OPMD and Oral Cancer

Question 1

What is meant by a potentially malignant lesion

Answer 1

Altered tissue in which cancer more likely to form

Question 2

What is meant by potentially malignant disorder

Answer 2

Generalised state with increased cancer risk

Question 3

Name some potentially malignant conditions

Answer 3

Lichen planus

Oral submucous fibrosis

Iron deficiency

Tertiary syphilis

Question 4

Name some potential malignant lesion

Answer 4

Leukoplakia
-chronic hyperplastic candidosis
-proliferative verrucous leukoplakia

erythioplokia

Question 5

What type of pt would have chronic hyperplastic candidosis and what it show

Answer 5

Smokers

Commisures

Dysplasia may be present

Question 6

What is PAS

Answer 6

Periodic Schiff stain

Question 7

What does PAS stain

Answer 7

To demo Candida albicans hyphae clearly

Question 8

How do you treat chronic hyperplastic candidosis

Answer 8

Systemic anti fungal
-fluconazole capsules 14 days

Biopsy to diagnose

Stop smoking

Question 9

In the UK where do most oral carcinomas arise

Answer 9

Clinically normal mucosa

Question 10

What is more likely to progress to cancer than normal mucosa

Answer 10

Leukoplakia 50-100 times

Question 11

What sites is leukoplakia low risk to turn cancer

Answer 11

Buccal

Question 12

What sites is leukoplakia high risk to turn cancer

Answer 12

Floor of mouth

Tongue

Question 13

What clinical appearance appearance of leukoplakia wousk be a good sign

Answer 13

Homogenous

Question 14

What clinical signs of leukoplakia would be a bad sign

Answer 14

Non homogenous
-verrucous, ulcerated Leuko erythroplakia

Question 15

What type of leukoplakia has highest chance of turning malignant

Answer 15

Proliferation verrucous leukoplakia

Question 16

What is the criteria for diagnosis of a potentially malignant Lesion

Answer 16

Asses architectural changes
-abnormal maturation and stratification

Assess cytological abnormalities
-cellular atypia

Question 17

How do you grade epithelial dysplasia

Answer 17

Hyperplasia

Mild
Moderate
Severe

Carcinoma in situ

Question 18

What is basal hyperplasia and what does it look like

Answer 18

Increase in basal cell numbers

Regular stratification
Basal compartment is larger
No cellular atypia

Question 19

What does milf dysplasia look like histologically

Answer 19

Changes in the lower third of the architecture

Mild atypia

Question 20

What does moderate hyperplasia look like

Answer 20

Architecture- changes extend to middle third

Cytology- moderate atypia

Question 21

What does severe dysplasia look like

Answer 21

Architecture- changes extend to upper third

Cytology- severe atypia and numerous mitoses, abnormally high

Question 22

What are onco genes

Answer 22

gene that has the potential to cause cancer

Question 23

What are tumour suppressor genes

Answer 23

They suppress the growth of cells

Question 24

What is important about tp53

Answer 24

If it’s mutated or inactivated it results in a p53 protein that is less able to control cell proliferation. Specifically, it is unable to trigger apoptosis in cells with mutated or damaged DNA

Question 25

What is meant by knudsons two got hypothesis of carcinogenesis

Answer 25

in order for a particular cell to become cancerous, both of the cell’s tumor suppressor genes must be mutated

Question 26

What changes happen to DNA in cancer

Answer 26

Changes to chromosomes
-aneuploidy, translocations, amplifications

Genes
-mutations, deletions, amplifications

Epigenetic changes

Question 27

What are the 6 hallmarks of cancer

Answer 27

Self sufficiency in growth signals

Insensitivity to anti growth signals

Tissue invasion and metastasis

Limitless reply drive potential

Sustained angiogenesis

Evading apoptosis

Question 28

How can oral cancer spread

Answer 28

Local extension of disease

Lymphatic spread

Haematogenous spread