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Pathology I > Head and Neck Mesenchymal > Flashcards

Head and Neck Mesenchymal Flashcards

1
Q

what is the most common tumor of the oral cavity

A

fibroma

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2
Q

what is a fibroma

A

reactive response to local irritation and trauma
- hyperplasia of fibrous connective tissue

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3
Q

what are the clinical features of fibroma

A
  • most common on buccal mucosa along bite line
  • other site: labial mucosa, tongue, gingiva
  • smooth surface, pink nodule
  • may appear white from keratinization
  • asymptomatic
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4
Q

what is the treatment for a fibroma

A

conservative surgical excision

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5
Q

what does a fibroma feel like on palpation

A

firm

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6
Q

what does the histo slide of a fibroma look like

A

proliferation of CT with fibroblastic cells- purple cells

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7
Q

what is inflammatory papillary hyperplasia and what is it caused by

A

-reactive tissue growth that develops under a denture
- often caused by ill-fitting denture, poor denture hygiene, 24 hour denture wear

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8
Q

what are the clinical features of inflammatory papilary hyperplasia

A
  • usually occurs on hard palate, under denture
  • uncommonly develops on edentulous mandibular ridge
  • erythematous mucosa
  • pebbly, papillary surface
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9
Q

what is the treatment for inflammatory papillary hyperplasia

A
  • removal of denture to allow healing
  • antifungal therapy
  • surgical excision
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10
Q

describe oral focal mucinosis

A
  • uncommon, focal tumor like mass
  • overproduction of hyaluronic acid by fibroblasts
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11
Q

what are the clinical features of oral focal mucinosis

A
  • 2:1 female
  • gingiva: most common site in 2/3 of cases
  • may occur on hard palate, other sites rare
  • mucosal colored, nodular mass
  • asymptomatic
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12
Q

what is the treatment for oral focal mucinosis

A

surgical excision
- shouldnt recur

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13
Q

what is the histology of oral focal mucinosis

A

loose CT with fibroblastic cells
- over production of hyaluronic acid causing loose appearance
- mucin or hyaluronic acid will stain blue or purple on certain stains

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14
Q

what are the 3 P’s

A
  • pyogenic granuloma
  • peripheral giant cell granuloma
  • peripheral ossifying fibroma
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15
Q

what do the 3 P’s have in common

A

benign lesions occurring on the gingiva

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16
Q

what is a pyogenic granuloma

A

exuberant tissue response in response to local irritation or trauma

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17
Q

what is the most common of the 3 P’s

A

pyogenic granuloma

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18
Q

what are the clinical features of pyogenic granuloma

A
  • most common in females
  • 75% occur on gingiva
  • smooth, erythematous lobulated mass
  • “pregnancy tumor”
    asymptomatic
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19
Q

what is the treatment for pyogenic granuloma

A
  • surgical excision
  • pregnant patients- after delivery if possible
  • thorough scaling
  • encourage OHI
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20
Q

what does a pyogenic granuloma look like

A

smooth erythematous lobulated mass

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21
Q

what is the histology of pyogenic granuloma

A

proliferation of vascular tissues lined by endothelial cells

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22
Q

what is a peripheral giant cell granuloma caused by

A

likely a reactive lesion to local irritation and trauma

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23
Q

what are the clinical features of peripheral giant cell granuloma

A
  • occurs exclusively on gingiva/alveolar ridge
  • occurs at any age
  • red, red- blue nodular mass
  • cupping resorption of bone on xray
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24
Q

what is the treatment for peripheral giant cell granuloma

A
  • surgical excision
  • thorough scaling
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25
what is the histology of peripheral giant cell granuloma
- proliferation of giant cells in a background of small spindle shaped mesenchymal cells - hemorrhage - red cells- extravasated red blood cells in foreground - multinucleated giant cells are needed to make dx!!
26
what is peripheral ossifying fibroma caused by
a reactive lesion
27
what does peripheral ossifying fibroma contain
calcification/ossification
28
what are the clinical features of peripheral ossifying fibroma
- most common in young adults - exclusively on the gingiva - nodular mass, red/pink
29
what is the treatment for peripheral ossifying fibroma
- surgical excision - thorough scaling
30
what is the histology for peripheral ossifying fibroma
- numerous fragments of calcified tissue- calcification or ossification is necessary for dx
31
what is a lipoma
- benign tumor of fat - most common mesenchymal neoplasm - most occur on trunk and extremities
32
what are the clinical features of lipoma
- observed mainly in adults - buccal mucosa and vestibule: 50% cases - soft, smooth surfaced, nodular mass - yellow tint may be observed
33
what is the treatment for lipoma
surgical excision - unlikely to reoccur
34
what does a lipoma feel like on palpation
soft
35
what does the histology for a lipoma look like
sheets of mature fat cells - looks like "chicken wire"
36
what is a neurofibroma
- most common peripheral nerve neoplasm - schwann cells, perineural fibroblasts
37
what are the clinical features of neurofibroma
- most common on tongue and buccal mucosa - pink, slow- growing nodule - may occur in jaws- radiolucency - may be a component of neurofibromatosis
38
what is the treatment for neurofibroma/NFI
- solitary neurofibroma: surgical excision, recurrence is rare - NFI: Tx directed towards management of complications such as neurofibrosarcoma
39
how often does neurofibrosarcoma occur as a complication of neurofibroma/NFI
5% of cases
40
what is the histology for neurofibroma
loose appearance from perineural fibroblasts and schwann cells- wavy appearance
41
what is a schwannoma
- benign neural neoplasm of schwann cell origin - 25% cases occur in head and neck - neurofibromatosis II: bilateral schwannomas of CN VIII
42
what is neurofibromatosis II (NF2)
- "acoustic neuromas" - deafness, dizziness, tinnitus
43
what is another name for schwannoma
neurilemoma
44
what are the clinical features of schwannoma
- most common in young to middle aged adults - slow- growing encapsulated nodule - oral most common on tonuge - may occur in jaws as a radiolucency
45
what are the histology patterns for schwannomas and describe each
- antoni A: characterized by streaming fascicles of spindle shaped schwann cells and nuclei are lined up - Antoni B: nuclei are not lined up
46
what are the clinical features of congenital epulis
- occurs in newborns - 90% female - almost exclusively on alveolar ridge: maxillary >> mandibular - pink-red, polypoid mass on alveolar ridge
47
what is the treatment for congenital epulis
- surgical excision - may regress on its own
48
what is the histology for congenital epulis
- CT full of granular cells - cells have granularity in cytoplasm and small nuclei
49
what are the clinical features of a granular cell tumor
- most common on tongue - 1/3 of cases - 2:1 female prediliction - 4th-6th decade of life - pink- yellow nodule
50
what is the treatment for granular cell tumor
surgical excision - shouldnt recur
51
what is the histology for granular cell tumor
granular cells with granular cytoplasm
52
what is the most common tumor of infancy
hemangioma
53
what are the clinical features of hemangioma
- 3:1 female - head and neck: 60% of cases - may appear raised and firm - red, blue, purple hue - often demonstrates rapid development - 90% resolve by age 9 - may result in permanent scarring
54
what are the treatments for hemangioma
- observation, likely to regress - surgical removal in some cases
55
what is a lymphangioma
benign growth of lymphatic vessels
56
what are the clinical features of lymphangioma
- head and neck: 50-75% of cases - 90% develop by 2 years of age - cervical malformation: soft, fluctuant masses - oral: most common on anterior tongue -> macroglossia - pebbly surface, vesicle appearance
57
what is the treatment for lymphangioma
- depends on size, location- surgery may be indicated - non enlarging lesions of the tongue- may observe
58
what is the histology for lymphangioma
- dilated vascular channels - lymph fluid
59
what is a leiomyoma
- benign tumor of smooth muscle - most common in the uterus, GI tract, skin
60
what are the clinical features of leiomyoma
- rare in the oral cavity, most common subtype: angiomyoma - slow growing mucosal nodule - common sites: lips, tongue, palate, cheek - usually asymptomatic
61
what is the treatment for leiomyoma
surgical excision
62
what is the histology for leiomyoma
smooth muscle cells spindle shaped and arranged in vesicular pattern - need to see vessel
63
what is kaposi sarcoma and what is it caused by
- vascular endothelial malignancy - caused by human herpesvirsus HHV-8 - observed primarily in HIV infected adults
64
what are the four clinical presentations of kaposi sarcoma
- classic type - endemic (African) - iatrogenic (transplant associated) - epidemic (AIDS related)
65
what is the clinical presentation of classic type kaposi sarcoma
- older adults 70-95% men - italian, jewish ancestry - blue/purple macules and plaques -> tumor nodules
66
what is the clinical presentation of endemic kaposi sarcoma
- younger adults, children - indolent skin lesions, or aggressive tumors
67
what is the clinical presentation of iatrogenic kaposi sarcoma
- recipients of solid organ transplant - loss of cellular immunity from immunosuppressive therapy
68
what is the clinical presentation of epidemic kaposi sarcoma
- AIDS related, most common type observed in USA - less common after cART therapy - sexual transmission - appx 70% demonstrate oral lesions - most common locations: hard palate, gingiva, tongue
69
what is the treatment for kaposi sarcoma
- dependent on clinical subtype and stage - radiation therapy for skin lesions - surgical excision for isolated lesions - AIDS- related cases: may regress with cART therapy
70
what is the presentation of kaposi sarcoma in the mouth
buccal and lingual aspect on alveolar ridge
71
what is the histology of kaposi'a sarcoma
vascular proliferation- proliferation of spindle cells with extravasated erythrocytes surrounded vessel
72
what is rhabdomyosarcoma
- malignant neoplasm of skeletal muscle differentiation - most common soft tissue sarcoma in children
73
what are the clinical features of rhabdomyosarcoma
- most common head and neck area- 35% of cases - most common 1st decade of life, rare above 45 years old - infiltrative mass that often grows rapidly - oral cavity: most common in palate
74
what is the treatment for rhabdomyosarcoma
local surgical excision, radiation, and chemotherapy
75
what is the histology for rhabdomyosarcoma
small spindle and rounded cells but all are malignant - to make dx you need to see rounded pink cells called pink bellies

Pathology I (24 decks)

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