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Pathology I > Head and Neck Development Disorders > Flashcards

Head and Neck Development Disorders Flashcards

1
Q

what do orofacial clefts result from

A

disturbances in growth of face and oral cavity

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2
Q

what is cleft lip

A

defective fusion with the medial nasal process and maxillary process

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3
Q

what is cleft palate

A

failure of palatal shelves to fuse

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4
Q

what is the prevalance of cases in orofacial clefts

A
  • CL and CP: 45% of cases
  • CP: 30% of cases
  • CL: 25% of cases
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5
Q

what population are orofacial clefts most common in

A

native americans and asians

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6
Q

what are the causes and risk factors of orofacial clefts

A
  • genetic factors, syndromic
  • environmental factors
  • maternal alcohol and tobacco
  • anticonvulsant therapy - phenytoin 10x risk
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7
Q

what is the possible prevention of orofacial clefts

A

folic acid in prenantal vitamins

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8
Q

what are the clinical features of orofacial celfts

A

-complete CL: extends upwards into nostril
- incomplete CL: does not involve the nose
- CP: may involve hard and soft palate
- minimal manifestation: bifid uvula
- may interfere with teeth development

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9
Q

how can orofacial clefts interfere with teeth development

A
  • hypodontia
  • malformed teeth
  • bony defects
  • malocclusion `
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10
Q

what is the treatment for orofacial celfts

A
  • multidisciplianry approach
    -surgical treatment
  • prosthetic appliances
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11
Q

is there tx indicated for bifid uvula

A

no

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12
Q

what are paramedian lip pits

A

congenital invaginations of the lower lip
- autosomal dominant inheritance

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13
Q

what are the clinical features and tx of paramedian lip pits

A
  • bilateral and symmetrical fistulas on either side of midline of lower lip
  • subtle depression or prominent buldge
  • tx: none except for cosmetic reasons
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14
Q

what is Van der Woude syndrome

A

lip pits with CL and/or CP
- most common form of syndromic clefting

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15
Q

what are fordyce granules

A

ectopic sebaceous glands in oral mucosa

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16
Q

what are the clinical features and tx of fordyce granules

A
  • multiple yellow or yellow-white papules
  • buccal mucosa, vermillion of upper lip, retromolar pad, tonsillar area
  • tx: none
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17
Q

do fordyce granules require biopsy

A

no

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18
Q

what feature is necessary in histopath to identify fordyce granules

A

sebaceous lobules

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19
Q

what is the cause of leukoedema

A

unknown

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20
Q

what are the clinical feautres and tx of leukoedema

A
  • diffuse, gray-white color
  • folded, wrinkled mucosa
  • bilateral buccal mucosa
  • white appearance disappears when mucosa is stretched
    -tx: none
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21
Q

what is the differential dx for leukoedema and how do you rule out

A
  • lichen planus
  • leukoplakia
    -candidiasis
  • all ruled out when mucosa is stretched
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22
Q

is microglossia common

A

no

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23
Q

what are the clinical features and tx of microglossia

A
  • abnormally small tongue
  • may be associated with a syndrome
  • tx: depends on nature and severity. surgery and ortho
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24
Q

what is macroglossia

A
  • enlargement of tongue
  • more common than microglossia
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25
Q

what are the congenital causes of macroglossia

A
  • vascular malformations
  • lymphangioma
  • hemihyperlasia
  • down syndrome
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26
Q

what are the acquired causes of macroglossia

A
  • edentulous patients
  • amyloidosis
  • myxedema
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27
Q

what is ankyloglossia - tongue tie

A

developmental anomaly of the tongue

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28
Q

what are the clinical features and tx of ankyloglossia

A
  • short, thick frenum
  • may result in speech defects
  • may result in breast feeding difficulties
  • tx: frenectomy for functional problems
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29
Q

what is the lingual thyroid

A

normally the thyroid descends into neck anterior to trachea
- when the primitive gland does not descend normally, ectopic thyroid tissue may be found between foramen cecum and epiglottis

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30
Q

what are the clinical features of lingual thyroid

A
  • Most common in females (4x) due to hormonal influences
  • ectopic gland (70%) is often only thryoid tissue
  • range in size: small, asymptomatic, large lesions may block airway and cause dysphagia or dyspnea
  • hypothyroidism in 33%
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31
Q

how is lingual thyroid dx

A
  • thyroid scan
  • avoid excisional biopsy because may be patients only thyroid tissue
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32
Q

what is the tx for lingual thyroid

A

-periodic follow uo
- thyroid hormone replacement

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33
Q

how is lingual thyroid determined in biopsy

A

if there is iodine present

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34
Q

describe fissured tongue

A

often hereditary, may also be degenerative process

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35
Q

what are the clinical features of fissured tonuge and tx

A
  • dorsal surface grooves, furrows
  • 2-6mm in depth
  • usually asymptomatic
  • strong associated with geographic tongue
  • tx: non, encourage good OH
36
Q

what other finding is common with fissured tongue

A

geographic tongue

37
Q

what is hairy tongue

A

marked elongations of filiform papilla due to keratin accumulation

38
Q

what are the risk factors for hairy tongue

A

-smoking
- poor OH
- general debilitation
- radiation therapy
- medications

39
Q

what are the clinical features and tx of hairy ongue

A
  • dorsal tongue
  • elongated papillae usually brown, yellow or black
  • patients may complain of bad taste
  • tx: eliminate predisposing factors such as tobacco
  • oral hygiene
40
Q

how is hairy tongue dx on histopath

A

layers of keratin over epithelium

41
Q

what are varicosites

A
  • abnormally dilated or tortuous veins
  • age related degeneration
42
Q

what are the clinical features and tx for varicosites

A
  • sublingual varicosities - 2/3 of people above 60 years
  • blue- purple, elevate papular blebs- ventral and lateral tongue
  • may also occur on the lips, buccal mucosa
  • usually asymptomatic
  • tx: none for sublingual varicosites, solitary varicosities may need excision to confirm dx
43
Q

what are exostosis

A
  • localized bony protuberances arise from cortical plate
  • may be related to stresses from teeth
44
Q

what are the clinical features of tx of exostosis

A
  • observed in adults
  • buccal and palatal exostosis
  • tx: distinctive clinically, bx usually unnecessary
  • surgical removal for denture prosthesis
45
Q

what are the clinical features and tx of torus palatinus

A
  • bony hard nodule of midline suture of hard palate
  • 2:1 female
  • most common in asian and inuit
  • tx: similar to exostoses, may leave if. not causing any issue
46
Q

when would you need to remove tori or exostosis

A

when fabricating dentures

47
Q

what are the clinical and radiographic features of torus mandibularis

A
  • bony hard nodule on lingual aspect of mandible
  • 90% bilateral involvement
  • most common in premolar regino
  • most common in asian and inuit
  • radiograpj: bony nodule superimposed on teeth
48
Q

what is the tx for torus mandibularis

A

similar to exostosis

49
Q

what is stafne defect

A

-developmental defect in mandibular alveolar bone
- may contain normal salivary gland tissue
- 80-90% of males
- reported in adults

50
Q

what are the radiographic features in stafne defect

A
  • radiolucency below the mandibular canal, lingual cortical defect
  • occasionally may occur anteriorly
  • well defined, with sclerotic border
  • usually remains static over time
  • asymptomatic
51
Q

what is the tx for stafne defect

A

none

52
Q

what is a palatal cyst of the newborn and how is it formed

A
  • small developmental cysts on palate of newborn
  • may result from trapped epithelium during palatal fusion in embryogenesis
53
Q

what are the clinical features of palatal cyst of the newborn

A
  • common, may occur in 55-85% of newborns
  • most along the midline of hard or soft palate
  • appear as small white or yellow-white papules on palate
  • cysts are 1-3mm keratin filled cysts
54
Q

what is the tx for palatal cyst of newborn

A

none- they usually regress on their own after a few weeks

55
Q

describe nasopalatine duct cysts

A
  • most common developmental non-odontogenic cyst
  • arises from remnants of nasopalatine duct
  • most common in 4-6th decade of life
  • male predilection
56
Q

what are the clinical features of nasopalatine duct cyst

A
  • may exhibit swelling of anterior palate, drainage
  • occasionally painful
  • 1-2.5cm in diameterw
57
Q

what are the radiographic features of nasopalatine duct cyst

A
  • well defined RL near midline of anterior maxilla apical to central incisors
  • may be difficult to distinguish small cyst from large incisive foramen
58
Q

what is the tx for nasopalatine duct cyst

A

surgical enucleation

59
Q

what is the normal upper limit size of the incisive foramen

A

6mm

60
Q

what is the histopath presentation of nasopalatine duct cysts

A
  • classic cyst lining
  • cilia
  • glandular tissue
  • inflammation with lymphocytes
61
Q

what is an epidermoid cyst of the skin

A
  • common skin cyst, arises from the hair follicle
  • accounts for 80% of follicular cysts of the skin
62
Q

what are the clinical features of epidermoid cysts of the skin

A
  • common in acne prone regions
  • common areas: scalp, face, back
  • nodular, fluctuant subcutaneous swelling
  • unusualy before puberty unless associated with gardner syndrome
63
Q

what is the tx for epidermoid cyst of the skin

A

conservative enucleation

64
Q

what is the histopath presentation of epidermoid cyst of skin

A

cyst lining filled with keratin

65
Q

what is a dermoid cyst

A
  • developmental cystic malformation
  • lined by epidermis, with dermal adnexal structures within cyst wall
  • benign cystic form of a teratoma
  • most common in ovaries and testes
66
Q

what is a teratoma

A

developmental tumor composed of more than one germ layer - ectoderm, mesoderm or endoderm

67
Q

what is the tx for dermoid cyst

A

surgical removal because it has small chance of malignant transformation

68
Q

what are the clinical features of a dermoid cyst

A
  • most common in children and young adults
  • most common midline FOM
  • soft, doughy mass
  • may produce submental swelling
69
Q

what is the tx for a dermoid cyst

A

surgical excision

70
Q

what is the differential for a dermoid cyst

A

-lipoma
- salivary gland tumor
- soft tissue tumors

71
Q

what is the histopath for a dermoid cyst

A
  • keratin in lumen
72
Q

what differentiates a dermoid cyst from an epidermoid cyst

A

dermal adnexal structures and sebaceous glands and immature hair follicles in histopath

73
Q

what does the thyroglossal duct cyst arise from

A

thyroglossal duct remnants that normally undergo atrophyw

74
Q

what are the clinical features of thyroglossal duct cyst

A
  • develops from foramen cecum to suprasternal notch
  • 60-80% develop adjacent to hyoid bone
  • dx in 1-2nd decade of life, 50% by age of 20
  • fluctuant, movable swelling
  • usually asymptomatic
75
Q

what is the tx for thyroglossal duct cyst

A

surgical excision

76
Q

what is the histopath for thyroglossal duct cyst

A

cyst lining and presence of thyroid follices

77
Q

what is a branchial cleft cyst

A

developmental cyst that develops from branchical arch remnants- usually the second

78
Q

what are the clinical features of branchial cleft cysts

A
  • upper lateral neck anterior or deep to SCM
  • develop in children and young adults
  • soft, fluctuant mass, 1-10cm in diameter
79
Q

what is the tx for branchial cleft cyst

A

surgical excision

80
Q

what is the differentail for branchial cleft cyst

A
  • thyroglossal duct cyst- however would be in midline
  • dermal cyst
  • lipoma
  • dermal and CT lesions
81
Q

what is a lymphoepithelial cyst

A
  • lesion that develops from oral lymphoid tissuew
82
Q

what are the clincial features of lympepithelial cysts

A
  • small, submucosal mass, usually <1 cm
  • common on posterior lateral tongue, anterior tonsillar pillar
  • firm or soft to palpation
  • often white or yellow, keratin in lumen
  • usually asymptomatic
83
Q

what is the tx for lymphoepithelial cyst

A

-surgical excision, should not recur
- if distinctive, biopsy is not necessary

84
Q

what is the histopath for lymphoepithelial cyst

A

entire cyst structure is retained - no breach in wall
- lymphoid aggregate in wall

85
Q

what is the differential for lymphoepithelial cysts

A
  • lipoma: wouldnt be this small though
  • salivary stone- but this would feel hard
86
Q
A

Pathology I (24 decks)

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