Oral and Maxillofacial Pathology Flashcards
What are the three different types of biopsy?
- 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)
When would you refer to oral medicine for a biopsy?(6)
- red/white patches
- erosions/ulcers
- vesiculobullous lesions
- burning mouth syndrome
- facial pain
- xerostomia
What is the name for when multiple biopsies are used?
Mapping biopsies
What are the different methods of biopsies?(5)
- standard soft tissue tray
- diathermy
- punch biopsy
- CO2 laser therapy
- Cryotherapy
What are the benefits of frozen sections (cryotherapy) for biopsies?
You can get a rapid diagnosis of malignancy (1 hour) and you can exclude carcinoma at the time of surgery
What are the disadvantages of frozen sections (cryotherapy) for biopsies?
It is difficult to assess the dysplasia with confidence
What type of biopsy is required for direct immunofluorescence?
Frozen sections (cryotherapy)
What is exfoliative cytology?
The removal of surface cells by scraping with a spatula or cytobrush
What does fine needle aspiration cytology (FNAC) help to determine?
Whether a lesion is solid or cystic (fluid filled)
When is fine needle aspiration most useful?
With lumps in the parotid glands and neck lumps to determine if the lump is a tumour
When are true cut biopsies usually used?
For neck lumps
What are labial gland biopsies usually used for?
To determine salivary gland pathology and aid in the diagnosis of Sjorgens syndrome
How does Toluidine blue work?
It binds to and dyes acidic tissue components of DNA and RNA
What does Toludine blue help to detect?
Oral epithelial dysplasia
What is the ViziLite System used to detect?
The mucosal tissues undergoing abnormal metabolic or structural changes that have different absorbance and reflectance profiles when exposed to different forms of light sources
What does VELscope (visually enhanced lesion scope) work on the principle of?
That tissues become fluorescent on excitation with a suitable wavelength but diseased tissues loose fluorescence (so appear darker in colour)
How is leukoplakia diagnosed?
By exclusion of everything else (a white plaque with no other cause)
What is the prevalence of leukoplakia?
1-4%
What is the % of malignant transformation leukoplakia?
8-22%
How is leukoplakia treated?
Surgical excision, serial biopsies and serial reviews with photography
What does leukoplakia present as?
A white plaque (with no other cause)
What does erythroleukoplakia present as?
Red, pebbly, granular plaque
What % of erythroleukoplakia will have dysplasia (abnormal cells in the tissue - pre-malignancy)?
90%
What is submucous fibrosis characterised by?
Juxtaepithelial inflammation and fibrosis of oral mucosa with progressive trismus
