Hyperplastic lesions Flashcards
What are TWO histological features of hyperplastic lesions?
- Hyperkeratosis
- Acanthosis (thickening of prickle cell layer)
What feature would make a lesion harder or easier to excise?
Pedinculated (stalk) or sessile
For lesions, what does papillary mean?
Any small growth projecting into a cavity
What does Verrucous mean?
Warty surface appearance
What is an epulis?
Lump on the gingiva (non-neoplastic)
Is linea alba more commonly unilateral or bilateral?
bilateral
Describe the appearance of smokers keratosis and why.
- White patches on palate (hyperkeratosis) with red dots (inflamed salivary ducts)
Fibroepithelial hyperplasia:
- Most common cause
- Clinical presentation
- Main histological feature
- Mainly caused by chronic trauma
- Exophytic growth with normal mucosa colour +/- inflammation (e.g. due to biting on the growth)
- Reactive (due to trauma) collagen production (ie. fibrous tissue)
What is a fibroepithelial polyp?
Very localised fibroepithelial hyperplasia
Pyogenic granuloma:
- Most common cause/association
- Clinical presentation
- Histology
- Treatment
- Differences to epulis
- Increased incidence in puberty and pregnancy (can occur in males and females)
- Rapidly forming red, haemorrhagic, growth with ulcerated surface. Mainly seen on interdental papillae.
- Granulation tissue histology (essentially an atypical healing response to subgingival plaque)
- Treatment: excision and removed of irritating factors
- Way more rapid onset than epulis
Peripheral giant cell granuloma:
- Clinical presentation
- Histology
- Cause
- Pyogenic granuloma + bony spicules (clinically or radiographically detected)
- Pyogenic granuloma + Giant cells + bone spicules
- Not mediated by hormones. Trauma possible cause.
Calcifying fibroblastic granuloma:
- Clinical presentation
- Histology
- Fibroepithelial hyperplasia on gums. Rapid onset, faster than epulis but slower than pyogenic granuloma. Usually smaller than 1cm.
- Very cellular with calcifications
One mechanism through which Phenytoin (Dilantin) may cause gingival hyperplasia
Impair collagen degradation through inhibition of MMP/TIMP pathway.