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AU18: Oral Path 2 > Premalignant Epithelial Lesions > Flashcards

Premalignant Epithelial Lesions Flashcards

1
Q

T/F: Leukoplakia is a diagnosis.

A

False

Clinical finding

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2
Q

What is the most common oral precancerous lesion?

A

Leukoplakia

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3
Q

T/F: A biopsy is mandatory when leukoplakia is seen.

A

True

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4
Q

What causes the white color involved with leukoplakia?

A

Thickened keratin in a moist environment

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5
Q

T/F: Ill-fitting dentures, poor oral hygiene, and broken teeth increase a patients risk for oral cancer.

A

False

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6
Q

T/F: Moderate alcohol use by itself is a risk factor for oral cancer.

A

False

Strong synergism with tobacco

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7
Q

What differentiates frictional keratosis from leukoplakia?

A

Blended borders with frictional keratosis

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8
Q

T/F: Nicotine stomatitis is precancerous.

A

False

Due to heat

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9
Q

What is the most common form of candidiasis?

A

Erythematous candidiasis

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10
Q

How do you differentiate leukoedema from tobacco pouch keratosis?

A

Tobacco pouch keratosis does not disappear when stretched

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11
Q

T/F: Gingival recession and loss of buccal bone can be associated with tobacco pouch keratosis.

A

True

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12
Q

What causes the gray, translucent appearance in tobacco pouch keratosis?

A

Contact irritation - cessation of the habit will resolve lesion within 5-6 weeks

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13
Q

Patient stops using smokeless tobacco for 5-6 weeks but leukoplakia is still seen at reevaluation. What to do?

A

Biopsy

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14
Q

T/F: Smokeless tobacco is a bigger risk for cancer than cigarette smoking.

A

False

Smokeless tobacco has significantly less risk than cigarettes

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15
Q

How is epithelial dysplasia graded?

A

Microscopic analysis:

Mild - lower 1/3
Moderate - lower 1/2
Severe - upper 1/3

Carcinoma in-situ - full thickness of epithelium

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16
Q

What are some histopathological features of leukoplakia?

A

Keratosis, often sharp transition from affected to normal

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17
Q

What percentage of leukoplakias show hyperkeratosis without epithelial dysplasia?

A

80% of leukoplakias show hyperkeratosis without epithelial dysplasia

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18
Q

What happens to the rete ridges of epithelium as dysplasia progresses?

A

They become more bulbous and coalescent

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19
Q

What percentage of patients with leukoplakia are smokers?

A

80% of patients with leukoplakia are smokers

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20
Q

T/F: Brush biopsy is just as useful as scalpel biopsy.

A

False

21
Q

How do you calculate pk/yr TOB?

A

(Number of packs of cigarettes per day) x (number of years smoked)

Ex. Patient smokes 2 packs per day for 10 years = 20 pk/yr TOB

22
Q

What is the most definitive clinical feature of a leukoplakia?

A

Sharply demarcated, crisp borders

23
Q

What is the most common site for leukoplakia?

A

Buccal mucosa

24
Q

What is another term for erythroleukoplakia?

A

Speckled leukoplakia

25
Q

What is the clinical appearance of an erythroleukoplakia?

A

Red and white components

26
Q

T/F: An erythroleukoplakia is more severe than a leukoplakia.

A

True

27
Q

What is the prognosis for a leukoplakia?

A

Guarded

15% non-dysplastic lesions will transform to SCC if not treated

33% dysplastic lesions will transform

30% will recur even after complete clinical excision

28
Q

What are some definitive features of proliferative verrucous leukoplakia (PVL)?

A

Grows laterally; slow, persistent spreading

Will involve multiple sites

“Warty” rough projections

29
Q

T/F: PVL is seen mostly in females and has less association with smoking.

A

True

30
Q

PVL will often transform to squamous cell carcinoma within _______ years.

A

8

31
Q

T/F: Erythroplakia is has a worse prognosis than leukoplakia.

A

True

32
Q

T/F: Erythroplakia is more prevalent in men.

A

False

Unlike leukoplakia, Erythroplakia has no gender predilection

33
Q

What are the most common sites of Erythroplakia?

A

Lateral tongue, floor of mouth, soft palate

34
Q

What are the clinical features of Erythroplakia?

A

Well demarcated, velvety red patches

35
Q

What percentage of Erythroplakia show severe epithelial dysplasia or worse at the time of biopsy?

A

90%

36
Q

What are the highest risk sites for leukoplakia?

A

Ventral tongue, floor of mouth, soft palate/tonsillar pillars

37
Q

What is a major risk factor for oral submucous fibrosis?

A

Betel quid, paan, masala, gutkha, mawa

*Indian subcontinent, Southeast Asia, etc.

38
Q

What are the clinical features of oral submucous fibrosis?

A

Pallor and fibrosis (white color) to soft palate with the uvula retaining normal color

*burning and intolerance to spicy foods, limited incisal opening

39
Q

T/F: Oral submucous fibrosis will regress with habit cessation.

A

False

40
Q

T/F: Actinic keratosis is caused by UV rays.

A

True

41
Q

A light skinned 51 yr old male has a scaly plaque with sandpaper texture on his forehead. Likely diagnosis?

A

Actinic keratosis

42
Q

What is likely seen histopathologically with actinic keratosis?

A

Hyperkeratosis, solar elastosis, epithelial dysplasia

43
Q

What is the term for actinic keratosis involving the vermilion zone of lips?

A

Actinic cheilitis

44
Q

Who is the most likely to get actinic cheilitis?

A

male over 45 with fair skin

45
Q

What are some major clinical features of actinic cheilitis?

A

Dryness, fissures, blended vermillion border

Dry portions may thicken and become leukoplakias

46
Q

T/F: Hyperkeratosis may be seen in actinic cheilitis and actinic keratosis.

A

True

47
Q

T/F: Actinic cheilitis is more likely to become cancer than actinic keratosis.

A

True

48
Q

T/F: Actinic cheilitis has a better prognosis than intraoral SCC.

A

True

AU18: Oral Path 2 (18 decks)

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