Oral Pathology 2

Question 1

What is the most common developmental non-odontogenic cyst and how does it present radiographically?

Answer 1

• Incisive canal cyst (Nasopalatine duct cyst)

- often heart shaped lucency between 2 max central incisors

Question 2

What is white sponge nevus?

Answer 2

• Genodermatosis (autosomal dominant)

- Bilateral buccal mucosa, white folds of tissue with no eye involvement

Question 3

Where do cleft palates usually take place?

Answer 3

• Between lateral incisors and canines

Question 4

Describe actinic cheilitis.

Answer 4

• Lip’s vermillion becomes indistinct

- Potential for dysplasia to undergo malignant tranformation into SQUAMOUS CELL CARCINOMA = pre-malignant

Question 5

Describe cheilitis glandularis.

Answer 5

• Mucous minor salivary glands of lips are inflamed

- Premalignant condition -> SQUAMOUS CELL CARCINOMA

Question 6

What are some key characteristics of Oral Hairy Leukoplakia?

Answer 6

• White, rough plaque on lateral border of tongue (most common site)
• Seen in HIV patients progressing to AIDS
• Caused by Epstein-Barr virus

Question 7

What is seen with mutlifocal periapical lucencies which mature over time, become mixed lucent/opaque and finally opaque lesions towards the anterior mandible?

Answer 7

• Periapical cemento-osseous dysplasia

- - teeth are VITAL

Question 8

How does florid osseous dysplasia differ from periapical cemento-osseous dysplasia?

Answer 8

• Mutli-quadrant, fibro-osseous intrabony lesions, no treatment necessary.

Question 9

Which pathology is associated with Wickam’s striae and what is it?

Answer 9

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

Question 10

What is a soft tissue lesions that is not in bone, but makes osteoid/bone?

Answer 10

Peripheral ossifying fibroma

Question 11

What pathology is associated with multiple unerupted supernumerary teeth, retention of primary teeth, missing clavicles, frontal bossing and a large head?

Answer 11

Cleidocranial dysplasia

Question 12

What disease shows multiple neurofibromas of the skin and oral cavity with cafe au lait pigmentation?

Answer 12

Neurofibromatosis, type 1 (von Recklinghausen’s disease of skin)

Question 13

What pathology shows a histology of ghost cells and calcifications?

Answer 13

Calcifying odontogenic cyst (Gorlin Cyst)

Question 14

What presents as red, inflamed minor salivary gland ducts with background of luekoplakia change?

Answer 14

Nicotine Stomatitis

Question 15

What is auriculotemporal syndrome (frey syndrome)?

Answer 15

• Presents after parotid glad surgery

- sweating of unilateral facial skin prior to eating, affects cranial nerve V

Question 16

Why do you always want to aspirate before biopsing lesions?

Answer 16

Always in anterior maxillary/mandibular radiolucency prior to biopsy to rule out vascular nature.

Question 17

What lesions presents with sulfur granules and has multiple draining fistulas?

Answer 17

Actinomycosis

Question 18

Which way will the chin deviate upon closing, in a patient with condylar hyperplasia?

Answer 18

Chin deviates AWAY from affected side

Question 19

Where is dens-in-dente most often found?

Answer 19

In anterior jaw, especially lateral incisors

Question 20

What presents radiographically with mis-shapen teeth, type 1 - “rootless” teeth and periapical radiolucencies?

Answer 20

Dentin dysplasia

Question 21

What is associated with ill-fitting denture flange?

Answer 21

Epulis fissuratum - hyperplastic connective tissue like fibroma

Question 22

What causes a “lead line” - a blue line that parallels free marginal gingiva?

Answer 22

Heavy metal systemic intoxication

Question 23

What is a red to blue elevated lesions that blanches and is compressible?

Answer 23

Hemangioma

Question 24

What is a lymphangioma?

Answer 24

• Lymph-filled superficial vessels, most common cause of macroglossia

Question 25

What is the most common cause of macroglossia?

Answer 25

Lymphangioma

Question 26

What is seen generalized in acromegaly, and at times seen in Paget's disease of bone?

Answer 26

Hypercementosis

Question 27

Describe infectious mononucleosis.

Answer 27

- Cervical swelling, lateral - Sore throat, teenagers - Epstein-Barr virus association

Question 28

How can you tell the difference between internal vs external tooth resorption?

Answer 28

Internal - pink tooth when crown involved | Radiographic - can't tell in early process - round or ovoid radiolucency

Question 29

What does irradiation therapy lead to?

Answer 29

Causes cervical caries secondary to inducement of xerostomia. **Does not result in pulp necrosis**

Question 30

What are the different types of acquired melanocytic nevus and which one is most likely to undergo malignant tranformation?

Answer 30

- Junctional type - most likely to go malignant - Intramucosal type - most common oral - Compound type

Question 31

What is the etiology of Kaposi's sarcoma?

Answer 31

- Herpes type 8

Question 32

How can you differentiate between a squamous cell carcinoma of the face and lip versus a keratoacanthoma?

Answer 32

Keratin plug in the center of the ulceration

Question 33

Where is Warthin's tumor most commonly?

Answer 33

Primary site = PAROTID gland

Question 34

Describe a stafne bone defect.

Answer 34

Salivary gland depression defect, developmental, asymptomatic, vital teeth, well demarcated lucency found near angle of mandible beneath the mandibular canal

Question 35

Sjogren's syndrome is often presented in patients with other autoimmune diseases - what are those diseases?

Answer 35

- Lupus | - Rheumatoid arthritis

Question 36

What presents iwth bilateral hilar lymphadenopathy (on chest xray) and cutaneous lesions?

Answer 36

Sarcoidosis - treat with corticosteroids

Question 37

What presents with inferior border of posterior mandible is a common site - with onion skin pattern on radiographic appearance.

Answer 37

Proliferative periostitis - Garre's

Question 38

Describe Peutz-Jeghers Syndrome

Answer 38

``` Pigmented macules (brown) on lips, tongue, buccal mucosa, vermillion and skin of lip. Intestinal polyps ```

Question 39

What is the most common primary malignancy of bone in people less than 25 years of age?

Answer 39

Osteosarcoma

Question 40

How are mandibular fractures diagnosed?

Answer 40

Often with 2 radiographs - | 1. Panoramic and 2. Occlusal

Question 41

Where does malignant melanoma most commonly present?

Answer 41

Hard palate and gingiva

Question 42

What lesion presents with "punched-out lucencies?"

Answer 42

Multiple Myeloma

Question 43

Describe multiple myeloma

Answer 43

- Bence-Jones proteinuria, immunoglobin spike, multiple bone sites (calvaria, spine, pelvic girdle, jaws)

Question 44

What is caused by introduction of air into oral soft tissues with resulting sudden painless swelling and crepitance?

Answer 44

Cervical emphysema (can be from air/water syringe)

Question 45

What lesions closely resembles ameloblastoma and is characterized by a multilocular lucency with "soap bubble pattern?"

Answer 45

Odontogenic myxoma