Reactive Lesions of Oral Mucosa Flashcards
what are the 3 gross types of oral mucosa
lining
masticatory
gustatory
para vs ortho keratinised
ortho - no dots pure keratin
para - remains of nuclei of squamous cells present in keratin layer
why may lining mucosa appear paler when stained with H and E
cells store glycogen
5 layers of epithelium
stratum basale
stratum spinosum
stratum lucidum (thick skin)
stratum granulosum
stratum corneum
acanthosis
hyperplasia of stratum spinosum
histological signs that may indicate keratosis
acanthosis
keratosis (of a non keratinised site)
elongated rete ridges
why may atrophic areas of buccal mucosa also have a yellow tinge
underlying adipose tissue (buccal fat)
erosion vs ulceration
erosion - loss of upper layers of epithelium (red)
ulceration - full thickness of epithelium lost (yellowy due to fibrin on top)
what is dysplasia
disordered maturation of cells, has malignant postential
can only be detected via microscope not clinically
dysplasia vs cellular atypia
dysplasia - changes in tissue
atypia - changes in cells
epulis (epulides)
reactive hyperplastic lesions on gingiva only
main aetiological factors of an epulis
sub gingival plaque and calculus
fibrous epulis
firm, pedunculated or sessile lesion of similar colour to adjacent mucosa
most common on posterior teeth
vascular epulis
essentially a pyogenic granuloma on the gingiva
soft bright swelling which is often ulcerated. haemorrhage can occur spontaneously or in response to trauma
pregnancy epulis
vascular epulis during pregnancy
wait until after birth for removal
pyogenic granuloma
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
giant cell lesions
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
what systemic disease symptom is histopathologically identical to giant cell lesions
browns tumours of hyperparathyroidism
must rule out this before giant cell diagnosis
fibroepithelial polyp
fibrous epulis at sites other than gingivae
thick fibrous tissue covered by thick epithelium
caused by trauma
drugs that may induce hyperplasia
calcium channel blockers
phenytoin
valproate
cyclosporin
