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BDS3 > Neoplasm > Flashcards

Neoplasm Flashcards

1
Q

What are FOUR environmental risk factors for malignant transformation?

A
  • UV light
  • smoking
  • alcohol
  • HPV
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2
Q

What are FIVE architectural features of epithelial atypia (ie. dysplasia)?

A
  • Drop shaped rete pegs
  • Single-cell keratinisation (dyskeratosis)
  • Superficial mitotic figures
  • Loss of polarity of basal cells
  • Irregular stratification
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3
Q

What are TWO cytological features of epithelial atypia (ie. dysplasia)?

A
  • Nuclear pleomorphism
  • Cellular pleomorphism
    (pleomorphism = abnormal size/shape)
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4
Q

What is carcinoma in situ?

A

Severe epithelial dysplasia but not past the basement membrane

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5
Q

Oral submucous fibrosis:

  • Clinical features
  • Cause
  • Consequence
A
  • Submucosal striated whitening (limited mouth opening in severe cases)
  • Tobacco chewing cause
  • Also cancer risk
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6
Q

True or false: There is no cancer risk in Syphilis.

A

False, there is a very high cancer risk in tertiary syphilis.

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7
Q

Leukoplakia:

  • Clinical appearance
  • Cause
  • Types
  • Consequence
A
  • A fixed white patch/plaque that cannot be characterised clinically/pathologically as any other disease.
  • Obscure: trauma/alcohol/food/infections/tobacco
  • Homogenous and speckled
  • Speckled has malignancy risk
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8
Q

True or false: Erythroplakia has a cancer risk.

A

True

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9
Q

Why can’t acute hyperplastic candidiasis be termed candidal leukoplakia while chronic hyperplastic candidiasis can?

A

In chronic, the white lesion is fixed (not easily scraped off).

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10
Q

Lichen planus:

  • Clinical appearance
  • Common onset
  • Histology
  • Management
A
  • Often bilateral, either striated (painless) or atrophic/erosive (painful)
  • > 40yo
  • Striated (hyperkeratosis, saw-tooth rete pegs), atrophic/erosive (thinning of epithelial layer), both have lots of T-cell involvement causing the destruction (apoptosis of basal keratinocytes)
  • Corticosteroids (topical/systemic), CHX for pain
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11
Q

What is the common clinical appearance of gingival lichen planus? What else might you use to differentiate it from other gingival redness?

A
  • Atrophic mostly with straited on interdental papillae

- Lichen planus on the rest of the mouth may be present (or you could just take a biopsy)

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12
Q

True or false: Lichen planus and chronic candidiasis do not have a cancer risk.

A

False, although cancer risk for them is low.

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13
Q

What is ONE example topical corticosteroid with instructions for treatment of lichen planus.

A 
Betamethasone dipropionate (Diprosone) 0.05% ointment
- Apply tid after meals for a max of 6 weeks.
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14
Q

What are THREE risk factors for SCC?

A
  • Smoking (main)
  • Alcohol (main - may potentiate smoking risk factor by making mucosa more accessible via atrophy)
  • HPV type 16 or 18 (SCC less mutations so easier to treat)
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15
Q

SCC clinical appearance?

A

Quite variable.
Red, speckled or white patches.
Can be raised nodule or non-healing ulcer with raised borders.

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16
Q

What does it mean when a lesion is less differentiated?

A

Growth rate is more out of control and differentiation cannot keep up.

17
Q

What is the grading system for SCC degree of differentiation? What is an example feature?

A 
Grade 1 (Well differentiated) - (moderate) - (poorly) -  Grade 4 (Anaplasia - similar to poorly)
Example: Are there prickle cells and keratin formed?
18
Q

Tumour location in the oral cavity can determine risk of spread. How so?

A

The more posterior the tumour is, the greater chance of spread (more vascularity and lymphatics)

19
Q

Describe the TNM staging system.

A 
T = size (T1, T2 2-4cm diameter, T3, T4 >4cm and invading local structures)
N = condition of regional lymph nodes (N0, N1 ipsilateral, N2 contra/bilateral, N3 fixed)
M = metastases (M0, M1)

Stage 1 = T1, N0, M0
Stage 2 = T2, N0, M0
Stage 3 = T3, N0, M0 or N1 with any T
Stage 4 = N2/N3 with any T or M1 with any T/N

Stage 1/2 = >50% 5yr survival
Stage 3 = 15-20%
Stage 4 = <5%

20
Q

What are THREE dentally relevant side effects of radiotherapy? Which is generally a long term side effect?

A
  • Mucositis
  • Xerostomia (caries, candida, taste - long term)
  • Osteoradionecrosis
21
Q

What are the suffixes for benign and malignant lesions?

A

“oma” = benign (e.g. osteoma)

“carcinoma” (epithelial) or “sarcoma” (mesenchymal) = malignant (e.g. osteosarcoma)

22
Q

Give examples of benign and malignant fibrous tumours and one fact for each.

A

Benign
- Solitary fibrous tumour (collagenous)
- Myxoma (myxoid stroma = non-collagenous, lots of ground substance)
Malignant
- Fibrosarcoma (most common malignant mesenchymal tumour in oral/oropharynx with many pts <20yo - painless growth)

23
Q

Name benign and malignant tumours for:

  • Fat
  • Muscle
  • Endothelium
  • Nerve
A
  • Fat (lipoma, liposarcoma)
  • Muscle (leiomyoma, leiosarcoma, rhabdomyosarcoma)
  • Endothelium (angioma, angiosarcoma)
  • Nerve (schwannoma, neurofibroma - both benign)
24
Q

Do malignant peripheral nerve sheath tumours appear radioopaque or radiolucent?

A

Radiolucent

25
Q

Granular cell tumour and granular cell epulis:

  • Clinical appearance
  • Location
  • Histology
A

Granular cell tumour (found on the tongue)
Granular cell epulis (on newborns alveolar ridge)

Both

  • Painless smooth swellings (benign)
  • Histology: cells with granular cytoplasm
26
Q

What is a lymphoma and where would we find non-hodgkin lymphoma vs. hodgkin lymphoma?

A 
Lymphoma = tumour of the lymphoid cells
Non-hodgkin = palate, gingiva, tongue
Hodgkin = Waldeyer's ring (palatine tonsil), rarely oral cavity
27
Q

Metastatic tumours generally present as radioopaque or radiolucent?

A

Radiolucent

BDS3 (22 decks)

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