Pathology Mental Dental] Flashcards
Benign but Aggressive
Classic DDx for multilocular RL in post mand is _______, KCOT, CGCG, COF
Tx: wide excision or resection, high reccurence if too conservative
Ameloblastoma
RL with driven snow calcification (white flecks)
Amorphous pink amyloid with concentric calcifications termed Liesegang rings
Tx: excision, good prog
CEOT: Pinborg tumor
Contains epithelia duct-like spaces and enameloid material
Mostly in anterior max and over impacted canine
Tx: surg excision, good prog
AOT
Myxomatous connective tissue= slimy stroma
Messy RL with unclear borders and honeycomb pattern
Tx: surgical excision, moderate recurrence
Odontogenic Myxoma
Dense collagen strands of epithelium
Central: bone, well defined multilocular RL
Mostly in post mand
Central odontogenic fibroma
Well-circumscribed RO mass
Ball of cementum and cementoblasts replacing tooth root
Tx: surg excision and TE
Cementoblastoma
Occurs in children and teens
Mostly seen in post mand
Myxomatous connective tissue
Called different name is odontoma is also present
Tx: surg excision
Ameloblastic fibroma
RO lesion composted of dental hard tissues
Can block eruption
Compound: mostly anterior and toothicles
Complex: posterior, conglomerate mass
Garder syndrome: multiple odontomas and intestinal polyps
Odontoma
COmposed of fibroblastic stroma in which goci of mineralized products are formed
Central: bone, well-circumscribed RL
Juvenile= aggressive variant, rapid growth, younger population
Similar in appearance and behavior to cementifying fibroma
Tx: surg excision
Central ossifying fibroma
Ground glass appearance
Usually stops growing after puberty
McCune-Albright Syndrome; polyostotic fibrous dysplasia, cutaneous cafe au lait spots, endocrine abnormalilites like precocious puberty
Fibrous dysplasia
Reactive process of unknown orgin
Most common at apices of mand anterior teeth
Most common in middle aged black femals
Teeth are vital
Lucent to opaque
No tx
Periapical cemento-osseous dysplasia
Circumscribed opaque mass of bone and osteoblasts
Tx: surg excision
Osteoblastoma
Composed of firbroblasts and multinucleated giant cells
Anterior mand favored
Central= bone RL with thin wispy septations
Tx Excisiton
Central giant cell granuloma
Pseudocyst composed of blood filled spaces
ML RL
Expansile
Post mand favored
Tx Excision: Apsiration biopsy
Aneurysmal bone cyst
Causes multiple bone lesions resulting from excessive levels of PTH
Brown tumor= due to excess osteoclast activity
Elevated alkaline phosphatase due to too much breakdonw of bone
Von Recklinghhausen’s disease of bone= the result of this condition
Hyperparathyroidism
Austomsomal dominant
Symmetical bilateral swelling, expansile bilateral multilocular RLs
Stops growing after puberty
Giant cell lesion
Cheubism
Rare type of cancer
Langerhan cells are normally found in the skin as antigen presenting cells, but can cause damage if they buildup in certain parts of the body
Discrete punched out ice cream scoop RLs that lead to floating teeth
Tx: excision, radiation, chemo
Langerhans cell ds
Progressive metabolic distrubance of many bones causing symmetrical enlargement
Usually adults over 50
Elevated alkaline phosphatase due to breakdown of bone
Cotton wool appearance
Dentures and hats become too tight
Tx: bisphosphonates and calcitonin
Paget’s ds
Approx 1 in 1000 birth
Unilateral (80%) or bilateral (20%)
Lack of fusion between medial nasal process and max process
Cleft lip
Approx 1 in 2000 births
Lack of fusion of palatal shelves
Cleft palate
Invaginations at commissures or near midline
Van der Woude Syndrome= clefts and pits
Lip pits
Ectopic sebaceous glands
Fordyce Granules
White or whitish-gray edematous lesion of buccal mucosa
Dissipates when cheek is stretched
Leukoedema
Thryoid tissue mass at midline base of tongue
Located along embryonic path of thyroid descent
Lingual thyroid
Midline neck swelling
Located along embryonic path of thyroid descent
Thyroglossal duct cyst
White annular (ringed) lesions surrounding central red islands that migrate over time
Occasionally hurt and burn
Tx: none
Geographic tongue
Folds and furrows of tongue dorsum
Melkersson-Rosenthal Syndrome= fissured tongue + granulomatous chelitis + facial paralysis
Fissured tongue
Tumors of blood vessels or lymph vessels
Angioma
Congential focal proliferation of capillaries
Most undergo involution but persistent lesions are excised
Hemangioma
Congential focal proliferation of lymph vessels
Oral are very rare purple spots on tongue
Called cystic hygroma when occurs in the neck
Sturge Weber syndrome: angiomas of leptomeninges (arachnoid and pia mater) + skin along th distribution of the trigeminal nerve
Lymphangioma
Mass in midline floor of mouth if about mylohyoid
Mass in upper neck if below mylohyoid
Contains adnexal structures like hair and sebaceous glands
Doughy consistency
Dermoid cyst
Lateral neck swelling
Epithelial cyst within lymph node of neck
Branchial cyst
Epithelial cyst within lymphoid tissue of oral mucosa
Palatine and lingual tonsils are common regions
ORal lymphoepithelial cyst
RL in post mand below mand canal
Due ot lingual concavity of jaw
Stafne defect
Heart shaped RL in nasopalatine canal
Caused by cystification of canal remnants
Tx: excision
Nasopalatine duct cyst
Large RL scalloped around roots
No epithelial lining in mand of teens
Tx: aspiriate to Dx just monitor
Traumatic bone cyst
White line in buccal mucosa
Type of focal hyperkeratosis due to chronic friction on mucosa
LInea alba
Red dots are inflamed salivary duct openings
ONly premalignant if related to reverse smling
Nicotine stomatitis
Traumatic implantation of amalgam particles into mucosa
Tiny RO particles in xray
Amalgam tattoo
Benign hyperpigmenation in mucous membranes
Basicallly a freckle of mucosa
Peutz-Jehgers: freckles and intestinal polyps
Melanotic macule
Elongated FILIFORM papilllae
Hairy tongue
Related to surfactant ingredient SLS
Dentrifice Assc sloughing
Primary: pan oral self limiting and childhood
Latent in Trigemial gang
Recurrent: keratinized mucosa only
Labilalis and recurrent intraoral
Whitlow: fingers
Gladiatorum: head
Acyclovir in prodromal period
HSV
Primary: chihckenpox, slef-limiting and childhood
Latent in trigemianl
Recurrent: shingles
Ramsay Hunt Syn: herp zoster in geniculate gang affecting CN 7 and 8 resuling in facial paralysis, vertico , deafness
Tx: acyclovir
Varicella zoster virus
Hand foot and mouth disease
Herpangina: posterior oral cavity
Coxsackie virus
Koplik’s spots (buccal mucosa dot ulcers) precede skin rash
Primary: self limiting and childhood
Measles (rubeola)
Caused by several strains of HPV
Benign epithelial pedunculated or sessile proliferation on skin or mucosa
Papilloma (wart)
Caused by several strains of HPV
Common skin wart
Verruca vulgaris
Caused by HPV 6 and 11
Genital wart or from oral sex with somone with genital warts
Tx: excision with high recurrence
Condyloma acuminatum