Final Revision Flashcards
How is Squamous Papilloma caused:
HPV 6 and 11 infection
From which other disease is difficult to distinguish Squamous Papilloma from?
verruca vulgaris, condyloma acuminatum, verruciform xanthoma, or multifocal epithelial hyperplasia
Verruca Vulgaris (Common Wart):
caused by:
most often in which people:
- HPV 2
- Is contagious and can spread to other parts of a person’s skin or mucosa
- Most often arises in children
SOS
Condyloma Acuminatum (Veneral Wart):
=
caused by:
how is transmitted?
which people?
=is an HPV virus of stratisfied squamous epithelium
- HPV 6 and 11
- sexually transmitted disease
- anogenital region, mouth, and larynx
- anogenital condylomata infected with HPV 16 or 18
- Is usually seen in immunocompromised patients
SOS
Histopathologic Features of Condyloma Acuminatum (Veneral Wart):
- multiple pieces of soft tissue composed of papillary surface epithelium with an underlying fibrous CT core
- the spinous layer has cells with empty looking cytoplasm and small nuclei consistent with koilocytes
Keratoacanthoma is caused by:
sun damage, tar exposure, HPV, immunosuppression, certain drugs, tattooing, and burns or trauma
Inflammatory Papillary Hyperplasia:
=
caused by?
- reactive tissue growth
- in maxilla
Due to:
• Ill-fitting denture
• Poor denture hygiene
• Wearing the denture 24 hours a day
Inflammatory Papillary Hyperplasia - Clinical Features:
where does it occur?
symptomatic or not
- early lesions may involve only the PALATAL VAULT, although advanced cases cover most of the palate
- asymptomatic
Verruciform Xanthoma probably represents an:
unusual reaction or immune response to localized epithelial trauma or damage
Clinical Features of Verruciform Xanthoma:
- on the gingiva and alveolar mucosa
- well-demarcated lesion
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What is the most common benign salivary neoplasm?
a. mucocele
b. ranula
c. warhin’s tumor
d. none of the above
d. none of the above
answer: pleomorphic adenoma
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What is the most common malignant neoplasm?
mucoepidermoid carcinoma
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What is the most common side for major salivary gland tumors? (in general)
parotid
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What is the most common intraoral side for minor salivary gland tumor?
palate
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Bilateral parotid glands are most likely in what type of benign tumors?
warthin tumors
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Older females and salivary gland in upper lip most likely will be?
What benign neoplasm is most likely to appear in the upper lip?
canalicular adenoma
- is most often in OLDER females
- may also be a basal cell adenoma
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Association pain due to perineural invasion what is the first malignant neoplasm that comes in mind?
adenoid cystic carcinoma (ACC)
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If the tumor is ulcerated or is in palate/parotid gland and we have facial nerve paralysis or weakness this tumor is always: benign or malignant?
Malignant until proven otherwise
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What is the most common malignancy in children? (salivary gland)
Where?
mucoepidermoid carcinoma
-in parotid gland most common
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Which malignant salivary neoplasm is almost exclusively a tumor of the minor salivary glands?
/ Minor salivary gland, only seen on palate, painless, or can erode the underlying bone - we are talking about:
Polymorphous low grade adenocarcinoma (plga)
-exclusively on minor salivary gland
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Differential diagnosis depends/based on:
the SITE of the tumor and the clinical FEATURES
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If there is a tumor in the palate and overlying mucosa is ulcerated and the ulceration is not related to trauma or biopsy the mass is malignant or benign?
malignant until proven otherwise
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If there is a tumor in the parotid gland WITHOUT any facial nerve paralysis or weakness the first in mind will be:
If there is a tumor in the parotid gland WITH facial nerve paralysis or weakness the first in mind will be:
Which malignant tumor is not in parotid gland:
benign neoplasms (ex: pleomorphic adenoma, warthin tumor or basal cell adenoma) and secondly: malignant tumor such as neuroepidermoid carcinoma low graded
mucoepidermoid carcinoma high graded (1st) b/c of its propercity to appear in parotid gland and (2ndly) carcinoma ex pleomorphic adenoma, acinic cell carcinoma, MASC of coarse
polymorphous low grade adenocarcinoma
SOS
If the tumor appears in the upper lip you can have in mind which types of tumors?
canalicular adenoma basal cell adenoma (can occur in upper lip but most commonly in parotid gland) plga acinic cell carcinoma MASC
=>pleomorphic adenoma(uncommon in upper lip)
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A tumor in the parotid gland is most likely to be benign or malignant?
benign
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A tumor in submandibular and sublingual gland is most likely to be benign or malignant?
malignant
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Which type of tumor is most likely for older smoking males with bilateral parotid gland to have?
warthin tumors
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If the tumor is in palate and has an intact mucosa, what type of tumor is it?
benign salivary gland neoplasm
-> pleomorphic adenoma
low grade b/c of intact mucosa
you can also consider acinic cell carcinoma and plga and also non-salivary gland tumors like non-Hodgkin’s lymphoma and other benign neural tissue tumors like neurofibroma
Warthin tumor:
- exclusivelly in parotid gland
- occurs billaterally
- most common in: older men who smoke
- painless
- will not be present in the deep lobe of the parotid gland or in an oral site
What imaging test would be most appropriate for a woman presented with a firm, expanding mass of one of her parotid glands?
ultrasound, but computed tomography is an
alternative first-line imaging to ultrasound
For what type of salivary gland disease is MRI particularly effective?
- Magnetic resonance imaging (MRI) distinguishes the water content of tissue, so is effective in diagnosing soft-tissue lesions
- MRI is especially good at differentiating between cystic and solid masses
Which is the most common location of the the most common benign salivary neoplasm??
parotid
When benign salivary neoplasms arise in the oral mucosa, which is the site of predilection?
palate and also upper lip
Which is the 2nd most common benign salivary neoplasm?
warthin
what is a leiomyoma?
= benign tumor of smooth muscle
what are the types of leiomyomas:
2 common types in oral cavity - solid or vascular
From which side of the lesion you will take a sample for incisional biopsy?
center of the tissue b/c maybe there is an information that you may lose it so include both a bit of ulcer and a bit of border
Why mucoepidermoid carcinoma sometimes appears bluish? What a blue colored MEC can be mistaken clinically for?
Mucocele
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Which is the most common location of the the most common malignant salivary neoplasm??
2nd most common?
parotid gland
palate
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Cheilitis Glandularis occurs on:
lower lip vermilion
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Cheilitis Glandularis types:
based on the severity of the disease
- Simple
- Superficial suppurative (Baelz disease) !!!!!!!!!!!!
- Deep suppurative
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Acute form of Sarcoidosis:
- Heerfordt-Waldenstrom Syndrome = Uveoparotid fever !!!!!
2. Lofgren Syndrome
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Ocular involvement is noted in sarcoidosis cases and most often appears as:
Anterior uveitis
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Intraosseous lesions cases in Sarcoidosis, most appeared as:
ill-defined radiolucencies eroding the cortex but never create an expansion
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Sarcoidosis - histopathological features:
Schaumann bodies - are degenerated
lysosomes/lesions
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Scleroderma - other name called as?
or Systemic sclerosis
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Scleroderma clinical feature:
microstomia
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Salivary Benign Lymphoepithelial Lesion:
according to Sjogren and lymphoma
lymphocyte hyperplasia of the salivary gland is not contributed to Sjogren b/c a 50% of pt with that disease do not have Sjogren, but Sjogren pts have a high possibilty of developing lymphoma
-take biopsy and other laboratory tests to rule out lymphoma
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Salivary Benign Lymphoepithelial Lesion - histopathological features:
epimyoepithelial islands show infiltration by the lymphocytic infiltrate
SOS
The most important disease to differentiate from Salivary Benign Lymphoepithelial Lesion is:
Malignant lymphoma
What is the most common type of peripheral nerve neoplasm?
Neurofibroma
Most important clinical risk factor of Sjogren syndrome is:
Salivary gland enlargement
What is Keratoacanthoma?
self-limiting, epithelial proliferation with a strong clinical and histopathologic similarity to well- differentiated squamous cell carcinoma
Squamous Papilloma - extensive coalescing papillary lesions (papillomatosis) of the oral mucosa may be seen in:
nevus unius lateris, acanthosis nigricans, focal dermal
hypoplasia (Goltz-Gorlin) syndrome, and Down
syndrome
Mucus Retention Cyst - Salivary Duct Cyst =
true developmental cyst that arises from salivary gland tissue and is lined by epithelium
Are mucoceles true cysts?
no b/c it is not lined by epithelium
- difference with the mucus retention cyst
- by the histopathologic identification of an epithelial lining rather than a lining of granulation tissue
Why is Mucus Retention Cyst a true cyst?
b/c it is lined by epithelium
What is the most common location of Necrotizing Sialometaplasia?
minor salivary glands- palate
Necrotizing Sialometaplasia can be misdiagnosed with:
squamous cell carcinoma
or
mucoepidermoid carcinoma
The most common salivary gland in Sialolithiasis is:
a. sublingual gland
b. parotid gland
c. submandibular gland
d. both a and b
c. submandibular gland
Sialolithiasis causes:
swelling of the affected gland, especially at meal- time
Sialadenitis - most common viral infection is:
mumps
Obstruction caused by:
sialolithiasis and ductal strictures
Which tests do you use for stones?
Sialography, ultrasound, and CT scanning
What other diseases cause parotid gland enlargement?
diabetes, bulimia, alcohol use
+sialolithiasis