Reactive Lesions of Oral Mucosa

Question 1

what are the 3 gross types of oral mucosa

Answer 1

lining
masticatory
gustatory

Question 2

para vs ortho keratinised

Answer 2

ortho - no dots pure keratin
para - remains of nuclei of squamous cells present in keratin layer

Question 3

why may lining mucosa appear paler when stained with H and E

Answer 3

cells store glycogen

Question 4

5 layers of epithelium

Answer 4

stratum basale
stratum spinosum
stratum lucidum (thick skin)
stratum granulosum
stratum corneum

Question 5

acanthosis

Answer 5

hyperplasia of stratum spinosum

Question 6

histological signs that may indicate keratosis

Answer 6

acanthosis
keratosis (of a non keratinised site)
elongated rete ridges

Question 7

why may atrophic areas of buccal mucosa also have a yellow tinge

Answer 7

underlying adipose tissue (buccal fat)

Question 8

erosion vs ulceration

Answer 8

erosion - loss of upper layers of epithelium (red)
ulceration - full thickness of epithelium lost (yellowy due to fibrin on top)

Question 9

what is dysplasia

Answer 9

disordered maturation of cells, has malignant postential
can only be detected via microscope not clinically

Question 10

dysplasia vs cellular atypia

Answer 10

dysplasia - changes in tissue
atypia - changes in cells

Question 11

epulis (epulides)

Answer 11

reactive hyperplastic lesions on gingiva only

Question 12

main aetiological factors of an epulis

Answer 12

sub gingival plaque and calculus

Question 13

fibrous epulis

Answer 13

firm, pedunculated or sessile lesion of similar colour to adjacent mucosa
most common on posterior teeth

Question 14

vascular epulis

Answer 14

essentially a pyogenic granuloma on the gingiva
soft bright swelling which is often ulcerated. haemorrhage can occur spontaneously or in response to trauma

Question 15

pregnancy epulis

Answer 15

vascular epulis during pregnancy
wait until after birth for removal

Question 16

pyogenic granuloma

Answer 16

granulation tissue in response to trauma
can occur at any mucosal site in mouth
most common site is gingiva where it is termed vascular epulis

Question 17

giant cell lesions

Answer 17

can arise anywhere on gingiva (epulis) or alveolar mucosa
made up of lots of multinucleated giant cells
histopathologically identical to central giant cell granulomas so sometimes termed peripheral giant cell granulomas

Question 18

what systemic disease symptom is histopathologically identical to giant cell lesions

Answer 18

browns tumours of hyperparathyroidism
must rule out this before giant cell diagnosis

Question 19

fibroepithelial polyp

Answer 19

fibrous epulis at sites other than gingivae
thick fibrous tissue covered by thick epithelium
caused by trauma

Question 20

drugs that may induce hyperplasia

Answer 20

calcium channel blockers
phenytoin
valproate
cyclosporin