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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

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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
In soft tissue, outside the bone
Peripheral
26
What type of tumor? Very rare; any odontogenic cyst or tumor can do this
Peripheral ameloblastoma
27
What type of tumor? Tx = excision with limited recurrence, so tx is similar to POF and PG
Peripheral ameloblastoma
28
What type of tumor? Found in posterior jaws in pts under 20 years of age Unilocular radiolucency associated with an impacted tooth Solid tumor
Ameloblastic fibroma
29
When should you add ameloblastic fibroma to your differential?
If it's a young patient and it's NOT a 3rd molar
30
What type of tumor? Found in both jaws and affects a wide age range
Odontogenic fibroma
31
There are malignant odontogenic tumors, but you can also have a malignant transformation of an odontogenic cyst. How do you distinguish from benign?
Pain + paresthesia Ill-defined border w/ cortical destruction (rather than just thinning/expansion)
32
What type of lesion? Intrabony lesion of unknown cause
Central giant cell granuloma
33
What type of lesion? Reactive: some are small with no symptoms and slow growing (non-aggressive)
Central giant cell granuloma
34
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)
Central giant cell granuloma
35
What type of lesion? 60% occur in patients under 30
Central giant cell granuloma
36
What type of lesion? Affects the mandible, often in the anterior and can cross midline
Central giant cell granuloma
37
What type of lesion? Most often painless, expansile, unilocular/multilocular radiolucency that can displace and resorb teeth
Central giant cell granuloma
38
Central giant cell granulomas have multinucleated __________ cells, fibroblasts, monocyte/mac type cells, RBCs, and hemosiderin
giant
39
What does central mean? What does peripheral mean?
Central = in bone Peripheral = in soft tissue
40
In central giant cell granulomas, what color is the tissue?
Dark brown
41
What should you always rule out if you see something that looks like a central giant cell granuloma?
Brown tumor of hyperparathyroidism
42
What type of lesion? Tx = aggressive curettage if isolated
Central giant cell granuloma
43
What type of lesion? Developmental depression in the bone due to normal salivary gland tissue (pseudocyst)
Stafne defect
44
What type of lesion? Asymptomatic Well-defined radiolucency Sclerotic border of posterior mandible below IAN canal (submandibular gland) or anterior teeth (sublingual gland)
Stafne defect
45
What type of lesion? Strong majority occur in men
Stafne defect
46
What type of lesion? Although this is developmental, it occurs in middle-aged to older adults
Stafne defect
47
What type of lesion? Diagnosed by CBCT Tx = none
Stafne defect
48
What type of lesion? Found in the posterior mandible within the mandibular canal
Schwannoma/neurofibroma
49
What type of lesion? Well-defined Unilocular/multilocular radiolucency Pain + paresthesia may occur Benign
Schwannoma/neurofibroma
50
What type of lesion? Tx = conservative excision, little tendency to recur
Schwannoma/neurofibroma
51
What type of lesion? May be associated with other conditions or syndromes
Bony vascular malformation
52
What type of lesion? Has a direct connection of arterial and venous channels
Arteriovenous malformation
53
What type of lesion? If high pressure/flow is maintained, biopsy or trauma can cause life-threatening hemorrhage
Arteriovenous malformation
54
What type of lesion? Ill-defined Cyst-like radiolucent defect Multilocular May detect pulsation on palpation or bruit (abnormal sound) on ascultation
Arteriovenous malformation
55
What type of lesion? Overlying skin is warm
Arteriovenous malformation
56
What type of lesion? Yields bright red blood on aspirate
Arteriovenous malformation
57
What type of lesion? Tx = embolization +/- excision
Arteriovenous malformation
58
What should you do before opening into any radiolucent lesion?
Aspirate!!!
59
What should be your differential diagnosis? Unilocular or multilocular periocoronal radiolucency in the jaws
Dentigerous cyst OKC Ameloblastoma Other benign odontogenic tumor
60
What should be your differential diagnosis? Unilocular or multilocular periapical/periradicular radiolucency in the jaws
OKC Ameloblastoma Other benign odontogenic tumor (do NOT put PA cyst/granuloma -> they are always unilocular!)
61
What type of lesion? Asymptomatic Ill-defined radiolucency Found in body of mandible at old ext site
Focal osteoporotic marrow defect
62
What type of lesion? May resemble metastatic disease, biopsy is sometimes necessary
Focal osteoporotic marrow defect
63
What type of lesion? Fatty and hematopoietic marrow seen microscopically
Focal osteoporotic marrow defect
64
What patients are typically affected by Focal osteoporotic marrow defects?
Middle-aged females
65
Is treatment needed for Focal osteoporotic marrow defects?
No! (not connected with a hematologic disorder)
66
Lesions _________ the IAN canal are in the alveolar bone, and are usually tooth related
above
67
Lesions _________ the IAN canal are usually NOT tooth related
below
68
Lesions _________ the IAN canal have a vascular or neural origin
within
69
What are the following symptoms indicative of? Pain (mimics a toothache) Tooth mobility Paresthesia (numb chin sign) Rapid growth/expansion Ill-defined
Radiolucent malignancies involving bone
70
What are the 4 radiolucent malignancies involving bone in children?
Leukemia Lymphoma Rhabdomyosarcoma Ewing sarcoma
71
What are the 3 radiolucent malignancies involving bone in adults?
Metastatic carcinoma (mandible) Lymphoma Multiple myeloma
72
What type of malignancy? Extranodal disease May be isolated, or evidence of widespread disease
Non-Hodgkin Lymphoma
73
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
Non-Hodgkin Lymphoma
74
What type of malignancy? In the jaws: Vague pain (toothache-like) Paresthesia, numb chin sign Ill-defined Expansion and perforation into soft tissue
Non-Hodgkin Lymphoma
75
What type of malignancy? A common lymphoid malignancy; median age is 70 yrs old
Multiple myeloma
76
What type of malignancy? Involves bone marrow with lytic lesions; often "punched-out" radiolucencies throughout the skeleton (vertebrae, ribs, skull)
Multiple myeloma
77
What type of malignancy? Most frequent M protein is IgG
Multiple myeloma
78
What type of malignancy? If kappa or lambda light chains are produced, their small size allows excretion in the urine (Bence-Jones proteins)
Multiple myeloma
79
What is the treatment for Multiple myeloma?
Chemotx Bisphosphonates
80
What happens if you don't treat Multiple myeloma?
Death in a year
81
Used to treat Multiple myeloma; proteasome inhibitors
Chemotx
82
Used to treat Multiple myeloma; inhibits bone resorption, reduces fractures and hypercalcemia
Bisphosphonates
83
A form of Multiple myeloma that may be asymptomatic for many years
Smoldering myeloma

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