Granuloma & Lipoma Flashcards
What is pyogenic granuloma?
Common tumor-like growth of the oral cavity that traditionally has been considered to be non-neoplastic in nature
Are pyogenic granulomas related to infection?
Once through to be caused by pyogenic prganisms but now believed to be unrelated to infection
pyogenic granulomas are a response to what?
Exuberant response to local irritation or trauma
Are pyogenic granulomas a true granuloma?
NO
Clinical presentation of pyogenic granulomas
Smooth or lobulated mass that is usually pedunculated though some are sessile
Surface is characteristically ulcerated and ranges from pink to red to purple depending on age of lesion
How do young pyogenic granulomas appear?
highly vascularized appearance (red)
How do collagenized pyogenic granuloma lesions appear?
collagenized and pink
Are pyogenic granulomas painful?
Painless
Do pyogenic granulomas bleed easily?
Yes because its extremely vascularity
Where do pyogenic granulomas often occur in the mouth?
gingiva
What population often develops pyogenic granulomas?
pregnant women
What are epulis granulomatosis?
hyperplastic growths of granulation tissue that sometimes arise in healing extraction sockets
Lesion resembles pyogenic granulomas and usually represent a granulation tissue reactrion to bony sequestra in the pocket
What is the histpathologic appearance of pyogenic granulomas?
Highly vascular proliferation that resembles granulation tissue
Contains numerous small and larger endothelium-lined channels engorged with RBCs
Vessels sometimes are organized in lobular aggregates
Exophytic mass of granulation like tissue with an ulcerated surface
Lobular endothelial proliferation in the deeper CT
Tx for pyogenic granulomas
conservative surgical excision is usually curative
For gingival lesions, the excision should extend down to the periosteum and the adjacent teeth should be thoroughly scaled to remove any source of irritation
Is there recurrence after pyogenic granuloma removals?
lesion can recur and re-excision is necessary
What is a peripheral giant cell granuloma?
relatively common tumor-like growth in the oral cavity
Not a true neoplasm but a reactive lesion caused by local irritation or trauma
Where in the oral cavity do peripheral giant cell granuloma exclusively occur?
gingiva and edentulous alveolar ridge
What is the appearance of peripheral giant cell granuloma?
Red or red-blue nodular mass
Histopathologic appearance of peripheral giant cell granuloma
Nodular proliferation of multinucleated giant cells within the gingiva
Giant cells reside within a hemorrhagic background of ovoid and spindle shaped mesenchymal cells
Tx of peripheral giant cell granuloma
local surgical excision down to underlying bone
adjacent teeth should be carefully scaled down to remove any source of irritation and to minimize the ris kof recurrence
what % of peripheral giant cell granuloma excisions undergo recurrence?
10%
What is a lipoma?
Benign tumor of fat
Most common mesenchymal neoplasm
What is the pathogenesis of lipoma?
Uncertain but appear more common in the obese
Is metabolism of lipomas dependent of normal body fat?
No, metabolism of lipomas is completely independent of normal fat
Do lipomas commonly occur in the oral and maxillofacial region?
No, less frequent
Where do lipomas most often occur?
Trunk and proximal portion of the extremities
Clinical appearance of oral lipomas?
Oral lipomas are usually soft, smooth-surfaced, yellow nodular masses that can be sessile or pedunculated
When do some buccal lipomas not represent true tumors?
Some buccal cases may not represent true tumor but rather herniation of the buccal fat pad through the buccinator muscle which may occur after local trauma in young children or subsequent to surgical removal of 3rd molars in older pts
What is the histopathologic appearance of lipomas?
Composed of mature fat cells that look like the surrounding normal fat
Tumor is well-circumscribed and may demonstrate a thing fibrous capsule
Distinct lobular arrangement of cells
Central cartilaginous oro sseous metaplasia may occur
Tx for lipoma
Conservative local excision
Recurrence is rare
