bone

A

Fibrous dysplasia

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24
Q

Fibrous dysplasia that is used to describe the process in one bone

A

Monostotic fibrous dysplasia

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25
Q

Fibrous dysplasia that applies to cases in which more than one bone is involved.

A

Polyostotic fibrous dysplasia

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26
Q

Which is more common. Polyostotic or monostotic fibrous dysplasia?

A

Monostotic fibrous dysplasia (80%) of cases

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27
Q

When fibrous dysplasia maxillary lesion that may extend to involve the maxillary sinus, zygoma, sphenoid bone and floor of the orbit. This is now referred to as?

A

Craniofacial fibrous dysplasia

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28
Q

Maxilla > mandible for fibrous dysplasia. But, if lesion is in mandible, the most common occurrence is where?

A

Body of the mandible

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29
Q

Onset of fibrous dysplasia

A

First or second decade of life

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30
Q

Gender predisposition of mono and poly fibrous dysplasia

A

Monostotic = gender prediection

Polystotic = more common in female

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31
Q

Radiographic appearance of fibrous dysplasia

A

Radiopaque that imparts a “ground glass” or “peau d’orange” effect

32
Q

How many radiographic patterns is fibrous dysplasia have?

A

Radiolucent to radiopaque mass
1. Ground glass effect
2. Unilocular or multilocular radiolucency - in long bones
3. Mottled radiolucent and radiopaque appearance - long standing disease

33
Q

Aside ffrom ground glass effect seen in radiographic features of fibrous dysplasia. What are the other radiograph features to support that the lesion is a fibrous dysplasia?

A

Fingerprint bone pattern

Superior displacement of the mandibular canal in mandibular lesions

34
Q

An important distinguishing feature of fibrous dysplasia

A

Poorly defined radiographic and clinical margins of the lesion

35
Q

Normal medullary bone is replaced by an abnormal fibrous connective tissue proliferation in which new, nonmaturing bone is formed

A

Fibrous dysplasia

36
Q

Lab findings in fibrous dysplasia for monostotic and polyostotic

A

Mono = Serum calcium, phosporus, alkaline phosphatase are normal

Polyostotic (McCune-Albright syndrome) = altered

37
Q

DD of fibrous dysplasia

A

Ossifying fibroma
Chronic osteomyelitis
- inflammation, tenderness, pain
Malignancy (osteosarcoma)

38
Q

Treatment for fibrous dysplasia

A

Though growth, it stabilizes

Surgical recontouring for large lesions that causes functional deformity

RANKL medications - to improve pain and bone density

39
Q

A type of fibrous dysplasia that can cause malignant transformation, though less than 1% of cases

A

Polyostotic type of fibrous dysplasia

40
Q

% of regrowth in fibrous dysplasia

A

25%

41
Q

Unusual response of Periapical bone and cementum to some undetermined local afactori

A

Periapical cemento-osseous dysplasia

42
Q

3 types of cemento osseous dysplasia

A

Periapical COD
Focal COD
Florid COD

43
Q

Characterized by the replacement of normal bone with a collagenous matrix containing trabecular of immature bone and in some instances, cementum-like material

A

Cemento osseous dysplasia

44
Q

Uncommon primary lesion of bone that arises in maxilla or mandible

It is a benign neoplasmof undetermined cause

A

Osteoblastoma

45
Q

A lesions that Clinically and histologically, they may be confused with osteosarcoma

A

Osteoblastoma

46
Q

CM in diameter for osteoblastoma and steoid osteoma

A

Osteoblastoma = larger than 1.5cm in diameter

Osteoid osteoma = 1.5cm or less

47
Q

Common location of osteoblastoma

A

Most often in vertebrae and long bones

Less in jaws

48
Q

Common location of osteoblastoma if located in the jaw

A

Posterior tooth bearing regions of maxilla and mandible

49
Q

Age for osteoblastoma

A

Second decade

90% appears before age of 30

50
Q

Gender predilection of osteoblastoma

A

2:1
Male , female

51
Q

Radiographic feature of osteoblastoma

A

Well circumscribed and have a lytic to mixed lucent-opaque pattern

52
Q

A constant feature of osteoid osteoma that may be absent in osteoblastoma

A

Sclerosis of perilesional bone

53
Q

Composed of irregular trabecular of osteoid and immature bone within a stroma containing a prominent vascular network

A

Osteoblastoma

54
Q

DD of osteoblastoma

A

Cementoblastoma
Ossifying fibroma
Fibrous dysplasia
Osteosarcoma

55
Q

Treatment for osteoblastoma

A

Conservative surgical approach (curettage or local excision)

56
Q

Associated with gardner’s syndrome
Consists of mature, compact, or cancellous bone.

A

Osteoma

57
Q

Osteoma that arise on the surface are called ___
Osteoma that develop centraly within bone ___

A

Periosteal osteoma

Endosteal or solitary central osteoma

58
Q

Age and gender predilection of osteoma

A

2nd to 5th decade of life

Male > female

59
Q

An osteoma that clinically presents as asymptomatic, slow-growing, bony, hard masses.

A

Periosteal osteoma

60
Q

An osteoma that occurs within the medullary bone and may be discovered during routine radiographic exam as dense, well-circumscribed radiopacities

A

Endosteal osteomas

61
Q

70% of cases located within the mandible

A

Osteoma

62
Q

Symtpoms associated with these tumor .

Headaches, recurrent sinusitis, ophthalmologic complains

A

Osteomas

63
Q

Inherited as an autosomal-dominant disorder, is characterized by intestinal polyposis, multiple osteomas, fibromas of the skin, epidermal and trichilemmal cysts, impacted permanet and supernumerary teeth and odontomas

A

Gardner syndrome

64
Q

Genetic defect is gardner syndrome is found in?

A

Small region on the long arm of chromosome 5 (5q21)

Where the familial adenomatous polyposis (APC) gene resides

65
Q

Intestinal polyps associated with gardner syndrome are commonly located in the __ and __

A

Colon and rectum

66
Q

Two distinct histologic variant of osteoma

A
  1. Composed of relatively dense, compact bone with SPARSE marrow tissue.
  2. Lamellar trabecular of cancellous bone with ABUNDANT fibrosis-fatty marrow
67
Q

Osteoblasts may be numerous, but osteoclasts are sparse

A

Osteoma

68
Q

DD of osteoma

A

Exostosis
Osteoblastoma/osteoid osteoma
Odontoma, cemenoblastoma, condensing osteitis, focal sclerosing osteomyelitis

69
Q

Developmental

  1. Single/multiple bone
  2. Max > mndi
  3. Slow, painless swelling
  4. Polyostotic; syndromes (mccune albright syndrome)
A

Fibrous dysplasia

70
Q

Most common: tooth bearing areas

  1. Mid-aged female, asymptomatic
A

Cemento osseous dysplasia

71
Q

Neoplasm

  1. 20-30 years old: female
  2. Mandi < max
  3. Small: asymptomatic
  4. Large: painless swelling
A

Ossifying fibroma

72
Q

Mode of ossification of bone

A

Intramembranous ossification

73
Q

Darker purple stain indicates?

A

Immature bone or woven bone

74
Q

In this lesion, the bone is predominantly woven

Bony trabeculae assume irregular shapes likened to chinese characters

A

Fibrous dysplasia

75
Q

Composed mostly of lamellar bone, compact or trabecular, in which osteoblasts and osteoclasts are usually inconspicuous

A

Osteoma

Opath 2 Midterms (6 decks)

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