Pathology of the mouth, oral cavity and oropharynx Flashcards
What causes herpetic stomatitis?
HSV type 1 and HSV type 2
What are the symptoms of herpetic stomatitis?
lesions consisting of vesicles, bullae and shallow ulceration
What are the histological characteristics of herpetic stomatitis? (3)
- inter- and intra-cellular oedema
- eosinophilic intranuclear inclusions
- giant cells
What is reactivation of herpetic stomatitis triggered by? (5)
- trauma
- UV light
- menstruation
- pregnancy
- immunosuppression
What causes oral candidiasis?
candida albicans
What does oral candidiasis present as?
grey-white plaques on the oral mucosa consisting of fungus in a fibrinosuppurative exudate
can be scraped off
In whom is oral candidiasis seen? (4)
- neonates
- diabetes
- neutropaenia
- immunodeficiency
What is hairy leukoplakia caused by?
epstein barr virus
What does hairy leukoplakia present as?
white patches of fluffy hyperkeratosis on lateral tongue borders which cannot be scraped off
In whom is hairy leukoplakia seen?
immunocompromised patients
What is aphthous stomatitis associated with?
coeliac disease and inflammatory bowel disease
What does aphthous stomatitis present as?
small painful ulcers on oral mucosa
What do the ulcers in aphthous stomatitis look like?
shallow with grey, necrotic base and haemorrhagic rim
When does glossitis occur?
in nutrient deficiency states (iron and B vitamins)
What does glossitis present as?
beefy red tongue
What is glossitis caused by?
papillae atrophy with mucosal thinning
shiny and more apparent vasculature
What is leukoplakia?
clinical term for plaques which are not clinically or pathologically characterised as any other disease
. . . cannot be removed by scraping
leukoplakia
leukoplakis is associated with . . . ? (5)
- heavy cigarette smoking
- heavy alcohol consumption
- chewing tobacco
- poor dental hygiene
- poor fitting dentures
What is erythroplakia?
red, velvety, flat lesion that is thin with a loss of differentiation which is transparent to the underlying tissue
In what age range does oral squamous cell carcinoma usually occur?
50-70 years
Where is oral squamous cell carcinoma usually found?
- mouth floor
- lateral tongue
- tongue base
- soft palate
why is lip cancer more common than intra-oral squamous cell carcinoma?
sunlight exposure
What are the risk factors for oral squamous cell carcinoma? (5)
- Tobacco
- Alcohol
- HPV
- Betel nut and paan chewing
- Genetics
What can the lesion be like in oral squamous cell carcinoma?
raised, firm, ulcerated or verrucous
What is the treatment for oral squamous cell carcinoma? (4)
- surgery - need clean margins
- lymph node removal
- radiation therapy
- chemotherapy
What are the histological characteristics of ulcerated squamous cell carcinoma? (5)
- ragged groups, islands
- cohesive cells
- intracellular bridges
- abundant eosinophilic keratin in cytoplasm
- (+/-) keratin pearls
What infectious diseases manifest orally? (3)
- scarlet fever
- measles
- infectious mononucleosis
What immune diseases manifest orally? (2)
- aphthous ulceration in coeliac and inflammatory bowel disease
- Behcets disease
What skin diseases manifest orally? (3)
- Lichen planus
- Blistering conditions
- Stevens-johnson syndrome
What deficiencies manifest orally? (1)
glossitis from vit b and iron deficiency
What iatrogenic diseases manifest orally? (2)
- mucositis
2. graft vs host disease
