Oral Cavity Path II Flashcards
oral hairy leukoplakia
immunosuppression and EBV
lateral border of tongue
lateral tongue, white, doesn’t scrape
oral hairy leukoplakia
**do an HIV test
balloon cells
balloon cells
oral hairy leukoplakia
black hairy tongue
poor hygiene
-don’t scrape off and debride surface of tongue
tobacco, coffee, tea
rash with ampicilin
mononucleosis
monospot test
neurophile antibodies - for EBV
-mono test
other mono test
mix serum from patient with sheep/horse RBCs
- EBV - creates heterophile antibodies
- positive - agglutination of RBCs - clumping
mononucleosis
hyperemic mucosa - posterior pharynx
irritation fibroma
bite line - tongue or mucosa
-repetitive trauma
reactive fibroblast tissue
tx - surgical excision
pyogenic granuloma
gingiva, tongue
-pregnancy tumor
reactive granulation tissue
- benign inflammatory vascular lesion
- may bleed
common in young people
tx - surgical excision
pregnancy tumor
pyogenic granuloma
granulation tissue
cancer of oral cavity
95% SCC
5% adenocarcinoma of salivary glands
tobacco and alcohol
india - chew betel quid and paan
oral pharynx - type 16 HPV
posterior pharynx cancer
HPV - 16 and 18
anterior mouth cancer
tobacco
cells pass BM
metastasis
need biopsy to determine lesion is malignant
leukoplakia
white patch/plaque
-cannot be scraped off
due to increased keratin
hyperkeratosis
not premalignant change
bx needed
erythroplakia
red patch
- less common than leukoplakia but more ominous
- 90% dysplasia or CIS
highly vascular eroded mucosa
keratin peral
squamous cell carcinoma
oral SCC
80% are stage II/III with high rate of recurrence
stage 3 and 4 SCC
always radiation
CIS SCC of oral cavity
treated like stage 1 - primary surgery/ radiation
five hear survival stage 1/2 SCC
70-90%
-need careful follow up
increased risk of second head and neck cancer as well as lung ca
wide local excision
oral cavity cancers
transoral laser resection
oropharynx, hypopharynx, larynx
strawberry tongue
scarlet fever
koplik spots
measles
acute pharyngitis and tonsillitis - gray white exudative membrane
infectious mono
wartons duct
submandibular gland
-gleeking
salivary glands
parotid - serous
submandibular - mixed
sublingual - mixed
minor salivary glands
lubrication
-buccal, gingival, palatal mucosa
acute b/l tender swelling of parotid and salivary glands lasting 2 days
mumps
-virus
mumps complication
testicular inflammation - orchitis
sterility may occur
parotitis
swelling of parotid gland
-mumps
may last up to 10 days
mumps vaccine
MMR
third dose - in outbreak setting
contraindication - pregnant, immunosuppressed, malignancy
sjogrens syndrome
third most common autoimmune
-female age 40yo
autoAbs agasinst Ags in salivary glands and lacrimal glands
keratoconjunctivitis and xerostomia
sjogrens
dry eyes and dry mouth
sicca syndrome
dry eyes and mouth
-sjogrens
severe sjogrens
risk of NHL
diagnosis of xerostomia
bx of salivary gland
-see lymphocytes attacking glands
sjogrens association
rheumatoid arthritis
SLE, polymyositis, scleroderma, vasculitis, thyroiditis
blurry vision, itchy, dysphagia, dry mouth, inabilty to taste
sjogrens
SS-A titers
extraglandular sjogrens disease - synovitis, pulmonary fibrosis, peripheral neuropathy
more likely to have early disease onset and longer duration as well
mikulicz syndrome
lacrimal and salivary gland enlargement from any cause
sjogrens dx
- biopsy
- CD4 T cells ans B cells
- rheumatoid factor - IgG
- ANAs on immunofluorescence
- SS-A and SS-B
mucocele
msot common lesion of salivary gland - mucous retention cyst
block of salivary gland tract
often lower lip**
tx - excision - if incomplete - recurrence occurs
sialolith
blockage of salivary duct - food particle = nidus
enlargement with aggregation of dehydrated mucous
often submandibular gland
bacterial sialadenitis
unilateral duct obstruction causes stasis
allows infection - staph aureus or strep viridans
acute inflammation - to chronic inflammation
benign tumors of salivary gland
pleomorphic adenima - mixed
warthin tumor
malignant tumor of salivary gland
mucoepidermoid carcinoma
adenoid cystic carcinoma
pleomorphic adenoma
mixed tumor- benign
-of salivary gland
50% of all tumors of salivary gland
epithelial and mesenchymal cells
-arise from basal myoepithelial cells
epihelial and myxoid tumor
pleomorphic adenoma of salivary gland
can be left in place
15 years - 10% develop to malignant
painless slow growing mobile discrete mass in submandibular/buccal area
pleomorphic adenoma
warthin tumor
papillary cystadenoma lymphomatosum
10% salivary tumors, benign
-males, 50-60yo, smokers**
warthin tumor bx
double layer of eosinophilic epithelial cells over lymphoid stroma*
malignant tumors of head and neck
adenocarcinoma
mucoepidermoid carcinoma
adenoid cystic carcinoma
mucoepidermoid carcinoma
parotid
- malignant
- slow growing
grade important for px
- high grade - invasive
- low-hrade - rare mets
mucicarmine stain - for mucin
and pink sqamous epidermoid cells
adenoid cystic carcinoma
malignant of salivary gland
infiltrate along nerve**
-perineural invasion
recurrent common
swiss cheese appearance - holes
