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Oral Pathology Midterm > Midterm > Flashcards

Midterm Flashcards

1
Q

Leukoplakia: Overview

A

White patch that cannot be rubbed off

Cannot be characterized as any other disease

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2
Q

What are the clinical features and most common sites of Leukoplakia?

A

ranges from thin, grayish, and translucent - rough, white/yellow, and leathery
Floor of mouth; ventrolateral tongue, lips

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3
Q

What ages and gender does leukoplakia effect?

A

Any age or gender equally

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4
Q

Histopathology of leukoplakia.

A

benign hyperkeratosis and acanthosis - epithelial dysplasia - invasive squamous cell carcinoma

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5
Q

What are treatment options for leukoplakia?

A
  • Site dependent
  • Long-term follow-up
  • Conventional or laser excision
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6
Q

What is the prognosis for leukoplakia?

A
  • Histology dependent

- Excellent - Poor

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7
Q

Frictional Keratosis overview:

A

Epithelial response to chronic trauma

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8
Q

What are the clinical featres for Frictional keratosis?

A

On palpation, it ranges from smooth to rough, irregular and leathery in consistency.

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9
Q

What are the most common locations Frictional Keratosis?

A

Lips, cheeks, and lateral tongue

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10
Q

What ages and genders are most commonly effected by frictional keratosis?

A
  • Can effect any age
  • No gender predilection
  • Commonly found in younger
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11
Q

Describe the histology of Frictional Keratosis,

A

Hyperkeratosis and/or acanthosis

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12
Q

What are the treatment options for Frictional keratosis?

A
  • Remove irritating factor
  • Biopsy persisting lesions
  • follow-up
  • rebiopsy
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13
Q

What are the clinical features of Tobacco Keratosis: Snuff Dipper’s Keratosis?

A

Well demarcated translucent grayish to rough and wrinkled or folded with deep furrows that are white or yellow in color

Gingival recession is present

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14
Q

What gender and ages are commonly effected by Tobacco keratosis?

A

White, blue-collar males

> 18 years old

10-30 years old

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15
Q

What are the histological features of Tobacco keratosis?

A

hyperkeratosis and acanthosis

longer use: epithelial dysplasia and/or invasive carcinoma (50 fold increase)

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16
Q

What are the treatment options for Tobacco Keratosis?

A
  • stop tobacco use
  • excision with clean margins if dysplasia
  • complete excision if in high risk locations
  • long-term follow-up
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17
Q

What is the prognosis of Tobacco keratosis?

A

Good - Poor

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18
Q

What are the clinical features of Cigarette Smoking-Related Keratosis?

A

smooth, white - rough -verruciform

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19
Q

What gender and ages are more commonly effected by Cigarette smoking-related keratosis?

A

Middle-aged males

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20
Q

What are the common sites of Cigarette keratosis?

A

Buccal mucosa, mucobuccal fold, and floor of mouth

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21
Q

Describe the histology of Cigarette keratosis.

A

benign, hyperkeratosis, acanthosis, and melanin incontinece

to

epithelial dysplasia, carcinoma in situ and invasive sqamous cell carcinoma

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22
Q

What are the treatment options for cigarette keratosis?

A

Removal and excision

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23
Q

Pipe/Cigar: nicotinic stomatitis

A

A benign epithelial change of both the surface and the minor salivary gland ducts;

Leads to hyperkeratosis and acanthosis with hyperplastic dilated salivary ducts

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24
Q

Where is nicotinic stomatitis most commonly found?

A

the palate (lip cancer where pipe is being held)

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25
Q

What are the clinical features of nicotinic stomatitis?

A
  • Diffuse white surface

- uniformly interspersed by small red dots (dilated salivary ducts)

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26
Q

Describe the histopathology of nicotinic stomatitis.

A

benign hyperkeratosis and acanthosis with salivary gland duct - proliferation and metaplasia

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27
Q

What are the treatment options for nicotinic carcinoma?

A

Stop smoking

examine lower lip and oro-naso pharyngeal area for SCC

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28
Q

What is the prognosis for nicotintic stomatitis?

A

depends on histology

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29
Q

Idiopathic Leukoplakia (keratosis) Overview.

A

Uncommon; histologically benign (hyperkeratosis and acanthosis)

can develop into SCC

can recur an dprogress over 1-2-30 years

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30
Q

What is the name of malignant Idiopathic Leukoplakia?

A

Proliferative verrucous leukoplakia (1/3 common smokers)

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31
Q

Erythroplakia overview:

A

Red patch that does does not represent any other disease. No histological connotation and should not be used as a diagnosis. Histological and clinical significance are much greater than leukoplakia

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32
Q

Erythorplakia vs. Leukoplakia

A

49% premalignant, 51% malignant VS. 80% benign, 17% premalignant, 3% SCC

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33
Q

Etiologies for erythroplakia?

A

tobacco and alcohol (75% of patients)

34
Q

What are the high risk sites for erythroplakia?

A

floor of mouth; ventrolateral tongue, soft palate area

35
Q

What are the clinical features of erythroplakia?

A

red, velvety, and well-demarcated areas

rough or smooth

rean and white (speckled) (sometimes)

ulcerated

36
Q

What gender and ages are most commonly effectedy by erythroplakia?

A

males over 45 yo

younger patients (smoking and tobacco)

37
Q

Describe the histology of erythroplakia.

A

mild epithelial dysplasia - CIS - SCC

38
Q

Clinical tips:

A
  • not a hemanioma = biopsy

- risk areas = biopsy

39
Q

What are the treatment options for erythroplakia?

A

Excision

40
Q

Papilloma overview

A

benign epithelial proliferation (may be true neoplasm of epithelial origin)

41
Q

What is the etiology of papilloma?

A

HPV 6/11

42
Q

what is the most common age papilloma occurs?

A

30-50 years old

43
Q

What are the risk areas for papilloma?

A

anywhere; floor of the mouth, soft palate, tongue

44
Q

What is the clinical presentation of papilloma’s?

A

Sessile or pedunculated, cauliflower-like keratotic lesion

45
Q

Describe the histology of a papilloma.

A

elevated finger-like projections of proliferateing epithelial cells supported by fibrous connective tissue core

46
Q

What are the treatment options for papilloma?

A

Excision

47
Q

Verruca Vulgaris

A
  • Common Wart

- benign lesions representing epithelial proliferation

48
Q

What is the etiology of VV?

A

HPV 2 and 4

49
Q

What are the clinical features of VV?

A

Indistinguishable from papilloma’s

Occurs in multiples (finger mouth)

50
Q

What ages are commonly effected by VV?

A

20% of all children

51
Q

Descrie the treatment options for VV?

A

thick keratin layers, alternating parakeratin and orthokeratin with granular cell layer and keratohyalin granules

52
Q

Condyloma acuminatium

A

Venereal wart
benign papillomatous proliferation of surface epithelium

30% of all STD’s

53
Q

What is/are the etiologies of conyloma acuminatum?

A

HPV 6/11

Sexually transmitted

54
Q

What are the clinical features of condyloma acuminatum?

A

common in genitals, occur in oral cavity

single papillary pinkish/white lesion or multiple membranous pink and papillomatous lesions

55
Q

Describe the histopathology of Condyloma acuminatum.

A

broad papillary projections with empty cytoplasm and meiosis

connective tissue is loose, vascular and filled with lymphoctes

56
Q

How do you treat condyloma acuminatum?

A

chemical cauterization, surgical removal

57
Q

Focal Epithelial Hyperplasia overview:

A

Heck’s disease.

Transmitted via contact and occurs in schools and families

58
Q

Who is commonly effected by focal epithelial hyperplasia?

A

Native Americans, South American Indians

59
Q

What are the clinical features of focal epithelial hyperplasia?

A

multiple lesions, slightly raised, smooth and same color as the surrounding mucosa

60
Q

What age group is usually effected by focal epithelial hyperplasia?

A
  • children younger than teenage years
  • rarely in 50yo patients
  • adult AIDS patients
  • congested areas
61
Q

Where are the most common locations of focal epithelial hyperplasia?

A

lip and buccal mucosa

then on the gingiva, palate and other

62
Q

Treatment for focal epithelial hyperplasia?

A

none, spontaneously go away

63
Q

Pigmented Nevi Overview:

A

benign neoplasms or hamartomas of melanocyte origin

64
Q

Junctional nevus Overview

A

Rare in the mouth

common on skin

65
Q

What are the clinica features of Junctional Nevus?

A

flat, well demarcated, brown

3% of all nevi in the oral cavity

66
Q

Describe the histology of a Junctional nevus.

A

nevus cells at the jucntion of the surface epithelium and underlying fibrous connective tissue
Melanin pigment is present

67
Q

Intramucosal Nevus Overview:

A

most common nevus of the oral cavity 55%

68
Q

What are the clinical features of intramucosal nevi?

A

elevated, papillary lesion, brown and/or amelanotic (pink)

69
Q

What is the most common location of intramucosal nevi?

A

gingiva

70
Q

Describe the histology of intramucosal nevi?

A

Aggregates and theaques of nevus cells in fibrous connective tissue, separate from the surface by a band of fibrous connective tissue

71
Q

Compund Nevus overview:

A

6% of all oral nevi

Brown elevated nodule

anywhere in the oral cavity

72
Q

Describe the histology of compund nevi.

A

aggregates of nevus cells present at the epithelial junctions and vibrous connective tissue

melanin pigment within nevus cells and surronding tissue

73
Q

Blue Nevus Overview

A

36% of oral nevi

74
Q

What are the clinical features of blue nevus?

A

slightly raised; bluish-black lesion

Most common on the palate

75
Q

Describe the histopathology of Blue nevus?

A

spinle-shaped nevus cells

in teh deeper portion of connective tissue parallel to collagen bundle

lots of melanin pigment

76
Q

Treatment options for blue nevus

A

excision (masticatory friction)

77
Q

Oral Squamous cell Carcinoma Overview

A

most common malignant neoplasm of the mouth

90% of all malignant neoplasms in the oral cavity

78
Q

What is the more common gender and age for SCC?

A

55 year old MEN or >60 men

young adults with history of tobacco chew

79
Q

What are the most common locations of SCC?

A

lateral and ventral tongue; floor of the moth, gingiva

80
Q

Clinical presentation of SCC?

A

benign - malignant looking

mistaken for lymphadenopathy

non-healing ulcer; red, red/white lesions; ulcers with rolled borders; fungating; fixation induration

81
Q

What are the main risk factors for SCC?

A

tobacco and aclohol

Oral Pathology Midterm (2 decks)

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