Path

Question 1

PATH

Answer 1

Mucocutaneous (Desquamatized gingiva)
Neoplastic
Salivary Gland
HT
Giant cell
Fibro-osseos lesions
Odontogenic tumours

Question 2

Mucocuteneous (desquamitised gingiva)

Answer 2

All Autoimmune:
Lupus erythematosus
Lichen Planus

7
Pemphigus
     5
Pemphigoid.    3

Question 3

Lichen Planus

Answer 3

Reticular (Lace Like), Plaque (white,non removable), Atrophic (dekeratinised erythematous), erosive (ulcer)

Histo: Thick basement membrane
sawtooth shaped retes ridges
Distinct dense subepith lymphocytic infil

Question 4

Pemphigus

Answer 4

Intraepithelial vesicles
Acantholysis (intraepithelial cleft)
Isolated Tzanck cells
Diffuse inflammatory infil 
immunofluorescence (everywhere of mesh) Increase IgG desmeloid 3

Question 5

Pemphigoid

Answer 5

Full thickness of epithelial layer detaches from underlying CT (lamina propria)
Subepithelial cleft
Hypochromatic basal cell layer

Question 6

Neoplastic

Answer 6

Benign: Pleomorphic Ademona
10
Carcinoma: Mucoepidermoid Carcinoma 4

Question 7

Pleomorphic Adenoma

Answer 7

• Well circumscribed and encapsulated (incomplete capsule) with lesional cells infil esp minor sal gland
• Vary App
• Epithelial lesion cells and myopepithelial cells within stroma - Stroma vary
• chondroid calcification
• Nucleus round and pushed to side
• clock eyed face
• myoepithelium: prominant/vary angular/spindles
• occ keratinising squamous and mucus gen cells

Question 8

Mucoepidermoid Carcinoma

Answer 8

Low Grade: cystic space and mucus> secrete lesional cells (and small proportion of epidermoid and intermediate)

High Grade: Less spaces, more dense (less mucus types>necrosis)

Question 9

Salivary Gland

Answer 9

Mucocoeles:
6
Extravasation
Mucus Retention Cyst

Question 10

Extravasation

Answer 10

Trauma - severed duct
Mucus spill into CT > inflam
Extravastated mucin (w PMNs) surrounded by inflamed fibrovascular granulation tissue 
adj sal gland parenchyma show chronic inflammation, ductal dilation, acinar atrophy and interstitial fibrosis
Thick psuedocystic wall

Question 11

Mucus Retention Cyst

Answer 11

Sal flow obstructed by blockage (sialolith).
Increase intraductal pressure
Salts around debris - concomitant infection causes discharge on pressure
Cystic cavity lined with ductal epithelium,
reactive metaplasia,
little inflammation in surrounding CT

Question 12

HT

Answer 12

DORN: All Well circumscribed, unilocular R/L with R/O margins:
2 Dentigerous Cyst
6 Odontogenic Keratocyst
6 Radicular Cyst
3 Nasopalatine duct cyst

Question 13

Dentigerous Cyst

Answer 13

Developing tooth

Connected to CEJ of impacted/displaced tooth

Question 14

Odontogenic Keratocyst

Answer 14

Keratosis(smooth/flat ep to CT) separates
unInflam fibrous wall
Thick parakeratanised 6-8 cell strat squamous
cystic lumin abundant keratin
polarised basal cell layer
Sml islands satellite epith in CT

Question 15

Radicular Cyst

Answer 15

Site of Exo
Reactive hyperplasia
Dystrophic calcification
wall fibrous and inflam infil
Rushlon bodies (eosinophillic) in epithelium
Cholestrol clefts, hyaline bodies, RBC,

Question 16

Nasopalatine duct cyst

Answer 16

Mx Ant Apical
Symmetrical round/heart
Varies lining - multi within

Question 17

Giant Cell Lesions

Answer 17

All R/L multilocular with multinucleated Giant Cells:
3 Anuerysmal bone cyst
3 Giant cell granuloma
6 Cherubism

Question 18

Anuerysmal bone cyst

Answer 18

RLmultilocular
fibrous tissue with Cavernous and Blood filled spaces
MGC + Haemosiderin

Question 19

Giant cell granuloma

Answer 19

RL multilocular/ central or peripheral
MNGC in immature fibrous tissue
prominent Vascular structure

Question 20

Cherubism

Answer 20

Replace Bone with ST
immature and woven bone spicules
hypodontia
bilateral
Lge No MNCG

Question 21

Odontogenic Tumours

Answer 21

AACCCFOOOO
Ameloblastoma
Ameloblastic Fibrosis
Calcifying Epithelial Odontogenic Tumour
Califying Cystic Odontogenic Tumour
Cementoblastoma
Fibrosis Dysplasia
Odontoma
Ossifying Fibrosis
Osseos Dysplasia
Osteosarcoma

Question 22

Ameloblastoma

Answer 22

“2 layers: Pre-Ameloblasts”
prolif ODG epith on fibrous stroma
Outerlayer=hyperchondric polarised cells=pre-AB, Central=loosley organised with stellate reticulum
-Follicular= island tumour
-Plexiform=irregular strands/mesh
-Acanthamatous=follicular but maybe keratin
-Granular cell type=stellate reticulum> increase eosinophillic

Question 23

Ameloblastic Fibrosis

Answer 23

Well defined unilocular R/L - sim to ameloblastoma

Question 24

Calcifying Epithelial Odontogenic Tumour

Answer 24

“Amyloid-like” - can calcify
Intraepithelial Amyloid-like=calcified
unerupted/impacted tooth ~50%
defined/irregular border

Question 25

Califying Cystic Odontogenic Tumour

Answer 25

“Ghost Cells” - that can calcify

cystic lined AB-like eptih

Question 26

Cementoblastoma

Answer 26

“Cotton Wool Ball”
sheets of cementum-like along roots.
Well defined R/O with R/L halo
calcified tissue like cementum with prominent reversal lines

Question 27

Odontoma

Answer 27

Complex: Irregular R/O masses calcified
Compound: Small teeth-like R/O

Question 28

Osteosarcoma

Answer 28

"Sun Ray"
sclerosing sun ray pattern
Resorp/displace/loose teeth
osteolytic=R/L - widen PDL
Subtypes- chondroid
hypercellular

Question 29

Fibro-osseos Lesions

Answer 29

7 Fibrosis Dysplasia
5 Ossifying Fibrosis
4 Osseos Dsyplasia

Question 30

Fibrosis Dysplasia

Answer 30

Asymp
Ill defined
Ground glass
Vary cystic - RO calcified RO fibrous
cellular
No hypochronatism/nuclear dysplasia
Rd islands w ob  layer around

Question 31

Ossifying Fibrosis

Answer 31

WD
Fibrocellular tissue and mineralisation
Vary app
Bony exp 
FB like and collagen

Question 32

Osseos Dysplasia

Answer 32

Replace bone with fibrous tissue and metaplastic bone
PA lesion ass w Vital tooth
Increase radiodensity over time
rich cellular, collagen, calcified bits