Oral Path 2 Flashcards
True or false… biopsy is mandatory with any leukoplakia
True
Proliferative verrucous leukoplakia is recurrent and warty. It may be associated with HPV ___ and ___. It has a high risk of malignant transformation to ___ and ___
16 and 18
SCC or verrucous carcinoma
Which has a higher risk of malignancy, leukoplakia or erythroplakia?
Erythroplakia
What is actinic cheilitis?
Lip inflammation/crusties due to sun damage (UVB rays especially)
What are the two highest risk sites for cancer lesions?
FOM
Posterior lateral tongue
Malignant neoplasm is a term given to cancer as soon as it invades past the ____
Basement membrane
Verrucous carcinoma is a [slow/fast] growing malignancy. It can be caused by ___ or ___ and ___. What is the treatment of choice?
Tobacco
HPV 16 and 18
Excision
SCC (squamous cell carcinoma) is caused by ___ or inactivation of ____. There is increased incidence of oropharyngeal SCC associated with ___ and ___. The 5-year survival rate is about ___%.
Oncogenes
Tumor suppressor genes
HPV 16 and 18
50%
____ is mucosal atrophy + dysphagia + iron deficiency anemia + increased risk of oral cancer
Plummer-Vinson Syndrome
What is the treatment of choice for SCC?
Excision or radiation
True or false… basal cell carcinoma frequently metastasizes
False, very rarely
Oral melanoma is a malignancy of ___. High-risk sites are the ___ and the ___. 5 year survival rate for skin lesions is greater than ___%, but less than ___% for oral lesions.
Melanocytes
Palate and gingiva
65%
20%
Name three medications that can cause gingival hyperplasia
Calcium channel blockers
Dilantin
Cyclosporine (immunosuppressant)
What is the treatment of choice for gingival hyperplasia?
Gingivectomy
Discontinue drug if possible
Denture-induced fibrous hyperplasia is called ___ if found in the vestibule and called ___ if found on the palate
Epulis fissuratum
Papillary hyperplasia
____ is an entangled submucosal mass of neural tissue and scar. Caused by injury to nerve.
Traumatic neuroma
Where is the most common location of a traumatic neuroma?
Mental foramen
____ = multiple neuromas + medullary thyroid cancer + pheochromocytoma of adrenal gland
Multiple endocrine neoplasia (MEN 2B)
Pyogenic granuloma is a hyperplasia of ____
Capillaries, causing it to be red
Nodular fasciitis is a neoplasm of ____. It is easy to eradicate and rarely recurs
Fibroblasts
____ is a neoplasm of fibroblasts, however it is difficult to eradicate and often recurs
Fibromatosis
A granular cell tumor is a neoplasm of ___. It is named such because these tumor cells have a ___.
Schwann cells
Granular cytoplasm
A granular cell tumor has _____ in the tumor which mimics SCC. Where is it most commonly found?
PEH (pseduoepitheliomatous hyperplasia)
Dorsal tongue
A variant of granular cell tumor is found on the gingiva of newborns. It is called ___ and it has no ___
Congenital epulis
No PEH (pseudoepitheliomatous hyperplasia)
____ is a neoplasm of Schwann cells and has acellular verocay bodies in antoni A tissue
Schwannoma (neurilemmoma)
A neurofibroma is a neoplasm of ___ and ___
Schwann cells and fibroblasts
Neurofibromatosis type 1 (von recklinghausen’s disease) = ___+ ___ + ___ + ___
Multiple neurofibromas
Multiple skin freckles (cafe au lait spots)
Axillary freckles (Crowe’s sign)
Iris freckles (lisch spots)
Note that neurofibromas can transform to neurofibrosarcomas in this syndrome
____ is a neoplasm of smooth muscle cells
Leiomyoma
___ is a neoplasm of skeletal muscle cells
Rhabdomyoma
____ is a neoplasm of fat cells. Intraorally, it is found most commonly ___
Lipoma
Buccal mucosa
_____ is a malignant proliferation of fibroblasts
Fibrosarcoma
____ is also known as a malignant peripheral nerve sheath tumor. It is a malignant proliferation of Schwann cells
Neurofibrosarcoma
Kaposi’s sarcoma is a malignant proliferation of ____. It is caused by HHV___ and most commonly seen as a complication of ___. The lesions are ___ in color.
Endothelial cells
8
AIDS
Purple
____ is a malignant proliferation of smooth muscle cells
Leiomyosarcoma
Mucous extravasation phenomenon is caused by trauma to ___
Salivary duct
What is the difference between a mucous retention cyst and a mucous extravasation phenomenon?
Mucous retention cysts histologically are true cysts as they are lined with epithelium.
Caused by blockage of a salivary duct by a sialolith
Necrotizing sialometaplasia is a [slowly/rapidly] expanding ulcerative lesion. It is usually due to ___ necrosis of minor salivary glands in response to trauma or local anesthesia. What is the treatment of choice?
Rapidly
Ischemic
It will heal on its own in 6-10 weeks
A sinus retention cyst is also called ____. It is caused by….
What is the treatment of choice?
Antral pseudocyst
Blockage of glands in sinus mucosa
None
Which expands faster, sinus retention cyst or a sinus mucocele?
Sinus retention cyst
Sarcoidosis is due to a [hyper/hypo] immune response resulting in granulomas. It may be triggered by ___. It is primarily a pulmonary disease but also affects ___ and ___
Hyperimmune
Mycobacteria
Salivary glands (resulting in xerostomia) and mucosa
___ syndrome = erythema nodosum + bilateral hilar lymphadenopathy + arthritis
Lofgren’s
____ syndrome = anterior uveitis + parotid gland enlargement + facial nerve palsy + fever; also called uveoparotid fever
Heerfordt
What is the treatment of choice for sarcoidosis?
Corticosteroids
Sjögren’s syndrome is autoimmune and is ___ mediated. It affects salivary and tear glands. What is the treatment of choice?
Lymphocyte
Treat the symptoms
What is the difference between primary and secondary Sjögren’s syndrome?
Primary = keratoconjunctivitis sicca (dry eyes) and xerostomia
Secondary = above plus another autoimmune disease (usually RA)
_____ is the most common benign salivary gland tumor. It is a firm, rubbery swelling. It is composed of what cell type?
Pleomorphic adenoma
Mixture of cell types (epithelial and CT), why it is also called mixed tumor
Where are the most common locations for a pleomorphic adenoma?
Palate for minor salivary glands
Ear for parotid gland
A pleomorphic adenoma is described as a ___ ___ swelling
Firm, rubbery
Monomorphic adenomas are composed of a single cell type. Name 4 different monomorphic adenomas
Basal cell adenoma
Canalicular adenoma
Myoepithelioma
Oncocytic tumor
Warthin’s tumor is composed of ___ (which are ___) and ___. It is usually found in the ___ gland of older men.
Oncocytes (whic are epithelial cells with excessive number of mitochondria)
Lymphoid cells
Parotid
Salivary gland diseases that are malignant are most common in which location?
Palate
What is the most common salivary gland malignancy? What cells is it composed of?
Mucoepidermoid carcinoma
Mucous and epithelial cells
What is the second most common salivary gland malignancy for minor glands?
Polymorphous low-grade adenocarcinoma
Adenoid cystic carcinoma has a ___ or ___ microscopic pattern. 5-year survival rate is __%, whereas the 15 year survival rate it ___%
Cribriform or Swiss cheese
70%
10%
True or false… all lymphoid neoplasms are malignant by nature
True
____ lymphoma has reed sternberg cells, which are malginant ___ cells.
Hodgkin’s
B
Non-hodgkin’s lymphoma is a neoplasm of __ or __ cells.
B or T
____ is a type of B cell non-hodgkins lymphoma (NHL) with bone marrow involvement, swelling, pain, tooth mobility, lip paresthesia, and halts root development
Burkitt’s lymphoma