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Oral Radiology and Pathology Midterm I > Lectures 11 & 12 - Cysts of the Jaw > Flashcards

Lectures 11 & 12 - Cysts of the Jaw Flashcards

1
Q

Inflammatory Tumors

A

Radicular
Residual
Buccal Bifurcation

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2
Q

Radicular Cyst Pathology

A

Non-vital tooth

inflammatory process

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3
Q

Radicular Cyst Clinical Appearance

A

MOST COMMON CYST
Apex of tooth
Sometimes lateral root

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4
Q

Radicular Cyst Clinical Symptoms

A

Asymptomatic (unless exacerbated)

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5
Q

Radicular Cyst Radiographic Appearance

A 
Well circumscribed radiolucency
Round
Not corticated
Does not cross midline
LOST lamina dura and PDL
Root resorption
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6
Q

Radicular Cyst Histologic Appearance

A

Hyperplastic stratified squamous epithelium
Fluid filled
Inflamed CT wall

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7
Q

Radicular Cyst Treatment

A

Root canal

Extraction

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8
Q

Residual Cyst Pathology

A

Radicular or dentigerous cyst left after tooth extraction

Associated w/ becoming carcinoma

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9
Q

Buccal Bifurcation Cyst Pathology

A

Often associated with proliferative periostitis of buccal cortex
Rare
Age 5-11
Bilateral 33%

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10
Q

Buccal Bifurcation Clinical Appearance

A

Usually mandible, 1st molar
Bulge on buccal side tips tooth
Roots point lingually, cusp points buccally

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11
Q

Buccal Bifurcation Clinical Symptoms

A

Buccal tenderness
Swelling
Foul taste

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12
Q

Buccal Bifurcation Radiographic Appearance

A

Well circumscribed
Unilocular
Involves buccal furcation area and root
Occlusal film most helpful

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13
Q

Buccal Bifurcation Histologic Appearance

A

Non-keratinizing stratified squamous epithelium
Hyperplastic areas
Chronic inflammation

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14
Q

Buccal Bifurcation Treatment

A

Enucleation

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15
Q

Dentigerous Cyst Pathology

A 
Associated with crown of UNERUPTED tooth
Fluid build up surrounding enamel (hyperplastic follicle)
Can resorb roots, enter sinus
Common
Age 10-30
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16
Q

Dentigerous Cyst Clinical Appearance

A

Most commonly 3rd molar

then Max. canine

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17
Q

Dentigerous Cyst Clincal Symptoms

A

No pain unless infected

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18
Q

Dentigerous Cyst Radiographic Appearance

A

Unilocular radiolucency around crown of unerupted tooth
Cyst wraps from CEJ to CEJ
Can be central (symmetrical over enamel) or lateral (asymmetrical)

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19
Q

Dentigerous Cyst Histological Appearance

A

Non-inflamed: thin non, keratinized, flat epithelium-CT interface
OR
Inflamed: hyperplastic lining, rete ridges, squamous features

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20
Q

Dentigerous Cyst Treatment

A

Enucleation
Marsupialize
Good prognosis

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21
Q

Eruption Cyst Pathology

A

Soft tissue analogue of dentigerous cyst

Develops when follicle separates from crown of erupting tooth within the gingival tissue

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22
Q

Eruption Cyst Clinical Appearance

A

Soft, translucent swelling in the mucosa overlying the crown of an erupting tooth
Usually Max. incisors and Mand. 1st molars

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23
Q

Eruption Cyst Radiographic Appearance

A

Soft tissue, duh

No radiographic evidence

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24
Q

Eruption Cyst Histologic Appearance

A

Oral epithelium w/ subadjacent inflammatory cell infiltrate

Think layer of non-keratinizing epithelium

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25
Q

Primordial Cyst Pathology

A

Cyst forms instead of tooth
Enamel organ degenerates before hard tissue develops
Often develops into a keratocystic odontogenic tumor (KCOT)

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26
Q

Primordial Cyst Radiographic Appearance

A

Round radiolucency under primary tooth

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27
Q

Gingival Cyst of the Newborn Treatment

A

Generally rupture on their own w/in 3mo of age

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28
Q

Gingival Cyst of the Newborn Histological Appearance

A

Thin, flattened lining with parakerototic (retained nuclei) surface
Lumen of cyst contains keratinaceous debris

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29
Q

Gingival Cyst of the Newborn Clinical Appearance

A

2-3mm white papules on alveolar mucosa
Usually multiples
Max more common than Mand

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30
Q

Gingival Cyst of Newborn Pathology

A

Small, superficial keratin-filled cyst arise from remnants of dental lamina
Similar to Epstein Pearls or Bohn nodules

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31
Q

Epstein Pearl

A

Inclusion cyst found in midline of palate

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32
Q

Bohn Nodules

A

Inclusion cyst found laterally on hard and/or soft palate

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33
Q

Gingival Cyst of Adult Pathology

A

Derived from rests of dental lamina

“Soft tissue counterpart to lateral periodontal cyst”

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34
Q

Gingival Cyst of Adult Clinical Appearance

A 
<0.5cm papule
Dome-like swelling
Blue-gray
Usually on facial gingiva or alveolar mucosa
Most common on Mand. canine or premolars
Age 40-60
Painless
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35
Q

Gingival Cyst of Adult Histological Appearance

A

Thin, flattened epithelial lining

Focal plaques may contain glycogen-rich clear cells

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36
Q

Gingival Cyst of Adult Treatment

A

Excision to confirm Dx
Will not resolve on own, deeper than newborn cyst
Excellent prognosis
Usually do not reoccur or become malignant

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37
Q

Lateral Periodontal Cyst Pathology

A 
Rare
Age 40-70
Botryoidal subtype
Usually VITAL tooth
Arise from rests of dental lamina
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38
Q

Lateral Periodontal Cyst Clinical Appearance

A

Commonly anterior to mandibular premolars

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39
Q

Lateral Periodontal Cyst Clinical Symptoms

A

Asymptomatic

40
Q

Lateral Periodontal Cyst Radiographic Appearance

A

Well circumscribed, round, corticated
Radiolucent
Lateral to mid-root
VITAL tooth, intact PDL and lamina dura

41
Q

Lateral Periodontal Cyst Histologic Appearance

A

Non-inflamed, thin epithelium
Flattened or cuboidal cells
Clear cells
Plaque-like thickening

42
Q

Lateral Periodontal Cyst Treatment

43
Q

Orthokeratinized Odontogenic Cyst Pathology

A

Orthokeratinized (NO nuclei) epithelial lining

NOT associated w/ Gorlin Synd.

44
Q

Orthokeratinized Odontogenic Cyst Treatment

A

Enucleation w/ curettage

2% recurrance rate

45
Q

Orthokeratinized Odontogenic Cyst Histologic Appearance

A

Orthokeratotic epithelium w/ keratohyaline granules

No prominent palisaded basal layer

46
Q

Orthokeratinized Odontogenic Cyst Radiographic Appearance

A

Usually unilocular

47
Q

Orthokeratinized Odontogenic Cyst Clinical Appearance

A

Typically young adult males
Most common Mand. 3rd molar
On Ddx w/ dentigenous cyst

48
Q

Keratocystic Odontogentic Tumor (KCOT) Pathology

A

Aggressive odontogenic tumor

MOST RECURRENT odontogenic cyst (epithelial lined)

49
Q

Keratocystic Odontogentic Tumor (KCOT) Clinical Appearance

A 
Peripheral lesion in gingiva
Usually interosseous, sometimes in soft tissue
Post. Mandible
Cheesy filling
Age 10-30
M>F
50
Q

Developmental Cysts

A 
Dentigerous
Eruption
Primordial
Gingival Cyst of the Newborn
Gingival Cyst of the Adult
Lateral Periodontal
Orthokeratinized odontogenic
Keratocystic odontogenic tumor (KCOT)
Calcifying odontogenic (Gorlin) cyst
Glandular odontogenic cyst
51
Q

Calcifying Odontogenic (Gorlin) Cyst Pathology

A

Calcification within cyst

Approx. 20% of calcifying odontogenic cysts are associated with odontomas

52
Q

Calcifying Odontogenic (Gorlin) Cyst Clinical Appearance

A

Appears as an obliteration of the vestibule
Often anterior, Max. or Mand.
Often unerupted teeth

53
Q

Calcifying Odontogenic (Gorlin) Cyst Radiographic Appearance

A

Unilocular lucency w/ flecks of opaque calcification
33% with mixed appearance?
33% associated w/ unerupted tooth

54
Q

Calcifying Odontogenic (Gorlin) Cyst Histologic Appearance

A

GHOST cells (eosinophilic epithelial cells w/o nuclei
Thick epithelium
Basal cells resemble ameloblasts

55
Q

Cacifying Odontogenic (Gorlin) Cyst Treatment

A

Enucleate

Recurance is uncommon

56
Q

Glandular Odontogenic Cyst Treatment

A

Enucleation or curettage

30% recurrence

57
Q

Glandular Odontogenic Cyst Histologic Appearance

A

Thin epithelial lining

Mucous cells & duct-like structures in the lining

58
Q

Glandular Odontogenic Cyst Radiographic Appearance

A

Usually multilocular
Well-defined margins
Sclerotic rim

59
Q

Glandular Odontogenic Cyst Clincal Appearance

A

Anterior Mandible (85%)

60
Q

Glandular Odontogenic Cyst Pathology

A

Also called Sialo-odontogenic cyst

Odontogenic cyst with glandular or salivary features

61
Q

Cysts of Bone

A

Nasopalatine duct / Incisive canal cyst
Surgical ciliated cyst of the maxilla

Controversial:
Medial palatal cyst (more posterior nasopalatine)
Globulomaxillary (probably KCOT)
Median mandibular (doesn’t exist?)

62
Q

Nasopalatine Duct / Incisive Canal Cyst Pathology

A

Left behind from nasopalatine duct formation

Unrelated to tooth vitality

63
Q

Nasopalatine Duct / Incisive Canal Cyst Clinical Appearance

A 
Most common NON-odontogenic cyst
M=F
age 30-60
Palatal swelling (rare) can push incisors anteriorly
Can erode floor of sinus
64
Q

Nasopalatine Duct / Incisive Canal Cyst Clinical Symptoms

A

Typically non-symptomatic

Salty taste = established communication w/ oral cavity

65
Q

Nasopalatine Duct / Incisive Canal Cyst Radiographic Appearance

A

Heart-shaped

Crosses midline

66
Q

Nasopalatine Duct / Incisive Canal Cyst Histologic Appearance

A

Stratifies squamous and/or respiratory epithelium

Wall with blood vessels and nerve trunks

67
Q

Nasopalatine Duct / Incisive Canal Cyst Treatment

A

Small cyst: No tx

Large cyst: Ennucleate, low recurrance

68
Q

Surgical Ciliated Cyst of the Maxilla Pathology

A

Derived from lining of the sinus entrapped during surgical closure

69
Q

Surgical Ciliated Cyst of the Maxilla Clinical Appearance

A

Typically maxillary sinus

M>F

70
Q

Surgical Ciliated Cyst of the Maxilla Radiographic Appearance

A

Well defined lucency

Unilocular OR multilocular

71
Q

Surgical Ciliated Cyst of the Maxilla Histologic Appearance

A

Lined w/ RESPIRATORY epithelium

May show squamous metaplasia

72
Q

Globulomaxillary Cyst

A

Usually KCOT
Pear-shaped radiolucency b/t lateral incisor and canine
Adjacent teeth are vital

73
Q

Cysts of Soft Tissue

A

Lymphoepitheilial
Nasolabial / Nasoalveolar
Dermoid and Epidermoid
Thyroglossal

74
Q

Pseudocysts

A

Not lined with epithelium

Traumatic bone cyst
Stafne bone cyst
Mucocele
Aneurysmal bone cyst
Periapical granuloma
75
Q

Lymphoepithelial Cyst Clinical Appearance

A

Cervical, Oral, OR Parotid
Yellow color

Cervical:
Occurs along anterior border of SCM
Left (66%) > Right
Age 20-40

Oral:
Along Waldeyer ring

76
Q

Lymphoepithelial Cyst Histologic Appearance

A

Stratified squamous epithelium with lymphoid tissue in cyst wall
Keratin in lumen (gives cyst yellow color)

77
Q

Lymphoepithelial Cyst Treatment

A

Excision

0% recurrance

78
Q

Nasolabial / Nasoalveolar Cyst Treatment

A

Enucleation

79
Q

Dermoid and Epidermoid Cyst Treatment

A

Complete surgical excision

80
Q

Dermoid and Epidermoid Cyst Histologic Appearance

A

Lined by stratified squamous epithelium
Dermoid - W/ skin appendages
Epidermoid - W/O skin appendages

81
Q

Dermoid and Epidermoid Cyst Clinical Appearance

A

Slow-growing rubbery or doughy masses
May be yellow color

Intraoral lesions are usually midline of floor of mouth

82
Q

Dermoid and Epidermoid Cyst Pathology

A

Derived from epithelial rests from entrapped embryonic cells

83
Q

Thyroglossal Duct Cyst Pathology

A

Derived from remnants of thyroglossal duct after migration of thyroid gland from the base of the tongue

84
Q

Thyroglossal Duct Cyst Clinical Appearance

A

Swelling at midline of neck below hyoid bone
F>M
50% of pts < 30 yo

85
Q

Thyroglossal Duct Cyst Histological Appearance

A

Lined by Respiratory and/or stratified squamous epithelium

50% - thyroid tissue in wall of cyst

86
Q

Thyroglossal Duct Cyst Treatment

87
Q

Traumatic Bone Cyst Histologic Appearance

A

Empty lumen

Distinguished from KCOT b/c not filled w/ cheese

88
Q

Traumatic Bone Cyst Radiographic Appearance

A

Scallops b/t roots of teeth

No cortication

89
Q

Stafne Bone Cyst Pathology

A

Developmental defect containing portion of salivary gland

90
Q

Stafne Bone Cyst Clinical Appearance

A

Focal concavity of cortical bone on lingual surface

M»F

91
Q

Mucocele Pathology

A

Ranula - when on floor of mouth

92
Q

Mucocele Treatment

A

May be self-limiting or require local excision

Local gland should be excised to prevent recurrence

93
Q

Mucocele Histologic Appearance

A

Mucin surrounded by granulation tissue

Numerous foamy histiocytes

94
Q

Mucocele Clinical Appearance

A 
Dome-shaped mucosal nodule
Swelling increases & decreases in size
Normal to blue color
Most common:
-younger age
-lower lip
95
Q

Aneurysmal Bone Cyst Clinical Appearance

A

Blood-filled cavities
30% associated w/ another lesion w/i the same bone
Not a true cyst, not lined with epithelium

Oral Radiology and Pathology Midterm I (10 decks)

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