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D2 Spring > Oral Path Exam 1 - Bone Lesion Radiolucencies Part 2 > Flashcards

Oral Path Exam 1 - Bone Lesion Radiolucencies Part 2 Flashcards

1
Q

What type of tumor?

Derived from/classified by presence of odontogenic epithelium and odontogenic ectomesenchyme

A

Odontogenic tumor

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2
Q

What is the tumor classification for the following?

Ameloblastoma
Adenomatoid odontogenic tumor
Calcifiying epithelial odontogenic tumor

A

Odontogenic epithelium

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3
Q

What is the tumor classification for the following?

Odontogenic fibroma
Odontogenic myxoma
Cementoblastoma

A

Odontogenic ectomesenchyme

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4
Q

What is the tumor classification for the following?

Ameloblastic fibroma
Ameloblastic fibro-odontoma
Compound or complex odontoma

A

Mixed (epithelium + ectomesenchyme)

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5
Q

What type of tumor?

Locally invasive benign odontogenic epithelial tumor

A

Ameloblastoma

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6
Q

What type of tumor?

Wide age range; most commonly found in the posterior mandible

A

Ameloblastoma

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7
Q

What type of tumor?

Slow-growing
Painless
Unicystic or multicystic/solid (“conventional”) tumor

A

Ameloblastoma

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8
Q

Describe a “conventional” ameloblastoma

A

Multicystic/solid

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9
Q

What type of tumor?

Unilocular or multilocular radiolucency
Cortical expansion & thinning
Looks like soap bubbles
Can resorb or displace roots
Can be associated w/ impacted tooth

A

Ameloblastoma

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10
Q

What type of tumor?

Variety of patterns of enamel organ-like odontogenic epithelium; cystic formation is common

A

Ameloblastoma

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11
Q

In ameloblastomas, peripheral cells resemble _____________

A

ameloblasts

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12
Q

Columnar shaped cells with palisaded nuclei away from BM; has “reverse nuclear polarity”

A

Ameloblasts

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13
Q

In ameloblastomas, central cells are more spindled and resemble ___________ ___________

A

stellate reticulum

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14
Q

What type of tumor?

Often extends beyond radiographic margin

A

Ameloblastoma

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15
Q

What type of tumor?

Recurrence is common when treated with curettage, particuarly for larger lesions

A

Ameloblastoma

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16
Q

What type of tumor?

Smaller lesions are treated with aggressive curettage and peripheral ostectomy (bur the bone)

A

Ameloblastoma

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17
Q

What type of tumor?

Larger lesions are treated with marginal or segmental resection (1-2 cm beyond border)

A

Ameloblastoma

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18
Q

What type of tumor?

Follow pt for recurrence; rare malignant transformation

A

Ameloblastoma

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19
Q

What type of tumor?

Unilocular lesion that is entirely cystic; no solid component

A

Unicystic ameloblastoma

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20
Q

What type of tumor?

Pericoronal to unerupted 3rd molar

A

Unicystic ameloblastoma

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21
Q

What type of tumor?

Tx = decompression tube is used to shrink the cyst and thicken the epithelial lining to allow easier enucleation

A

Unicystic ameloblastoma

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22
Q

What type of tumor?

10-20% recurrence with enucleation and curettage, so it is less aggressive than a conventional ameloblastoma

A

Unicystic ameloblastoma

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23
Q

What type of tumor?

Painless nodule of alveolar or gingival mucosa

A

Peripheral ameloblastoma

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24
Q

Within the bone

A

Central

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25
Q

In soft tissue, outside the bone

A

Peripheral

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26
Q

What type of tumor?

Very rare; any odontogenic cyst or tumor can do this

A

Peripheral ameloblastoma

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27
Q

What type of tumor?

Tx = excision with limited recurrence, so tx is similar to POF and PG

A

Peripheral ameloblastoma

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28
Q

What type of tumor?

Found in posterior jaws in pts under 20 years of age
Unilocular radiolucency associated with an impacted tooth
Solid tumor

A

Ameloblastic fibroma

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29
Q

When should you add ameloblastic fibroma to your differential?

A

If it’s a young patient and it’s NOT a 3rd molar

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30
Q

What type of tumor?

Found in both jaws and affects a wide age range

A

Odontogenic fibroma

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31
Q

There are malignant odontogenic tumors, but you can also have a malignant transformation of an odontogenic cyst. How do you distinguish from benign?

A

Pain + paresthesia
Ill-defined border w/ cortical destruction (rather than just thinning/expansion)

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32
Q

What type of lesion?

Intrabony lesion of unknown cause

A

Central giant cell granuloma

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33
Q

What type of lesion?

Reactive: some are small with no symptoms and slow growing (non-aggressive)

A

Central giant cell granuloma

34
Q

What type of lesion?

Neoplastic: some are fast growing and destructive with cortical perforation, root resorption or displacement, can cause pain/paresthesia and extend into soft tissue (aggressive)

A

Central giant cell granuloma

35
Q

What type of lesion?

60% occur in patients under 30

A

Central giant cell granuloma

36
Q

What type of lesion?

Affects the mandible, often in the anterior and can cross midline

A

Central giant cell granuloma

37
Q

What type of lesion?

Most often painless, expansile, unilocular/multilocular radiolucency that can displace and resorb teeth

A

Central giant cell granuloma

38
Q

Central giant cell granulomas have multinucleated __________ cells, fibroblasts, monocyte/mac type cells, RBCs, and hemosiderin

A

giant

39
Q

What does central mean? What does peripheral mean?

A

Central = in bone
Peripheral = in soft tissue

40
Q

In central giant cell granulomas, what color is the tissue?

A

Dark brown

41
Q

What should you always rule out if you see something that looks like a central giant cell granuloma?

A

Brown tumor of hyperparathyroidism

42
Q

What type of lesion?

Tx = aggressive curettage if isolated

A

Central giant cell granuloma

43
Q

What type of lesion?

Developmental depression in the bone due to normal salivary gland tissue (pseudocyst)

A

Stafne defect

44
Q

What type of lesion?

Asymptomatic
Well-defined radiolucency
Sclerotic border of posterior mandible below IAN canal (submandibular gland) or anterior teeth (sublingual gland)

A

Stafne defect

45
Q

What type of lesion?

Strong majority occur in men

A

Stafne defect

46
Q

What type of lesion?

Although this is developmental, it occurs in middle-aged to older adults

A

Stafne defect

47
Q

What type of lesion?

Diagnosed by CBCT
Tx = none

A

Stafne defect

48
Q

What type of lesion?

Found in the posterior mandible within the mandibular canal

A

Schwannoma/neurofibroma

49
Q

What type of lesion?

Well-defined
Unilocular/multilocular radiolucency
Pain + paresthesia may occur
Benign

A

Schwannoma/neurofibroma

50
Q

What type of lesion?

Tx = conservative excision, little tendency to recur

A

Schwannoma/neurofibroma

51
Q

What type of lesion?

May be associated with other conditions or syndromes

A

Bony vascular malformation

52
Q

What type of lesion?

Has a direct connection of arterial and venous channels

A

Arteriovenous malformation

53
Q

What type of lesion?

If high pressure/flow is maintained, biopsy or trauma can cause life-threatening hemorrhage

A

Arteriovenous malformation

54
Q

What type of lesion?

Ill-defined
Cyst-like radiolucent defect
Multilocular
May detect pulsation on palpation or bruit (abnormal sound) on ascultation

A

Arteriovenous malformation

55
Q

What type of lesion?

Overlying skin is warm

A

Arteriovenous malformation

56
Q

What type of lesion?

Yields bright red blood on aspirate

A

Arteriovenous malformation

57
Q

What type of lesion?

Tx = embolization +/- excision

A

Arteriovenous malformation

58
Q

What should you do before opening into any radiolucent lesion?

A

Aspirate!!!

59
Q

What should be your differential diagnosis?

Unilocular or multilocular periocoronal radiolucency in the jaws

A

Dentigerous cyst
OKC
Ameloblastoma
Other benign odontogenic tumor

60
Q

What should be your differential diagnosis?

Unilocular or multilocular periapical/periradicular radiolucency in the jaws

A

OKC
Ameloblastoma
Other benign odontogenic tumor

(do NOT put PA cyst/granuloma -> they are always unilocular!)

61
Q

What type of lesion?

Asymptomatic
Ill-defined radiolucency
Found in body of mandible at old ext site

A

Focal osteoporotic marrow defect

62
Q

What type of lesion?

May resemble metastatic disease, biopsy is sometimes necessary

A

Focal osteoporotic marrow defect

63
Q

What type of lesion?

Fatty and hematopoietic marrow seen microscopically

A

Focal osteoporotic marrow defect

64
Q

What patients are typically affected by Focal osteoporotic marrow defects?

A

Middle-aged females

65
Q

Is treatment needed for Focal osteoporotic marrow defects?

A

No!

(not connected with a hematologic disorder)

66
Q

Lesions _________ the IAN canal are in the alveolar bone, and are usually tooth related

A

above

67
Q

Lesions _________ the IAN canal are usually NOT tooth related

A

below

68
Q

What are the following symptoms indicative of?

Pain (mimics a toothache)
Tooth mobility
Paresthesia (numb chin sign)
Rapid growth/expansion
Ill-defined

A

Radiolucent malignancies involving bone

69
Q

What are the 4 radiolucent malignancies involving bone in children?

A

Leukemia
Lymphoma
Rhabdomyosarcoma
Ewing sarcoma

70
Q

What are the 3 radiolucent malignancies involving bone in adults?

A

Metastatic carcinoma (mandible)
Lymphoma
Multiple myeloma

71
Q

What type of malignancy?

Extranodal disease
May be isolated, or evidence of widespread disease

A

Non-Hodgkin Lymphoma

72
Q

What type of malignancy?

In soft tissue:
Non-tender, diffuse swelling
Buccal vestibule, posterior hard palate or gingiva
Normal to red/purple, possibly ulcerated, with a boggy consistency

A

Non-Hodgkin Lymphoma

73
Q

What type of malignancy?

In the jaws:
Vague pain (toothache-like)
Paresthesia, numb chin sign
Ill-defined
Expansion and perforation into soft tissue

A

Non-Hodgkin Lymphoma

74
Q

What type of malignancy?

A common lymphoid malignancy; median age is 70 yrs old

A

Multiple myeloma

75
Q

What type of malignancy?

Involves bone marrow with lytic lesions; often “punched-out” radiolucencies throughout the skeleton (vertebrae, ribs, skull)

A

Multiple myeloma

76
Q

What type of malignancy?

Most frequent M protein is IgG

A

Multiple myeloma

77
Q

What type of malignancy?

If kappa or lambda light chains are produced, their small size allows excretion in the urine (Bence-Jones proteins)

A

Multiple myeloma

78
Q

What is the treatment for Multiple myeloma?

A

Chemotx
Bisphosphonates

79
Q

What happens if you don’t treat Multiple myeloma?

A

Death in a year

80
Q

Used to treat Multiple myeloma; proteasome inhibitors

A

Chemotx

81
Q

Used to treat Multiple myeloma; inhibits bone resorption, reduces fractures and hypercalcemia

A

Bisphosphonates

82
Q

A form of Multiple myeloma that may be asymptomatic for many years

A

Smoldering myeloma

D2 Spring (18 decks)

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