Non-neoplastic proliferations

Question 1

which type of dog typically has calcinosis circumscripta?

Answer 1

less than 4yo large breed German shepherd

Question 2

which stain can be useful on cytological smears to identify calcinosis circumscripta?

Answer 2

von Kossa or Alizarin

Question 3

does calcinosis circumscripta come back or appear in new places?

Answer 3

no

Question 4

what is in a calcinosis circumscripta lesion?

Answer 4

• encapsulated deposit of minral salts (hydroxyapatite or amorphous calcium phosphate) most often on tongue (1st site - pelvic limb)

Question 5

what are the causes for drug-induced gingival enlargement?

Answer 5

• phenytoin derivatives - calcium channel blockers - cyclosporine - oral hygiene + genetic susceptibility

Question 6

describe the histopath findings of drug-induced gingival enlargement (verstraete)

Answer 6

• excessive accumulation of extracellular matrix proteins, such as collagen, or amorphous ground substance. An inflammatory infiltrate dominated by plasmacytes and thickened keratinized epithelium is typically present.

Question 7

what is fibrous focal hyperplasia?

Answer 7

sessile pink smooth mass due to reactive, subepithelial fibrosis as a result of chronic trauma (mostly on rostral maxilla)

Question 8

what are the other names for focal fibrous hyperplasia?

Answer 8

fibrous or fibromatous epulis

Question 9

how common (or rare) is fibrous focal hyperplasia in dogs?

Answer 9

very common 16 to 57% of oral lesions or 43,5% of epulis-like lesions

Question 10

what is the treatment for focal fibrous hyperplasia?

Answer 10

surgical excision + removal of the cause

Question 11

what does focal fibrous hyperplasia look like on histo?

Answer 11

bell: dense fibrous connective tissue with little epithelial hyperplasia or inflammation wiggs: exuberant stromal collagen, +- osseous metaplasia, mucosal epithelium that is hyperplastic or hyperkeratotic verstraete: dense fibrous connective tissue covered by stratified squamous epithelium

Question 12

according to verstraete, what breeds are predisposed to gingival hyperplasia?

Answer 12

boxer collie great dane dalmatian doberman

Question 13

what other entities are often present within gingival enlargement lesions in boxer dogs?

Answer 13

• fibromatous epulis of periodontal ligament origin (FEPLO)
• peripheral odontogenic fibroma (POF)

Question 14

what are the characteristics (including histo) of gingival hyperplasia according to bell?

Answer 14

• smooth to irregular nodular proliferation of the gingiva, usually affecting the free gingiva that cuffs the base of the tooth. - hyperplasia of both the mucosal epithelium and the subepithelial lamina propria. - The fibrous subepithelium is reminiscent of histologically normal tissue, just too much of it

Question 15

what is the lesion in cats caused by max PM4 on mand M1?

Answer 15

pyogenic or traumatic granuloma

N.B.: Can also be found in other locations: gingiva, mucosa, lips, tongue

Question 16

What is the histo of pyogenic granuloma?

Why is it called pyogenic?

Answer 16

• mass effect with granulation tissue, ulceration, fibrin, edema, epithial hyperplasia, lymphoplasmocytic inflammation, surface bacterial colonization from oral cavity.
• Pyogenic is a misnomer since not caused by bacteria infection; name originates from surface appearance of inflammed lesion with fibrinous membrane that resemble pustular discharge.

(Ref. Clinicopathologic charcterization of oral pyogenic granuloma in 8 cats. JOVD 2014)

Question 17

What is the treatment of choice for pyogenic granuloma?

Answer 17

• excision of lesion and odontoplastie of Mx PM4 (recurrence 25%) or extraction of MxPM4 and MxM1 (recurrence 10%).
• biopsy of lesion

Question 18

what is the real name of chewing lesions?

Answer 18

traumatic buccal (or sublingual) mucosal hyperplasia (verstraete)

Question 19

when is it advisable to treat chewing lesions?

Answer 19

only if they are in the occlusal path and keep being traumatized

Question 20

why are chewing lesions referred to as granulomas?

Answer 20

because it involves exuberant granulation tissue (as opposed to granulomatous inflammation)

Question 21

What is the differenc between Central Giant Cell Granuloma and Peripheral Gianl Cell Granuloma?

Answer 21

• 2 differents pathologies:
  
  • Central Giant Cell Granuloma: idiopahtic expansive radiolucent lesion of the jaw +/- agressive; Tx by curettage or radical sx
  • Peripheral Giant Cell Granuloma: frequent in cats (29% epulis); sessile or pedonculated pink-blue lesion of oral mucosl associated to trauma/maloccl.; mesenchymal cells + multinucleated giant cells among collagen matrix (not organised as true granuloma); excision + tx cause

Question 22

What is this condition?

Answer 22

Follicular Lymphoid hyperplasia (aggregates of lymphocytes/lymphoide tissue)

Question 23

What is this lesion?

Answer 23

Histocytic Foam Cells Nodules

• formed of vaculated histiocytes in skeletal myocytes or collagen stroma of tongue (Dachshund)

Question 24

What is Reactive Exostosis?

Answer 24

Proliferation of compact/cancelous alveolar bone due to repetitive trauma