Pathogenesis of head and neck cancer 3

Question 1

remember epithelial dysplasia is Epithelial changes due to genetic alterations with a risk of malignant transformation to squamous cell carcinoma

Question 2

in epithelial dysplasia atypical cells are where?

Answer 2

limited to the surface epithelium

Question 3

what are the sites in the mouth with a higher risk of malignant transformation?

Answer 3

Lateral border of tongue, ventral tongue, retromolar area and floor of the mouth

Question 4

Histological features of epithelial dysplasia
- Nuclear and cellular pleomorphism (variation in size and shape)
- Alteration in nuclear/cytoplasmic ratio (usually increase - more nucleus)
- Nuclear hyperchromatism (darkly stained nuclei due to abundance of DNA)
- Prominent nucleoli
- Increased and abnormal mitoses (cell proliferation)
- Loss of polarity of basal cells
- Basal cell hyperplasia (increased number of basal cells)
- Drop shaped rete pegs (wider at the deepest part)
- Irregular epithelial stratification or disturbed maturation
- Abnormal keratinisation - dyskeratosis - cell starts to keratinise before the surface is reached
- Loss/reduction of intercellular adhesion

Question 5

what are the grades for epithelial dysplasia?

Answer 5

mild
moderate
severe

Question 6

what is mild grade epithelial dysplasia?

Answer 6

disorganisation and atypia of the basal cells

Question 7

what is moderate grade epithelial dysplasia?

Answer 7

More disorganised affecting up to 2/3 of the epithelium

Question 8

what is severe grade epithelial dysplasia?

Answer 8

Full thickness of the epithelium appears abnormal

Question 9

which grade of epithelial dysplasia has a higher risk of malignant transformation?

Answer 9

severe grade

Question 10

what grade of epithelial dysplasia is this?

Answer 10

mild

Question 11

what grade of epithelial dysplasia is this?

Answer 11

moderate

Question 12

what grade of epithelial dysplasia is this?

Answer 12

severe

Question 13

describe this cell

Answer 13

dyskeratotic

Question 14

describe this cell

Answer 14

atypical mitosis

Question 15

how does squamous cell carcinoma differ from dysplasia?

Answer 15

atypical cells invade into the adjacent tissues in squamous cell carcinoma

Question 16

define oral potentially malignant disorders

Answer 16

Oral mucosal lesions that have a potential risk of developing into oral squamous cell carcinoma