Oral Malignancies Flashcards
Hodgkin lymphoma age of incidence/pattern?
bimodal - 15 to 35 and after 50.
Hodgkin lymphoma affects what lymph nodes?
cervical and supraclavicular nodes initially
Hodgkin lymphoma clinical presentation
Persistent enlarging, nontender mass in lymph node. Initially movable but becomes fixed.
Weight loss, fever, night sweats, generalized pruritus
Hodgkin lymphoma histopath
Reed-sternberg cell “owl eye”/”pennies on plate” nucleus
Non-hodgkin lymphoma most common in what patients?
Most common malignancy of AIDS patients
Non-hodgkin lymphoma magority are what cells?
Majority B-cell
MALT lymphoma is what kind of lymphoma? Associated with what sydnrome?
Non-hodgkin lymphoma, Sjogrens syndrome
Non-hodgkin lymphoma clinical presentation
mass of lymph nodes
erythematous and boggy soft tissue
Oral - soft tissue or bone
Bony involvement presents as vague pain with ill-defined radiolucency
Burkitt Lymphoma from expression of what virus?
EBV
Two types of Burkitt Lymphoma?
endemic/african - posterior maxilla/mandible, prevalent in young children
Sporadic/American - abdominal
Burkitt Lymphoma clinical findings
Facial swelling
Proptosis
Enlargement of gingiva Destruction of alveolar bone Deciduous tooth loss
Burkitt lymphoma genetic source?
t(8;14) MYC oncogene
Burkitt lymphoma histopath?
“starry sky” from macrophages
Extranodal NK/T-Cell Lymphoma aka?
Angiocentric T-Cell lymphoma,
midline lethal granuloma
Extranodal NK/T-Cell Lymphoma clinical features
Nasal/palatal perforations
Nasal stuffiness
Epistaxis
Swelling of soft palate/ulceration
Leukemia is malignancy of…
hematopoietic stem cells - proliferation of abnormal white blood cells & immature white cells
Leukemia forms..
Chronic myeloid - philadelphia chromosome 22
Chronic lymphocytic - most common type, elderly
Acute lymphoblastic - children
Acute myeloid - over 40 yrs
Clinical presentation of leukemia
Myelophthisic anemia fatigue thrombocytopenia fever oral findings
What is myelophthisic anemia
crowding out normal hematopoietic stem cells by malignant cells
What are intraoral findings of leukemia?
Diffuse boggy gingival enlargment (mostly in myelo types) Candidiasis Neutropenic ulcers Herpetic infection Tumorlike growth
Multiple myeloma malignancy of?
plasma cells
Multiple myeloma radiographic features?
punched out well defined radiolucency
Multiple myeloma presenting symptoms
bone pain
fatigue
renal failure
Multiple myeloma clinical features?
firm and enlarged tongue
periorbital skin firm waxy
Most common skin cancer?
Basal cell carcinoma
Basal cell carcinoma caused by
chronic exposure to UV rays
Basal cell carcinoma associated with what syndromes
Nevoid basal cell ca syndrome aka Gorlin syndrome
Basal cell carcinoma clinical features
firm, painless papule with central depression
Basal cell carcinoma metastasis how common?
Rare
Nasopharyngeal carcinoma caused by?
EBV
Lack vitamin C
salt fish
Malignant salivary gland tumors most common form?
mucoepidermoid carcinoma
Kaposi sarcoma caused by?
HHV 8
Epidemic form of Kaposi sarcoma appearance
Red/purple non-blanching plaques on hard palate, gingiva, tongue.
Can invade bone and cause tooth mobility
Rhabdomyosarcoma types?
embryonal - most common
alveolar
pleomorphic on extremities
Most common soft tissue sarcoma in children?
Rhabdomyosarcoma
Frequent location of Rhabdomyosarcoma?
head and neck, genital tract
Leiomyosarcoma malignancy of?
smooth muscle
Leiomyosarcoma common locations?
uterine wall and GI tract
Angiosarcoma malignant tumor of?
vascular endothelium
Malignant peripheral nerve sheath tumor common seen in patients with?
Neurofibromatosis type 1
Malignant peripheral nerve sheath tumor clinical features?
rapidly enlarging mass with pain & nerve deficit
Malignant peripheral nerve sheath tumor radiographic apperance
widening of mandibular canal or mental foramen
Osteosarcoma malignancy of?
mesenchymal cells that produce osteoid
Most common malignancy in bone (excluding hematopoietic neoplasms)?
osteosarcoma
Risk factor for osteosarcoma?
paget disease
osteosarcoma radiographic findings
Sunburst pattern Codman triangle elevation of periosteum Symmetrical widening of PDL Radiopaque Mixed Radiolucent with ill-defined borders
Chondrosarcoma neoplasm of tumor cells forming what?
cartilage lol
Ewing sarcoma - genetic source
t11;22
Ewing sarcoma radiographic apperance
onion skin
ill-defined radiolucency or mixed pattern
Explanation for blood-borne metastasis to head/neck?
Batson plexus - valveless vertebral venous plexus bypass filtration through lungs and allow retrograde spread of tumor cells
Common site of soft tissue metastasis?
gingiva
Clinical features for soft tissue metastasis
nodular mass, surface ulceration
Common metastasis sources to oral?
Men: lung, renal, skin
Women: breast, renal, genital
Most common cause of cancer involving bone?
metastatic carcinoma to bone
metastatic carcinoma to bone affects what bone in face?
mandible esp molar region
metastatic carcinoma to bone common tumor source
Breast, lung, prostate, thyroid, kidney
metastatic carcinoma to bone clinical features?
Pain, swelling, tooth mobility, trismus
Numb chin syndrome
metastatic carcinoma to bone radiographic features
ill-defined/moth-eaten radiolucent
Pathologic fracture
Widening of PDL
