Pathology of the Oral Cavity & Salivary Glands Flashcards
This disorder is inflammation of the salivary glands that causes swelling, xerostomia (dry mouth), and trismus (inability to open mouth).
Sialidentitis - usually due to salivary stones or post-operation dehydration
How does mucoepidermoid carcinoma differ from benign salivary gland tumors?
More rapid-growing, may or may not include pain, may or may not involve the facial nerve
Viral causes of oropharynx squamous cell carcinoma have surpassed tobacco and alcohol. What viruses are most associated with oropharynx squamous cell carcinoma?
HPV 16 & 18
Hairy leukoplakia is due to immunosuppression or viral infection. What viruses are associated with the oral pathology?
HIV, EBV
What is the malignant variant of leukoplakia?
Squamous cell carcinoma
True/False. Larger glands are more associated with malignant tumors.
False. Malignancy is more associated with small glands (sublingual). Larger glands (parotid) are more likely to have benign tumors.
Pain associated with sialolithiasis (improves/worsens) with eating.
Worsens - thinking about food or eating stimulates saliva production, which causes pain due to stones
Why are surgical interventions for parotid tumors rare?
The facial nerve runs through the gland
How does a canker sore differ from a cold sore?
Canker sores are oral ulcers often due to stress. Cold sores are due to primary or reactivation of an HSV-1 infection.
What is the most common salivary location of pleomorphic adenoma?
Parotid gland
This benign oral pathology has a red, velvety appearance and is highly associated with alcohol, tobacco, and carcinogens.
Erythroplakia
What marker can be used to measure HPV-mediated squamous cell carcinoma in the head and neck?
p16 - tumor suppressor that inactivates CDK4 to prevent phosphorylation of Rb. Production of p16 is increased due to stimulation of the cell cycle by E7
This benign oral pathology is caused by an autoimmune disorder that destroys the basal cell layer and gives a “sawtooth” pattern or “Lacy White lines” to the mucosa.
Lichen Planus
What pathogen is the most common cause of oral candidiasis?
Candida albicans
An individual with recurrent aphthous ulcers is given this diagnosis.
Sutton’s Disease - 5+ episodes per year
True/False. Pharyngitis generally has a bilateral onset.
True - if only one side if effected, other diagnoses should be considered
What is the treatment for oral candidiasis?
Nystatin
Disruption of cell cycle regulatory steps contributes to malignancy. What molecules are implicated in this process?
Cyclin-CDK4 (phosphorylates Rb) & p53
At what stage do cancerous cells invade the basement membrane?
Invasive carcinoma
What HPV proteins are implicated in tumor pathogenesis? What are their functions?
E6 - degrades p53
E7 - binds to and inhibits Rb so E2F continues to stimulate the cell cycle
What is the most common benign tumor of the salivary glands?
Pleomorphic adenoma
This cystic tumor has essentially no risk of malignant transformation and is the second most common parotid gland tumor.
Warthin’s tumor
How does Warthin’s tumor differ from pleomorphic adenoma?
Warthin’s tumor is cystic, may appear bilaterally, and is associated with smoking
What is the most common benign tumor of the oral cavity and oropharynx?
Squamous Papilloma
What is the clinical presentation of pleomorphic adenoma?
Slow-growing, unilateral, firm, painless salivary gland
Leukoplakia is a white patch or plaque in the oral cavity that cannot be scratched off. What is the treatment?
Leukoplakia is always due to some other underlying etiology (irritation, smoking, infection). The underlying cause must be treated and lesion removed.
What risk factors are most associated with squamous cell carcinoma of the oral cavity?
Tobacco, alcohol
This benign oral pathology is due to abnormal misfolded fibrillar proteins and is diagnosed with apple-green birefringence on Congo Red stain.
Amyloidosis
What is an aphthous ulcer?
Canker sore - ulcer of the non-keratinized oral mucosa often due to stress
What is the most common malignant salivary gland tumor?
Mucoepidermoid carcinoma
What is Behcet Syndrome?
Recurrent aphthous ulcers, genital ulcers, and uveitis (ocular inflammation).
With what virus is squamous papilloma most associated?
HPV 6 & 11
How can oral candidiasis be differentiated from hairy leukoplakia?
Oral candidiasis can easily be scrapped off, but hairy leukoplakia cannot.