Oral Pathology 2 Flashcards
What is the most common developmental non-odontogenic cyst and how does it present radiographically?
- Incisive canal cyst (Nasopalatine duct cyst)
- often heart shaped lucency between 2 max central incisors
What is white sponge nevus?
- Genodermatosis (autosomal dominant)
- Bilateral buccal mucosa, white folds of tissue with no eye involvement
Where do cleft palates usually take place?
- Between lateral incisors and canines
Describe actinic cheilitis.
- Lip’s vermillion becomes indistinct
- Potential for dysplasia to undergo malignant tranformation into SQUAMOUS CELL CARCINOMA = pre-malignant
Describe cheilitis glandularis.
- Mucous minor salivary glands of lips are inflamed
- Premalignant condition -> SQUAMOUS CELL CARCINOMA
What are some key characteristics of Oral Hairy Leukoplakia?
- White, rough plaque on lateral border of tongue (most common site)
- Seen in HIV patients progressing to AIDS
- Caused by Epstein-Barr virus
What is seen with mutlifocal periapical lucencies which mature over time, become mixed lucent/opaque and finally opaque lesions towards the anterior mandible?
- Periapical cemento-osseous dysplasia
- - teeth are VITAL
How does florid osseous dysplasia differ from periapical cemento-osseous dysplasia?
- Mutli-quadrant, fibro-osseous intrabony lesions, no treatment necessary.
Which pathology is associated with Wickam’s striae and what is it?
Lichen Planus
- Purple, polygonal, pruritic papules (skin)
- White papules that do not wipe off, most commonly seen in buccal mucosa
Can be reticular, cutaneous, hyperplastic or even erosive
What is a soft tissue lesions that is not in bone, but makes osteoid/bone?
Peripheral ossifying fibroma
What pathology is associated with multiple unerupted supernumerary teeth, retention of primary teeth, missing clavicles, frontal bossing and a large head?
Cleidocranial dysplasia
What disease shows multiple neurofibromas of the skin and oral cavity with cafe au lait pigmentation?
Neurofibromatosis, type 1 (von Recklinghausen’s disease of skin)
What pathology shows a histology of ghost cells and calcifications?
Calcifying odontogenic cyst (Gorlin Cyst)
What presents as red, inflamed minor salivary gland ducts with background of luekoplakia change?
Nicotine Stomatitis
What is auriculotemporal syndrome (frey syndrome)?
- Presents after parotid glad surgery
- sweating of unilateral facial skin prior to eating, affects cranial nerve V
Why do you always want to aspirate before biopsing lesions?
Always in anterior maxillary/mandibular radiolucency prior to biopsy to rule out vascular nature.
What lesions presents with sulfur granules and has multiple draining fistulas?
Actinomycosis
Which way will the chin deviate upon closing, in a patient with condylar hyperplasia?
Chin deviates AWAY from affected side
Where is dens-in-dente most often found?
In anterior jaw, especially lateral incisors
What presents radiographically with mis-shapen teeth, type 1 - “rootless” teeth and periapical radiolucencies?
Dentin dysplasia
What is associated with ill-fitting denture flange?
Epulis fissuratum - hyperplastic connective tissue like fibroma
What causes a “lead line” - a blue line that parallels free marginal gingiva?
Heavy metal systemic intoxication
What is a red to blue elevated lesions that blanches and is compressible?
Hemangioma
What is a lymphangioma?
- Lymph-filled superficial vessels, most common cause of macroglossia
What is the most common cause of macroglossia?
Lymphangioma
What is seen generalized in acromegaly, and at times seen in Paget’s disease of bone?
Hypercementosis
Describe infectious mononucleosis.
- Cervical swelling, lateral
- Sore throat, teenagers
- Epstein-Barr virus association
How can you tell the difference between internal vs external tooth resorption?
Internal - pink tooth when crown involved
Radiographic - can’t tell in early process - round or ovoid radiolucency
What does irradiation therapy lead to?
Causes cervical caries secondary to inducement of xerostomia.
Does not result in pulp necrosis
What are the different types of acquired melanocytic nevus and which one is most likely to undergo malignant tranformation?
- Junctional type - most likely to go malignant
- Intramucosal type - most common oral
- Compound type
What is the etiology of Kaposi’s sarcoma?
- Herpes type 8
How can you differentiate between a squamous cell carcinoma of the face and lip versus a keratoacanthoma?
Keratin plug in the center of the ulceration
Where is Warthin’s tumor most commonly?
Primary site = PAROTID gland
Describe a stafne bone defect.
Salivary gland depression defect, developmental, asymptomatic, vital teeth, well demarcated lucency found near angle of mandible beneath the mandibular canal
Sjogren’s syndrome is often presented in patients with other autoimmune diseases - what are those diseases?
- Lupus
- Rheumatoid arthritis
What presents iwth bilateral hilar lymphadenopathy (on chest xray) and cutaneous lesions?
Sarcoidosis - treat with corticosteroids
What presents with inferior border of posterior mandible is a common site - with onion skin pattern on radiographic appearance.
Proliferative periostitis - Garre’s
Describe Peutz-Jeghers Syndrome
Pigmented macules (brown) on lips, tongue, buccal mucosa, vermillion and skin of lip. Intestinal polyps
What is the most common primary malignancy of bone in people less than 25 years of age?
Osteosarcoma
How are mandibular fractures diagnosed?
Often with 2 radiographs -
1. Panoramic and 2. Occlusal
Where does malignant melanoma most commonly present?
Hard palate and gingiva
What lesion presents with “punched-out lucencies?”
Multiple Myeloma
Describe multiple myeloma
- Bence-Jones proteinuria, immunoglobin spike, multiple bone sites (calvaria, spine, pelvic girdle, jaws)
What is caused by introduction of air into oral soft tissues with resulting sudden painless swelling and crepitance?
Cervical emphysema (can be from air/water syringe)
What lesions closely resembles ameloblastoma and is characterized by a multilocular lucency with “soap bubble pattern?”
Odontogenic myxoma
