Oral mucosal lesions

Question 1

_______ cells are actively replicating in the oral mucosa

Answer 1

basal

Question 2

___________ is superficial CT

Answer 2

lamina propria

Question 3

What can cause mucosa to look white?

Answer 3

Increased keratin production
Increased thickness of epithelium

Question 4

_______ is when skin becomes thicker to protect (calluses)

Answer 4

Hyperkeratosis

Question 5

_______ is thickening of spinous cell layer

Answer 5

Acanthosis

Question 6

________ is chewing trauma

Answer 6

Frictional keratosis

Question 7

what is the histology of frictional keratosis?

Answer 7

“holes” in scan of cheek, superficial layer of keratin is shaggy and irregular in its appearance with bacterial colonization

Question 8

_______ is a fungus that can overgrow in the right environment

Answer 8

Candidiasis

Question 9

what is the histology like for Candidasis?

Answer 9

-increased keratin layering superficially
-Fungal hyphae noted throughout keratin layer
-Inflammatory cell exocytosis with neutrophils crossing over and collecting in superficial keratin layer
-Acanthosis
-Stains can highlight fungi

Question 10

______________ is caused by moist occlusion that can cause edema in the tissue

Answer 10

Tobacco pouch keratosis

Question 11

what is the histology of tobacco pouch keratosis?

Answer 11

-Hyperkeratosis
-Keratin can show chevron pattern
-Acanthosis
-Intraepithelial edema within the cells of the spinous later

Question 12

________ is swelling/inflammation on mucous membranes that looks like spiderwebs

Answer 12

Lichen planus

Question 13

what is the histology like for lichen planus?

Answer 13

-Hyperkeratosis
-Acanthosis
-Atrophy: areas of reduced thickening, can produce angular rete ridges
-Basal cell degeneration by inflammatory cells as well as inflammatory cell exocytosis into the epithelium
-Thickening of basement membrane zone
-Lamina propria shows superficial band like inflammatory cell infiltrate that is predominantly lymphocytic

Question 14

________ is a precancerous clinical diagnosis

Answer 14

Leukoplakia

Question 15

what are high risk cancer sites in the mouth?

Answer 15

lateral/ventral tongue, floor of mouth

Question 16

what is the histology of Leukoplakia?

Answer 16

-Rete ridges look rounder/more bullous
-Cell crowding

Question 17

what is the histology like of geographic tongue?

Answer 17

-Acanthosis
-Inflammatory cell exocytosis with neutrophils crossing over into the epithelium
-Aggregates of neutrophils noted in the superficial keratin and spinous cell layer

Question 18

________ is a clinical sign in which the gingiva appears reddish, glazed and friable with destruction of the epithelium

Answer 18

Desquamative gingivitis

Question 19

Clinical diagnosis of Desquamative gingivitis should include these following entities in a differential:

Answer 19

• lichen planus
• pemphigoid
• pemphigus

Question 20

_________ is the ability to produce a blister/slough tissue via physical pressure

Answer 20

Nikolsky sign

Question 21

what is the histology like of squamous cell carcinoma?

Answer 21

-Will show varying degrees of dysplastic change in the surface epithelium and invasive islands of atypical epithelial cells within the underlying CT
-Invasive islands are the defining feature
-keratin “pearl”
- abnormal mitosis

Question 22

______ is a single large dilated vessel

Answer 22

Varix

Question 23

________ is a proliferation of blood vessels within the underlying CT

Answer 23

Hemangioma

Question 24

_________ is a freckle-like, increased, melanin pigment deposition within the basal cell layer and often evidence of incontinent melanin pigment within superficial lamina propria

Answer 24

Melanotic macule

Question 25

______ is a disruption/loss of epithelium

Answer 25

Ulceration

Question 26

what is histology like in ulceration?

Answer 26

-loss of epithelium where epithelium is replaced by fibrinous exudate suspending inflammatory cells
-Underlying cell bed will consist of granulation tissue with subacute to chronic inflammation
-Looks like a canal

Question 27

what are the 3 types of ulceration?

Answer 27

-Aphthous ulcers (canker sores)
-Tugse: traumatic ulceration
-lichen planus

Question 28

what does lichen planus ulceration look like?

Answer 28

ulceration surrounded by striation

Question 29

__________ is an epithelial hyperplasia and papillary architectural change

Answer 29

Papillary surface change

Question 30

what is papilloma a result of?

Answer 30

HPV

Question 31

_________ is low risk HPV, like skin warts

Answer 31

Verruca vulgaris

Question 32

what is histology like for verruca vulgaris?

Answer 32

-papillary epithelial hyperplasia with prominent large intensely staining keratohyalin granules
-Papillary fronds will be parakeratotic
-Rete ridges at the periphery of the papillary proliferation will converge centrally

Question 33

what is this a scan of?

Answer 33

frictional keratosis

Question 34

what are these scans of?

Answer 34

Candidasis

Question 35

what is this a scan of?

Answer 35

tobacco pouch keratosis

Question 36

what is this a scan of?

Answer 36

lichen planus

Question 37

what is this a scan of?

Answer 37

sqamous cell carcinoma

Question 38

what is this a scan of?

Answer 38

mucous membrane pemphigoid

Question 39

what is this a scan of?

Answer 39

phemphigus vulgaris

Question 40

what is this a scan of?

Answer 40

Varix

Question 41

what is this a scan of?

Answer 41

melanotic macule

Question 42

what is this a scan of?

Answer 42

ulceration

Question 43

what is this a scan of?

Answer 43

Verruca vulgaris