RADIOLOGY - benign and malignant path Flashcards
list clinical signs and symptoms of malignancy in the oral cavity?
leukoplakia/ erythroplakia/ erythroleukoplakia
non healing socket
non healing ulcer
usually mobile tooth (with no hx of perio)
swelling/ exophytic mass
lymphadenopathy
pain
numbness
what are systemic signs and symptoms of malignancy?
weight loss (B symptom)
night sweats (B symptom)
problems moving tongue
dysphagia
dysphonia
loss of hearing
pathological #
what nerve controls moto movement of the tongue?
hypoglossal
what nerve controls hearing?
facial and vestibulocochlear
list radiographic signs of malignancy?
moth eaten bone
non healing sockets
floating teeth
unusual perio bone loss
spiculated periosteal reaction - “sunburst” reaction
unusual uniform widening of the PDL
generalised loss of lamina dura
loss of bony outlines for anatomical features
thinning of corticoendosteal margin
spiking root resorption
list what must be included in a radiological description?
size
site
shape
definition and margins
radiolucency/ opacity
expansion
effect on other structures
in regards to the margins of a lesion, what does bone cortication imply and why?
benign
cortication means the bone has had time to remodel at the periphery of the radiolucency
slow growing = benign
in regards to the margins of a lesion, what does a lack of cortication represent?
healing lesion
superimposed infection
in regards to the margins of a lesion, what does a moth eaten radiolucent bone with no margin imply?
bad prognostic sign
what effect may benign lesions have on other structures?
displace anatomical structures due to slow growth
what effect may malignant lesions have on other structures?
destroy anatomical structures
what are the key anatomical features seen of the maxillary antrum on an OPT?
pterygomaxillary fissure
superior wall/ inferior margin of the orbit
zygomatic buttress
what effects may malignant lesions have on the teeth?
spiking root resorption
generalised widening of the PDL
generalised loss of lamina dura
what age of people tend to present with osteosarcoma?
young adults around 30 years old
what are risk factors for osteosarcoma?
FD
retinoblastoma
previous exposure to radiation
previous primary bone cancer
pagets disease
chronic osteomyelitis
what percentage of osteosarcomas present in the head and neck?
10%
what are the most common symptoms of osteosarcoma?
persistent pain
oedema
paraesthesia
how does multiple myeloma occur?
multifocal proliferation of plasma cells in bone marrow leading to over production of immunoglobulins
what is a solitary lesion in multiple myeloma called?
plasmocytoma
what age of people does multiple myeloma affect?
middle aged adults
what are radiographic features of multiple myeloma?
round/ unilocular
radiolucent
punched out
well defined not corticated
large lesions can lead to pathological #
what is the most common type of lymphoma?
B cell lymphoma
what can lymphoma initially present as?
a soft tissue lump
what is the cause of langerhans histocytosis?
proliferation of Langerhans cells and eosinophillic leucocytes
what are the 3 manifestations of langerhans histocytosis?
eosinophilic granuloma
hand-schuller-christian disease (multifocal eosinophilic granuloma)
letterer-siwe disease
what type of langerhans histiocytosis affects children under 3 years old?
letterer-siwe disease
what are radiographic features of langerhans histiocytosis?
unilocular
radiolucent
punched out
smooth outline
floating teeth
no expansion
where in the body can head and neck bone metastasis originate from?
lung
prostate
breast
kidney
thyroid
how do metastasis present in the jaws?
typically radiolucent
breast and prostate metastasis can be sclerotic/ osteogenic
what does metastasis present as on a PET scan?
hot spots
what are differentials for moth eaten bone seen on plain film radiographs?
osteomyelitis
osteoradionecrosis
MRONJ
