Pathology of oral cavity Flashcards
One word
Single or multiple, shallow, mucosal ulcerations that are common, often recurreny and painful.
Aphthous ulcers (Canker sores)
Aphthous ulcers can be associated with which disorders?
Immunologic disorders e.g Inflammatory bowel disease
The Aphthous ulcers affect which patients for a long time?
Immunocompromised patients
True or False
The Aphthous ulcers usually self-resolves in a week but may persists for longer especially in HIV patients
True
What causes the oral herpes
HSV-1
HPV-2 causes what?
Genital herpes
In Children the oral herpes usually persists as what?
Acute herpetic gingivostomatitis (Usually 2-4 yo)
In children the oral herpes presents with what?/ characteristics of oral herpes in children
Vesicles and ulceration of the oral mucosa
In adults the oral herpes usually presents as what?
Acute herpes pharyngitis
After acute infection of oral herpes what happens to virus?
The virus treks along regional nerves and becomes latent within local ganglia
Reactivation of the HPV-1 results to what?
Reactivation results in recurrent herpetic stomatitis
The oral herpes in immunocompromised patients can persists as what?
Chronic mucocutaneous infection
The most common fungal infections of oral cavity?
Oral candidiasis (thrush)
Thrush refers to what?
Pseudomembranous of oral candidiasis
what is meant by pseudomembranous form of oral candidiasis?
Superficial gray-white inflammatory membrane composed of matted organisms in a fibrinosuppurative exudate that can be scrapped off, showing an erythematous inflammatory base
is oral candidiasis invasive?
Usually not invasive except on the setting of immunosuppression
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Oral lesion can be seen where?
Blood dyscrasias
examples where oral lesion can be seen?
Folic acid and vitamin B12 deficiency
List examples of mucocutaneous disorders
Lichen planus, pemphigus vulgaris, systemic lupus erythematosus, chemotherapy
List oral manifestation of systemic disorders
Oral lesion
Mucocutaneous diseases
one word
This is a severe, acute streptococcal cellulitis involving the neck, tongue and back of the throat.
Ludwig’s angina
Vincent’s angina is painful condition of what?
throat
the vincent’s angina is characterised by ?
Local ulceration of tonsils, mouth and pharynx
Causative organism of vincent’s angina
Vincent’s bacillus
is diphtheria a communicable or non-communicable disease?
communicable disease
diphtheria is casued by what?
corynebacterium diphtheriae
Diphtheria usually occurs in children and results in the formation of what?
a yellowish-grey pseudomembrane in the mucosa of nasopharynx, oropharynx, tonsils, larynx and trachea
Tonsilitis is caused by which organisms
Staphylococci
Streptococci
The tonsilitis that is characterised by enlargement, redness and inflammation
Acute tonsils
Chronic tonsilitis is caused by what?
is caused by repeated attacks of acute tonsilitis in which case the tonsils are small and fibrosed
A condition that occurs as a complication of acute tonsilitis
Peritonsilitis abscess (Quinsy)
The similarities between tonsilitis and peritonsilitis abscess
The causative organisms staphylococci or streptococci which are associated with infection of the tonsils
Formation of abscess in the soft tissue between posterio wall of the pharynx and the vertebral column is called what?
Retropharyngeal abscess
The spectrum of squmous lesion includes?
Malignant
Benign
premalignant
Most common benign epithelial neoplasm in the oral cavity, usually in adults
Squamous papilloma
The squamous papilloma is associated with low risk HPV subtypes?
HPV 6 and 11
Microscopic appearance of squamous papilloma
Exophytic papillary proliferation of hyperplastic stratified squamous epithelium with branching fibrovascular core. Should not have dyplasia
The white patch or plaque that cannot be scraped off and cannot be characterised clinically or pathologically as any other disease
Leukoplakia
Squmous epithelium lesion in leukoplakia is characterised by ?
5-25% are pregmalignant, all leukoplakia are considered premalignant until otherwise proven by histologic evaluation
Histology of leukoplakia
Spectrum of epithelium change form hyperkeratosis to severe dysplasia
red velvet area within oral cavity (+/- erosions)
Erythroplakia
Histology appearance of Erythroplakia
Almost all display severe display, carcinoma in-situ or minimally invasive carcinoma
Is Erythroplakia related to which lifestyle
Often related to tobacco use
Squmous Cell Carcinoma account for how much?
95% of all head or neck
Explain the pathogenesis of squamous cell carcinoma
Multifactorial, depends partly on tumour location. A growing proportion have no known risk factors
what causes SCC in oropharynx ?
High risk human papillomavirus infections (HPV 16)
what causes SCC in oral cavity?
Smoked tobacco, alcohol, chewing of betel quid (India and Asia)
what causes SCC in lower lip?
Actinic radiation (sun exposure) and pipe smoking
clinical features of SCC
Clinical features: Male preponderance. Patients with HPV-positive SCC tend to be younger and have
better long term survival compared to non-HPV associated SCC. Multiple primary tumours can occur
due to “field cancerisation”, often with worse outcomes, necessitating early detection
explain the Gross appearance of SCC
- Gross: HPV-associated SCC tend to be easily overlooked small primary tumours but accompanied by
significantly enlarged cervical lymph nodes, while non-HPV associated SCC appear as raised firm
plaques or roughed areas of mucosal thickening that can enlarge to form ulcerated masses with
indurated borders +/- background leukoplakia or erythroplakia
Explain the microscopic appearance of SCC
Microscopy: HPV-associated SCC are non-keratinizing SCC – nests and lobules of basaloid cells
which are p16 immunostain positive. Non-HPV associated SCC tend to bekeratinizing SCC that may
begin as dysplastic lesions
