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Oral Path I > Fibrous CT Proliferations > Flashcards

Fibrous CT Proliferations Flashcards

1
Q

what is the MOST COMMON hyperplastic growth of the oral cavity?

A

irritation fibroma

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2
Q

how do irritation fibromas form?

A

chronic irritation (chronic low grade inflammation)

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3
Q

what is the most common location of an irritation fibroma?

A

lateral borders of tongue & buccal mucosa (cheek)

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4
Q

how to you treat irritation fibromas?

A

excision (recurrence is rare)

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5
Q

when an irritation fibroma presents on the gingiva (INTERDETNAL PAPILLA) what is it called?

A

peripheral ossifying fibroma

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6
Q

do irritation fibromas involve bone?

A

NO (they are extraosseous)

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7
Q

do peripheral ossifying fibromas involve bone?

A

YES (has focal areas of bone)

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8
Q

histological features of irritation fibromas

A

fibroblasts and extensive COLLAGEN resembling scar like tissue

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9
Q

what is the histological variant of irritation fibromas with lots of STELLATE GIANT CELLS called?

A

giant cell fibromas

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10
Q

are irritation fibromas common in children or elderly?

A

NO

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11
Q

where do peripheral ossifying fibromas arise from?

A

PDL or periosteum

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12
Q

what group of people are peripheral ossifying fibromas are more common among?

A

WOMEN (20-30 y/o)

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13
Q

how do you treat peripheral ossifying fibromas?

A

excision, MUST include PDL BASE (i.e. needs to be accompanied by SRP to ensure all sources of irritation are removed)

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14
Q

although still rare, which has a greater chance of recurrence irritation fibroma or peripheral ossifying fibroma?

A

peripheral ossifying fibroma

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15
Q

what are peripheral giant cell granulomas?

A

a VASCULAR, extraosseous (purely in soft tissue), nodule of giant cells found on the gingival or alveolar ridge

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16
Q

do peripheral giant cell granulomas have a particular affinity for a certain age group?

A

NO, can occur at any age. However, peak incidence at 30 y/o and children w/ mixed dentition

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17
Q

what might you see radiographically to help you diagnose a peripheral giant cell granuloma?

A

a SAUCERIZED radiolucency

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18
Q

what is the most common location of peripheral giant cell granulomas?

A

MANDIBLE

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19
Q

histologically peripheral giant cell granulomas look similar to what other lesions?

A
  • brown tumor of hyperthyroidism
  • Cherubism
  • central giant cell granuloma
    (histology alone is NOT diagnostic)
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20
Q

lots of HEMOSIDERIN is present in what hyperplastic CT lesion

A

peripheral giant cell granulomas

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21
Q

do peripheral giant cell granulomas involve bone?

A

NO, they are extraosseous

22
Q

how do you treat peripheral giant cell granulomas?

A

excision, STEROID INJECTIONS to reduce the size of the lesion

23
Q

if peripheral giant cell granulomas recur what might be the cause and how do you treat it?

A

recurrence may be associated to PDL INVOLVEMENT, may need to extract associated teeth

24
Q

histologically what are you likely to see in peripheral giant cell granulomas

A

GIANT CELLS (duh) and lots of HEMOSIDERIN (iron-storage complex found in blood)

25
Q

what hyperplastic CT lesions are associated with ILL-FITTING DENTURES?

A
  • inflammatory fibrous hyperplasia

- inflammatory papillary hyperplasia

26
Q

where are inflammatory fibrous hyperplasias likely to occur?

A

around the DENTURE/PROSTHESIS flange in the MX or the MN

27
Q

where are inflammatory papillary hyperplasias likely to occur

A

in the MAXILLARY PALATE (never occurs in the MN)

28
Q

what is histologically unique about inflammatory fibrous hyperplasias?

A

the epithelium ACANTHOTIC (thickened)

29
Q

how do you treat inflammatory fibrous hyperplasia?

A

small lesions may resolve with a denture adjustment, but most require excision

30
Q

what is the clinical appearance of inflammatory papillary hyperplasia?

A
  • small, red, papillary nodules on the hard palate

- palate has a “cobblestone” appearance

31
Q

how do you treat inflammatory papillary hyperplasia?

A
  • excision
  • electrocautery
  • laser surgery
32
Q

if properly diagnosed are you worried about this transforming to a malignancy?

A

NO, no malignant potential

33
Q

what malignant condition looks similar to this

A

VERRUCOUS CARCINOMA

34
Q

how can you tell the difference between verrucous carcinoma and inflammatory papillary hyperplasia?

A
  • if it is only on the hard palate (i.e. it does not extend to the alveolar ridges), then it is inflammatory papillary hyperplasia
  • extension to alveolar ridges is indicative of verrucous carcinoma
35
Q

what is hyperplastic gingivitis?

A

focal or generalized fibrous hyperplasia of marginal gingiva associated with an inflammatory response (gingiva become overgrown)

36
Q

hyperplastic gingivitis has a predilection for what group of people?

A

WOMEN

37
Q

hyperplastic gingivitis is associated with what hormonal changes?

A

pregnacy and puberty

38
Q

how do you treat hyperplastic gingivitis?

A

usually resolves with SRP

39
Q

what hyperplastic CT lesion is associated with AUTOSOMAL DOMINANT or RECESSIVE disorders?

A

hereditary gingival fibromatosis

40
Q

hereditary gingival fibromatosis is associated with what other disorders?

A

HYPERTELORISM (wideset eyes), epilepsy, mental retardation, hypertrichosis

41
Q

what drugs cause drug-induced gingival hyperplasia?

A
  • DILANTIN (anticonvulsants)
  • CYCLOSPORIN
  • NIFEDIPINE
  • oral contraceptives
  • erythromycin
42
Q

what is histologically unique about drug-induced gingival hyperplasia?

A

overlying epithelium has ELONGATED RETE RIDGES

43
Q

what are the three intermediate fibrous tissue proliferations?

A
  • desmoplastic fibroma
  • nodular facitis
  • benign fibrous histiocytoma
44
Q

what intermediate fibroblastic CT proliferation is primarily found in the MN of young patients (avg. age 14 y/o)

A

desmoplastic fibroma

45
Q

key features of desmoplastic fibromas

A
  • MN of young patients
  • AGGRESSIVE
  • DENSE COLLAGEN
  • TX MN resection
  • 25% recurrence
  • assoc. with CTTNB1 mutations
46
Q

key features of nodular fascitis

A
  • often mistaken for a malignancy (microscopically looks like SARCOMA - SPINDLE CELL FORMATION)
  • 20% recurrence
47
Q

key features of benign fibrous histiocytomas

A
  • “CARTWHEEL” accumulation of histiocytes
  • nodular swelling or radiolucency
  • 20% recurrence
48
Q

what proliferative fibrous connective tissue lesion is a malignancy?

A

fibrosarcoma

49
Q

what is fibrosarcoma?

A

malignant neoplasm of FIBROBLASTS

50
Q

key features of fibrosarcomas

A
  • MALIGNANT
  • affects ATYPICAL FIBROBLASTS
  • extraosseous and intraosseous
  • affects SOFT TISSUE > bone
  • assoc. with pain, paresthesia, bleeding
  • poor prognosis (DEATH in 5-7 yrs), 40-60% survival
  • TX: excision, radiation therapy, chemo

Oral Path I (5 decks)

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