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Oral Path 2 > Radiolucent Non-Odontogenic Lesions > Flashcards

Radiolucent Non-Odontogenic Lesions Flashcards

1
Q

Nasolabial Cyst

A

RL Non-Odontogenic Cyst

  • Developmental cyst
  • Develops from remnants of nasolacrimal duct
  • Upper lip, lateral to midline
  • Nasal/MX processes
  • More common in females 2:1
  • Elevation of ala of the nose
  • Swelling of lip lateral to mimdline
  • Characteristically lined by pseudostratified columnar epithelium, often w/ Goblet cells & cilia
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2
Q

Nasolabial Cyst: Tx

A

RL Non-Odontogenic Cyst

Surgical excision

Recurrence is rare

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3
Q

Another name for Nasopalatine Duct Cyst

A

RL Non-Odontogenic Cyst

Incisive canal cyst

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4
Q

What is the most common non-odontogenic cyst?

A

RL Non-Odontogenic Cyst

Nasopalatine Duct Cyst

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5
Q

Nasopalatine Duct Cyst

A

RL Non-Odontogenic Cyst

  • Most common non-odontogenic cyst
  • Connects oral and nasal cavities in the incisive canal area
  • Swelling of anterior palate, w/ drainage and pain
  • Most common in 4th-6th decades of life
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6
Q

Nasopalatine Duct Cyst: Rad

A

RL Non-Odontogenic Cyst

  • RL
  • Well-circumscribed
  • Round/oval
  • Inverted pear
  • Heart shape
  • Lined by highly variable epithelium (75% stratified squamous)
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7
Q

Nasopalatine Duct Cyst: Tx

A

RL Non-Odontogenic Cyst

  • Surgical excision
  • Biopsy req’d
  • Lesions not dx radiographically
  • Other lesions can mimic this one
  • Recurrence is rare
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8
Q

Globulomaxillary Cyst

A

RL Non-Odontogenic Cyst

  • Fusion of globular and MX processes
  • B/w incisor & K9
  • THIS CYST DOESN’T EXIST
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9
Q

Median MN Cyst

A

RL Non-Odontogenic Cyst

  • Fusion of halves of MN during embryonic life
  • Most of these midline cysts are odontogenic in origin
  • THIS CYST DOESN’T EXIST
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10
Q

Idiopathic Bone Cavity

A

RL Non-Odontogenic Pseudocyst

  • AKA Simple Bone Cyst
  • Cavity usually filled w/ blood but not a real cyst b/c no epithelial lining; thinly corticated
  • Cause & pathogenesis are uncertain
  • In younger people (10-20yo) and not always from trauma
  • 90% in posterior MN
  • MOST OF THE TIME cavity has some mixture of blood and other fluids; otherwise filled w/ air
    • 65%: Sero-sanguinolent fluid
    • 35%: Empty bone cavity
  • Key: NO EPITHELIAL LINING = NOT A CYST
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11
Q

Idiopathic Bone Cavity: Rad

A

RL Non-Odontogenic Pseudocyst

  • Well-defined RL, thinly corticated superior border and non-corticated inferior border
  • Interdental scalloping: Classic feature of SBC/IBC
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12
Q

Idiopathic Bone Cavity: Tx

A

RL Non-Odontogenic Pseudocyst

  • Dx based on clinical, rad, surgical features
  • After surgical exploration, heals in 6mo
    • Open up and find it’s just filled w/ blood so close up and it will heal
  • Good px
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13
Q

Stafne Bone Cyst

A

RL Non-Odontogenic Pseudocyst

  • Focal concavity of bone on lingual surface of MN; associated w/ subMN gland
    • Defect from extra subMN gland tissue
  • Rarely found in upper MN ramus and anterior MN
  • Striking male predilection: 90% of cases in males
  • RL below MN canal; b/w molar teeth and angle of MN
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14
Q

Another name for Idiopathic Bone Cavity

A

Simple Bone Cyst

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15
Q

Another name for Stafne Bone Cyst

A

Stafne Bone Defect

Static Bone Cyst

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16
Q

Stafne Bone Cyst: Rad

A

RL Non-Odontogenic Pseudocyst

  • Usually has thick corticated borders
  • RL below MN canal; b/w molars and angle of MN
17
Q

Stafne Bone Cyst: Tx

A

RL Non-Odontogenic Pseudocyst

  • No tx needed
  • Excellent px
  • Lesions in anterior jaws may be difficult to recognize
  • Biopsy may be needed to r/o other pathologic lesions
18
Q

Central Giant Cell Granuloma

A

RL Non-Odontogenic Lesions: Other

  • More common in children & young adults but can occur in all ages
  • More common in MN, but can also occur in MX
  • Benign, but aggressive lesions can grow rapidly
  • More in women; <30yo
  • Classically found in anterior MN
19
Q

Aggressive CGCG vs. Non-Aggressive CGCG

A

RL Non-Odontogenic Lesions: Other

  • Most CGCG lesions are NON-AGGRESSIVE
    • Asymptomatic, slowly growing, no root resorption, no perforation of cortical bone
    • Tend not to recur after curettage
  • AGGRESSIVE CGCG
    • Pain or paresthesia, root resorption, cortical perforation
    • Higher recurrence rate after curettage
    • Still benign looking even though it’s aggressive
20
Q

CGCG: Rad

A

RL Non-Odontogenic Lesions: Other

  • RL lesions w/ well-defined borders, similar to odontogenic tumors & cysts
  • May or may not have corticated border
  • Unilocular or multilocular, depending on size
  • Can cause expansion and/or perforation of cortical plate
  • Tends to resorb roots horizontally
21
Q

CGCG: Microscopic features

A

RL Non-Odontogenic Lesions: Other

  • Fibrous tissue, numerous multinucleated giant cells, hemorrhage, hemosiderin
  • Resembles hyperparathyroidism & cherubism
22
Q

What pathogolies does CGCG resemble?

A

RL Non-Odontogenic Lesions: Other

  • Hyperparathyroidism
    • ​Increased serume PTH levels
  • Cherubism
    • <10yo, bilateral
23
Q

CGCG: Tx

A

RL Non-Odontogenic Lesions: Other

  • Usually curettage is used (15-20% recurrence rate)
  • Aggressive lesions: Intralesional corticosteroids, calcitonin, interferon
24
Q

Hemangioma/Vascular malformation

A

RL Non-Odontogenic Lesions: Other

  • Hemangioma: Benign proliferation of small BVs
  • Vascular malformation: AKA arteriovenous malformation and high flow angioma
    • Proliferation of small BVs and larger arterial vessels associated w/ more blood flow and can result in excessive bleeding during surgery
    • Part of Sturge-Weber Syndrome
  • Usually detected during first 3 decades of life
  • Vaslcular malformations may have thrill (pulsatile to palpation) or bruit (heard upon auscultation)
25
Q

Hemangioma/Vascular malformation: Rad

A

RL Non-Odontogenic Lesions: Other

  • RL lesions w/ well-defined, corticated borders
  • Usually RL, but may have RO areas and/or multilocular “honeycombed” or “soap bubble” appearance
  • May have coarse internal trabeculae
  • Aspiration of all bony lesions is done before biopsy or tooth extraction to r/o vascular malformations
26
Q

Hemangioma/Vascular malformations: Tx

A

RL Non-Odontogenic Lesions: Other

  • Angiography
  • Surgical resection
  • Thromboembolization of vascular malformations may be req’d before surgery
27
Q

Focal Osteoporotic Bone Marrow Defect

A

RL Non-Odontogenic Lesions: Other

  • Area of hematopoietic marrow that produces RL
  • May be confused w/ an intraosseous neoplasm
  • Variation of normal
  • Typically asymptomatic
  • No jaw expansion
  • Not completely RL so can’t be a cyst
  • 75% in women; typically posterior MN
28
Q

Focal Osteoporotic Bone Marrow Defect: Rad

A

RL Non-Odontogenic Lesions: Other

  • Key: Differentiate from other lesions
    • ​Irregular shape
    • Trabecular pattern still seen inside the lesion
  • No jaw expansion
  • Not completely RL so can’t be a cyst
  • Just widened trabecular spaces, not multilocular
29
Q

What are Radiolucent Non-Odontogenic Lesions?

A
  • Nasolabial Cyst
  • Nasopalatine Duct Cyst
  • Globulomaxillary Cyst ***
  • Median MN Cyst ***
30
Q

What are RL Non-Odontogenic Pseudocysts?

A
  • Idiopathic Bone Cavity
  • Stafne Bone Cyst
31
Q

What are Other RL Non-Odontogenic Lesions?

A
  • Central Giant Cell Granuloma
  • Hemangioma/Vascular Malformation
  • Focal Osteoporotic Bone Marrow Defect

Oral Path 2 (11 decks)

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