Histo Ddx Flashcards
1
Q
Acanthosis and balloon cells in upper layer of epithelium
A
- Hairy leukoplakia
- Morsicatio
- Leukoedema
- Linea alba
- Betel chewer’s mucosa
- Uremic stomatitis
- White sponge nevus
2
Q
Acantholytic lesions:
A
- Pemphigus
- Hailey-‐Hailey (chronic benign familial pemphigus – rare in mouth)
- Herpes
- Grover’s (transient acantholytic dermatosis – exclusively suprabasal split)
- Darier’s
- Warty dyskeratoma
- Varicella-‐zoster
- Squamous cell carcinoma
- Pyostomatitis vegetans (has eos)
3
Q
Amorphous material in connective tissue
A
- Amyloidosis (amyloid)
- Systemic sclerosis (collagen)
- Plasminogen deficiency (fibrin)
- Lipid proteinosis (basement membrane origin)
4
Q
Clear cell neoplasms of the jaws
A
- Clear cell odontogenic ca.
- Ameloblastoma (if there’s peripheral palisading)
- Mucoep, central (if there’s mucin in a mucicarmine stain)
- CEOT, clear cell variant (if there’s amyloid)
- Met (like Renal, breast, or clear cell melanoma)
- Melanoma (HMB-‐45 +)
5
Q
Clear cell salivary gland tumors:
A
- Hyalinizing clear cell ca. (dense hyalinized stroma)
- Myoepithelioma (extremely rare, benign features)
- Myoepithelial ca. (no ductal elements)
- Acinic cell ca. (typical areas are normally present)
- Clear cell adenoca.
- Epithelial-‐myoepithelial carcinoma (biphasic)
- Muco ep. (epidermoid cells present, typical areas normally present)
- Oncocytoma (usually has typical oncocytic cells)
- Sebaceous adenoma (clear cells have foamy cytoplasm)
- Sebaceous adenoca (clear cells have foamy cytoplasm)
- Metastatic renal cell carcinoma (very vascular, CD10+)
6
Q
Comedonecrosis:
A
- SNUC
- Basaloid SCC
- NPC
- Salivary duct ca.
- Met (breast, ductal ca)
7
Q
Cystic lesions of the salivary glands:
A
- Acinic cell
- BLEL/Sjögren’s
- Polycystic disease of the parotid/ HIV-‐related parotid cysts
- Papillary Cystadenoma/cystadenocarcinoma
- Warthin’s
- Salivary duct cyst
- Sclerosing polycystic adenosis
- Muco Ep
- Lymphoepithelial cyst/ Branchial cleft cyst
- Sebaceous lymphadenoma
- Dermoid/epidermoid cyst
8
Q
Dyskeratotic cells:
A
- Warty dyskeratoma
- Hereditary benign intraepithelial dyskeratosis
- Darier disease
- Hereditary mucoepithelial dysplasia
- Pachyonychia congenital
9
Q
Eosinophils
A
- Allergic fungal sinusitis
- Langerhan’s cell histiocytosis
- Angiolymphoid hyperplasia with eosinophilia
- Kimura’s disease
- Hodgkin’s lymphoma
- Peripheral T cell lymphoma (also shows fat invasion – panniculitis pattern)
- TUGSE
- Pyostomatitis Vegetans (microabcesses in epithelium)
10
Q
Fibrous tumors of the jaws:
A
- Odontogenic fibroma (w/o odontogenic epithelium, not the WHO type)
- Desmoplastic fibroma
- Fibromyxoma
- Hyperplastic dental follicle (if related to a tooth)
11
Q
Giant cell lesions of the oral cavity and jaws:
A
- Sarcoid
- Crohn’s disease
- Fungal infection
- Bacterial infection (TB/ leprosy)
- CGCG/ PGCG
- Brown tumor (hyperparathyroidism or renal osteodystrophy)
- Cherubism
- ABC
- Central odontogenic fibroma
- Osteosarcoma
- Foreign body reaction
- Juvenile xanthogranuloma
- Herpes
12
Q
Granular cell lesions:
A
- Granular cell tumor
- Congenital epulis
- Granular cell odontogenic tumor
- Granular cell ameloblastoma
13
Q
Granulomatous inflammation:
Caseating/ necrotizing-‐
A
- Tuberculosis
- Cat scratch
- Syphilis
- Foreign body
- Blastomycosis
- Wegener’s
14
Q
Granulomatous inflammation:
Non-‐necrotizing-‐
A
- Fungal (histoplasmosis, paracoccidioides, coccidioides imitans-‐San Joaquin Valley Fever)
- Leprosy
- Crohn’s
- Sarcoid
- Wegener’s
- Orofacial granulomatosis
- Foreign body
15
Q
Intraepithelial Abscess:
A
- Pyostomatitis vegetans (eos)
- Inverted papilloma
- Blastomycosis
- Psoriasis/ BMG/ EM (also, the lesions of Reiter’s)
- Papillary SCC/ VC
- Candidiasis
- Schneiderian oncocytic pap.
16
Q
Lichenoid
A
- Lichen planus
- Lichenoid drug reaction
- Amalgam reaction
- Graft versus host disease
- Systemic lupus erythematosum
- Chronic ulcerative stomatitis
- Cinnamon stomatitis
17
Q
Lymph node follicular hyperplasia
A
- Cat-‐scratch disease (shows necrosis)
- Kikuchi-‐Fujimoto (has necrotic areas without neutrophils)
- Toxoplasmosis (aggregates of histiocytes between follicles)
- Angiolymphoid hyperplasia with eosinophilia
- Kimura’s disease (peripheral eosinophilia)
- Follicular lymphoma (back-‐to-‐back, lacks starry sky, same size follicles?)
- Lymphoid hyperplasia
- Rosai-‐Dorfmann (emperipolesis)
- Castleman’s disease (onion-‐skin)
18
Q
Multiple CGCG
A
- Hyperparathyroidism
- Cherubism
- Ramon syndrome
- Jaffe-‐Campanacci
- Noonan-‐like syndrome
- Renal osteodystrophy
19
Q
Myxoid lesions:
A
- Myxoma (intrabony)
- Neurofibroma (cells usually seen in sheets, absence of well defined nodules)
- Oral focal mucinosis (no multinodularity, absence of S100 reactivity)
- Neurothekeoma (myxoid nodules of varying size/shape, separated by dense collagen septa)
- Lipoma/Liposarcoma
- Leiomyosarcoma
- Chondrosarcoma
- Rhabdomyosarcoma
20
Q
Necrotic Lymph Node:
A
- Kawasaki disease
- Kikuchi-‐Fujimoto (Histiocytic Necrotizing Lymphadenitis-‐ without neutrophils)
- Cat Scratch Disease (granulomatous inflammation with stellate abscess)
- Rosai-‐Dorfmann
21
Q
Nested Tumors:
A
- Paraganglioma
- Alveolar soft part sarcoma
- Plasmacytoma
- Melanoma
- Sebaceous adenocarcinoma
- Metastasis (renal)
- Meningioma (a little similar to the chondromyxoid fibroma)
- Alveolar rhabdomyosarcoma
- Salivary gland tumor
22
Q
Perivascular Inflammation:
A
- Wegener’s (“leukocytoclastic vasculitis”)
- Cinnamon contact stomatitis (lymphocytes and plasma cells)
- Lupus
- Syphilis (plasma cells)
- Behçet’s (“leukocytoclastic vasculitis”)
- Erythema multiforme
- Scleroderma
23
Q
Perivascular Tumor Sparing Pattern of Necrosis:
A
- MPNST
- Ewing’s sarcoma
- PNET
- Synovial sarcoma
24
Q
Psammoma Bodies:
A
- Meningioma
- Psammomatoid juvenile ossifying fibroma
- Nasopharyngeal papillary adenocarcinoma (low grade)
- Papillary thyroid ca.
- Chordoma
- Pindborg tumor (CEOT)
- Alveolar soft part sarcoma
- Renal papillary cell ca.
- Paraganglioma
- Malignant mesothelioma
25
Q
Psoriasiform mucositis
A
- Erythema migrans
- Psoriasis
- Cinnamon reaction
- Candidiasis
- Reiter’s syndrome
26
Q
PEH:
A
- Deep fungal (Blastomycosis and paracoccidiomycosis)
- Nicotine stomatitis
- Inflammatory papillary hyperplasia
- Pyostomatitis vegetans
- GCT
- Gumma
- IFH (epulis fissuratum)
- Necrotizing sialometaplasia
- Gingival fibromatosis
27
Q
Skin tumors:
A
- Chondroid syringoma: mixed tumor of skin
- Cylindroma: aka turban tumor; looks like basal cell adenoma, jigsaw puzzle
- Eccrine spiradenoma: ~ cylindroma, but lacks jigsaw puzzle. Dilated vessels on periphery of tumor islands
- Hydrocystoma: cystadenoma of skin
- Pilar cyst: aka trichilemmal cyst; looks like epidermoid cyst, but abrupt keratin filling lumen
- Pilomatrixoma: Gorlin cyst of skin, lots of ghost cells
- Syringocystadenoma papilliferum: looks like sialadenoma papilliferum of SG
- Syringoma: tadpole or comma-‐shaped tubules of cells
- Tricoepithelioma: ~ BCC, with horn cysts, no retraction artefact, rare connections to epidermis
- Tricofolliculoma
- Trichilemmoma: similar to tricoepithelioma but central cells are clear (seen in Cowden’s)
- Microcystic adnexal carcinoma: horn cysts on surface, ductal elements deeper, desmoplastic
- Lichen sclerosus et atrophicus
28
Q
Small Blue Cell Tumors
Adult
A
- Melanoma
- Rhabdomyosarcoma
- SNUC
- Lymphoma
- Ewing’s sarcoma
- Esthesioneuroblastoma (Olfactory neuroblastoma)
- PNET
29
Q
Small Blue Cell Tumors
Kids
A
Meduloblastoma
Rhrabdomyosarcoma
DSRCT (Desmoplastic small round cell)
Osteosarcoma
Wilms
Neuroblastoma
Ewing sarcoma
Retinoblastoma
30
Q
Spindle Cell Neoplasms (benign):
A
- Spindle cell lipoma
- Leiomyoma
- Hemangiopericytoma (CD34+)
- Fibromatosis
- Benign fibrous histiocytoma (Factor XIIIa +)
- Solitary fibrous tumor (CD34+)
- Neurofibroma (S100+)
- Nodular fasciitis
- Myofibroma (SMA+)
31
Q
Spindle cell neoplasms (malignant)
A
- Mesenchymal chondrosarcoma
- Malignant fibrous histiocytoma
- Angiosarcoma
- Fibrosarcoma
- Spindle cell carcinoma
- Malignant peripheral nerve sheath tumor (S100+)
- Leiomyosarcoma (SMA+)
- Rhabdomyosarcoma (myogenin +)
- Melanoma (HMB45+)
- Synovial sarcoma (CD99+)
- Kaposi’s (HHV8+)
32
Q
Staghorn Vessels:
A
- Solitary fibrous tumor (CD34, CD99+)
- Hemagiopericytoma (CD34, CD99+)
- Benign fibrous histiocytoma
- Mesenchymal chondrosarc.
- Vascular leiomyoma
- Leiomyosarcoma
- Infantile fibrosarcoma
- Myofibroma (actin+)
- Juv. nasoph. angiofibroma (ant. bowing of the post. wall of the max. sinus)
- Angiofibroma (like in tuberous sclerosis)
- Synovial sarcoma
