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ADH - Oral Pathology > Intra Oral Swellings > Flashcards

Intra Oral Swellings Flashcards

1
Q

Neoplasm

A

Abnormal growth of cells

Growth is uncontrolled and progressive

Can be benign or malignant

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2
Q

Hyperplasia

A

The increase in number of normal cells in a normal arrangement in a tissue

Contrast to hypertrophy, an increase in the size of an organ as a result of increase in cell size

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3
Q

What is a cyst?

A

An epithelial lined cavity or sac

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4
Q

Localised connective tissue hyperplasias

A
  • epulides
  • pyogenic granuloma
  • fibroepithelial polyp
  • denture induced hyperplasia
  • papillary hyperplasia of the palate
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5
Q

Epulis

A

Localised tumour like gingival swelling

Usually arising from interdental papilla

Interdental form of chronic irritation calculus

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6
Q

Congenital epulis

A
  • found in newborns
  • soft tissue growth on edentulous alveolus
  • effects F > M
  • anterior maxilla
  • pink, soft, compressible and pedunucleated
  • treatment - complete excision
  • recurrence unlikely
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7
Q

Fibrous epulides

A
  • pedunculated or sessile mass
  • firm in consistency
  • colour similar to surrounding tissues
  • 65% of epulides are fibrous
  • caused by low grade chronic irritation (eg plaque, calculus, trauma)
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8
Q

Pregnancy epulis

A
  • soft, deep, reddish, purple swelling
  • often ulcerated
  • anterior dental papillae
  • haemorrhage on minor trauma spontaneously
  • onset at end of first trimester
  • gradually increase in size during pregnancy
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9
Q

Pregnancy epulis

Histology?

Treatment?

A

Histology- vascular proliferation

Treatment
- OHI
- resolution after pregnancy
- excision should be delayed till after birth

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10
Q

Peripheral giant cell granuloma
(Giant cell epulis)

A
  • 7% of epulides
  • dark red
  • ulcerated
  • may involve underlying bone - central giant cell lesion
    (Radiograph required to confirm in involvement of underlying bone)
    (Confirm bone involvement prior to extractions - risk of bleeding +)
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11
Q

Pyogenic granuloma

A

Histologically and clinically identical to pregnancy epulis
Pregnancy epulis is pyogenic granuloma occurring in pregnancy
Together they make up 28% of epulides
May occur on other sites than gingiva (tongue, labial/buccal mucosa)

Aetiology - minor trauma

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12
Q

Other causes of generalised gingival swelling

A

Drug induced gingival overgrowth
Gingival fibromatosis
Acute leukaemia
Chronic plaque induced gingivitis (hyperplasticity form)

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13
Q

Fibroepithelial polyp

A
  • common lesion
  • pink, firm, painless, pedunculated or sessile polypoid swelling
  • size 2-3mm - 1cm diameter
  • mainly located in cheeks along occlusal line, lips and tongue
  • treatment - excision if symptomatic / doubt in diagnosis
  • aetiology - minor trauma
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14
Q

Denture induced hyperplasia (denture granuloma)

A
  • common
  • reactive inflammatory fibrous hyperplasia
  • smooth pink swelling, may be grooved
  • caused by chronic inflammation - poorly fitting denture flange
  • usually asymptomatic, may be ulcerated
  • treatment - relieve denture flange and excision
  • failure to relieve denture leads to recurrence
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15
Q

Papillary hyperplasia of the palate

A
  • multiple small papillary projections on palate (bubbly appearance)
  • related to ill fitting dentures
  • often there is an associated candidiasis
  • aetiology - minor trauma from denture
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16
Q

Connective tissue neoplasms

A
  1. Tumours of fibrous tissue
    - rare in mouth
  2. Tumours of adipose tissue
    - lipoma
  3. Tumours of vascular tissue
    - haemangioma
    - lymphangioma
  4. Malignant tumours of all types of connective tissue are rare intra-orally
17
Q

Lipoma

A
  • soft elastic yellowish coloured swelling
  • mostly cheek and tongue
  • filled with fats
  • NB flats when placed in the fixative after excision
18
Q

Types of cysts

A

Dermoid
Eruption
Mucocele
Nasopalatine/incisive canal

19
Q

Dermoid cyst

A

Aetiology - developmental
Rare
Site - painless swelling floor of mouth

20
Q

Eruption cyst

A

Appearance
- domed shapes bluish swelling, filled with blood or serum, eruption will break cyst
- arises from dental follicles
- treatment - incision of lesion if symptomatic

21
Q

Mucocele
Appearance?
What is it and cause?

A

Dome shaped, bluish, fluctuant, painless
Prone to rupture
Frequently return
Common site - lower lip

  • common
  • retention of mucous in sub epithelium tissues

Causes
- blockage in salivary duct - mucus retention cyst
- severance of a salivary duct - mucus extravasation cyst (common)

Ranula - large Mucocele in the floor of mouth, may involve sublingual gland

22
Q

Ranula

A
  • unilateral
  • 2-3cm in diameter
  • soft, fluctuant, bluish
  • mostly painless
  • can interfere with speech and mastication
  • removal
23
Q

Salivary gland neoplasms

A
  • rare
  • can involve major and minor salivary glands
  • 46% of minor gland tumours are malignant
  • most tumours in sublingual gland are malignant
  • usually grow rapidly, cause pain, may ulcerate, may involve nerves
24
Q

Oral tori

A

Bony modular growths
- tori, exostoses and osteomas

Benign lesion of compact bone

Name depends on site
- exostoses - facial aspect of mandibular and maxillary alveolus
- tori - palatal mid-line maxilla and lingual in the mandible

25
Q

Oral tori

A

Aetiology genetic
F > M
Contain compact cancellous bone, although latter is only found at the core of large specimens
Thin covering of mucosa
Treatment - excise if interferes with normal function, denture etc

26
Q

Other bone swellings

A

Pagers disease
- progressive jaw swelling
- hypercementosis

Fibrous displasia
- rare

27
Q

Other causes of intra oral swelling

A

Squamous cell papilloma
Warts
Verrucous carcinoma
Invading malignancy from relating anatomical structure
- descending natural or nasal carcinoma
Metastatic spread from remote tumour
- rare cause of intracranial swelling

ADH - Oral Pathology (4 decks)

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