Potentially Malignant Disorders and Oral Cancer Flashcards

1
Q

what is a potentially malignant lesion

A

altered tissue in which cancer is more likely to form

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2
Q

what is a potentially malignant condition

A

generalised state with increased cancer risk

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3
Q

name some potentially malignant oral conditions

A

lichen planus
oral submucous fibrosis
iron deficiency
tertiary syphilis

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4
Q

what version of lichen planus is more likely to be malignant

A

ulcerative or erosive

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5
Q

why is iron deficiency potentially malignant

A

atrophy of oral epithelium means the barrier function is diminished

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6
Q

what types of leukoplakia can be potentially malignant

A

chronic hyperplastic candidosis
proliferative verrucous leukoplakia

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7
Q

what are the 2 general types of potentially malignant lesions in the mouth

A

leukoplakia
erythroplakia

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8
Q

where does chronic hyperplastic candidosis occur

A

commissures

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9
Q

who gets chronic hyperplastic candidosis

A

smokers

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10
Q

what is chronic hyperplastic candidosis caused by

A

candida albicans

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11
Q

what do you need to do if you suspect chronic hyperplastic candidosis

A

take a biopsy

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12
Q

what takes of histology stains are needed for chronic hyperplastic candidosis

A

2 stains - H&E and PAS (periodic acid schiff)

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13
Q

what is seen on the H&E histology of chronic hyperplastic candidosis

A

excessive keratin formation where epithelium is generally non-keratinised
chronic inflammatory cells
microabscesses in upper layers

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14
Q

what would you see on the PAS histology of chronic hyperplastic candidosis

A

candida albicans hyphae

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15
Q

what is the treatment for chronic hyperplastic candidosis

A

systemic antifungal - fluconazole capsules 50mg once a day for 14 days
biopsy
smoking cessation
observe

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16
Q

what factors helps you predict whether a leukoplakia can become malignant

A

age and gender
idiopathic
site - floor of mouth and tongue
clinical appearance

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17
Q

what type of leukoplakia has the highest transformation rate

A

proliferative verrucous leukoplakia

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18
Q

what is seen on the histopathology of a leukoplakia turning malignant

A

dysplasia
atrophy of epithelium
candida infection

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19
Q

what is dysplasia

A

disordered maturation in a tissuewh

20
Q

at

A
21
Q

what are the 2 main groups of epithelial dysplasia

A

architectural changes
cytological abnormalities

22
Q

what type of changes are seen in the architecture of epithelium

A

abnormal maturation and stratification

23
Q

what type of changes are seen in the cytology of the epithelium

A

cellular atypia

24
Q

what is the grading of epithelial dysplasia based on

A

histopathology

25
Q

what is seen in basal hyperplasia

A

increased basal cell numbers
regular stratification but basal compartment larger
no cellular atypia

26
Q

what is seen in mild dysplasia

A

architectural changes in the lower third
mild atypia

27
Q

what is seen in moderate dysplasia

A

architectural changes extend into the middle third
moderate atypia

28
Q

what is seen in severe dysplasia

A

architectural changes extend to upper third
severe atypia and numerous mitoses

29
Q

what is seen in carcinoma in situ

A

abnormal architecture in the full thickness of viable cell layers
mitotic abnormalities frequent

30
Q

what are the disadvantages of biopsy

A

invasive
cannot monitor tissue response to treatment effectively
not suitable for mass screening

31
Q
A
32
Q

what techniques are available to identify potentially malignant lesions

A

vital staining
oral cytology
optical imaging

33
Q

what genes are involved in cancer

A

oncogenes
tumour suppressor genes
Tp53
genes which regulate apoptosis
genes involved in DNA repair
microRNA

34
Q

what changes to chromosomes can cause cancer

A

aneuploidy
translocations
amplifications

35
Q

what changes to genes can cause cancer

A

mutations
deletions
amplifications

36
Q

what are the hallmarks of cancer

A

self sufficiency in growth signals
evading apoptosis
insensitivity to anti-growth signals
sustained angiogenesis
limitless replicative potential
tissue invasion and metastasis

37
Q

what is included in the diagnosis of cancer

A

differentiation and grading
pattern of invasive front related to nodal spread
local extension of disease

38
Q

what type of front is associated with lymph node involvement

A

non-cohesive front

39
Q

where can oral cancer spread to

A

local extension - bone
lymphatic spread
haematogenous spread

40
Q

when a patient is edentulous how does cancer spread in the bone

A

in gaps in the cortex of the bone

41
Q

when a patient is dentate how does cancer spread in the bone

A

along the PDL

42
Q

where does the cancer spread if it spreads along a nerve

A

along the myelin sheath

43
Q

what system is used for staging oral cancer

A

TNM

44
Q

what does the letters TNM mean when it comes to staging oral cancer

A

T - size of tumour you can see
N - lymph node involvement
M - metastasis

45
Q
A