Oral and Maxillofacial Pathology Flashcards

1
Q

What are the three different types of biopsy?

A
  • Incisional (part of the specimen removed)
  • Excisional (entire of the specimen removed - include normal tissue too)
  • Resection (usually after incisional biopsy - removing the remaining tumour)
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2
Q

When would you refer to oral medicine for a biopsy?(6)

A
  • red/white patches
  • erosions/ulcers
  • vesiculobullous lesions
  • burning mouth syndrome
  • facial pain
  • xerostomia
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3
Q

What is the name for when multiple biopsies are used?

A

Mapping biopsies

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4
Q

What are the different methods of biopsies?(5)

A
  • standard soft tissue tray
  • diathermy
  • punch biopsy
  • CO2 laser therapy
  • Cryotherapy
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5
Q

What are the benefits of frozen sections (cryotherapy) for biopsies?

A

You can get a rapid diagnosis of malignancy (1 hour) and you can exclude carcinoma at the time of surgery

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6
Q

What are the disadvantages of frozen sections (cryotherapy) for biopsies?

A

It is difficult to assess the dysplasia with confidence

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7
Q

What type of biopsy is required for direct immunofluorescence?

A

Frozen sections (cryotherapy)

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8
Q

What is exfoliative cytology?

A

The removal of surface cells by scraping with a spatula or cytobrush

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9
Q

What does fine needle aspiration cytology (FNAC) help to determine?

A

Whether a lesion is solid or cystic (fluid filled)

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10
Q

When is fine needle aspiration most useful?

A

With lumps in the parotid glands and neck lumps to determine if the lump is a tumour

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11
Q

When are true cut biopsies usually used?

A

For neck lumps

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12
Q

What are labial gland biopsies usually used for?

A

To determine salivary gland pathology and aid in the diagnosis of Sjorgens syndrome

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13
Q

How does Toluidine blue work?

A

It binds to and dyes acidic tissue components of DNA and RNA

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14
Q

What does Toludine blue help to detect?

A

Oral epithelial dysplasia

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15
Q

What is the ViziLite System used to detect?

A

The mucosal tissues undergoing abnormal metabolic or structural changes that have different absorbance and reflectance profiles when exposed to different forms of light sources

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16
Q

What does VELscope (visually enhanced lesion scope) work on the principle of?

A

That tissues become fluorescent on excitation with a suitable wavelength but diseased tissues loose fluorescence (so appear darker in colour)

17
Q

How is leukoplakia diagnosed?

A

By exclusion of everything else (a white plaque with no other cause)

18
Q

What is the prevalence of leukoplakia?

A

1-4%

19
Q

What is the % of malignant transformation leukoplakia?

A

8-22%

20
Q

How is leukoplakia treated?

A

Surgical excision, serial biopsies and serial reviews with photography

21
Q

What does leukoplakia present as?

A

A white plaque (with no other cause)

22
Q

What does erythroleukoplakia present as?

A

Red, pebbly, granular plaque

23
Q

What % of erythroleukoplakia will have dysplasia (abnormal cells in the tissue - pre-malignancy)?

A

90%

24
Q

What is submucous fibrosis characterised by?

A

Juxtaepithelial inflammation and fibrosis of oral mucosa with progressive trismus

25
Q

What food is submucous fibrosis closely associated with?

A

Areca nuts

26
Q

What is the malignant transformation rate of submucous fibrosis?

A

7-30%

27
Q

How is submucous fibrosis treated?

A

Medical, physical and surgical management

28
Q

What is proliferative verucous leukoplakia (PVL)?

A

A progressive, multifocal, exophytic, persistent disorder

29
Q

What demographic does proliferative verrucous leukoplakia (PVL) usually present in?

A

Elderly women

30
Q

What is malignant transformation rate of proliferative verrucous leukoplakia (PVL)?

A

70-100%

31
Q

How long does the malignant transformation of proliferative verrucous leukoplakia take?

A

Around 23 months

32
Q

What is the currently used treatment for proliferative verrucous leukoplakia?

A

Surgery

33
Q

How long would an ulcer need to be present for it to be a cancer red flag?

A

More than 2 weeks (after removal of obvious causation)

34
Q

What are the lymphatic red flags for oral cancer?

A

Cervical lymphadenopathy (nodes enlarged by 1cm and be firm, fixed, tethered and non-tender)

35
Q
A