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Opath II block 5 > Simplified Block 5: histology > Flashcards

Simplified Block 5: histology Flashcards

1
Q

developmental cysts- ~12

A

DC. EC/EH. PC. OKC. NBCCS (Gorlin Syndrome). OKOC. LPC. GCA. COC (Gorlin Cyst or Dentinogenic ghost cell tumor). GOD (dialo-odontogenic cyst). Carcinoma arising in odontogenic cysts.

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1
Q

histology

developmental cysts- ~12

A

Dentigerous cyst. Eruption cyst. Paradental cyst. Odontogenic keratocyst. Nevoid basal cell carcinoma sydrome “Gorlin syndrome.” ortokeratinized dentinoGENIC cyst. Lateral periodontal cyst. Gingival cyst of a newborn. Gingival cyst of the adult. califying odontogenic cyst. glandular odontogenic cyst. [carcinoma arising in odontogenic cysts]

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2
Q

dentigerous cyst (DC)

A

Thin, non-keratinized epithelial lining, multipotential (may have mucous or other cells present), Inflamed cyst=APC histo

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2
Q

histology

dentigerous cyst (DC)

A

WD, CB, UL, RL around crown of an unerupted tooth, attached to the CEJ

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3
Q

eruption cyst (eruption hematoma)

A

Thin layer of keratinized squamous epithelium, may contain blood

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3
Q

histology

eruption cyst (eruption hematoma)

A

Soft, translucent swelling in gingival mucosa overlying the crown of an erupting tooth (most commonly 1st perm molars)

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4
Q

Paradental cyst

A

“inflamed dentigerous cyst”, Hx of pericoronitis

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4
Q

histology

Paradental cyst

A

Cyst on distal or buccal of partially erupted 3rd molar

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5
Q

odontogenic keratocyst (OKC)

A

Small satellite cysts in fibrous wall, uniformly thin epithelium, corrugated parakeratin, palisaded basal layer with hyperchromatic nuclei

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5
Q

histology

odontogenic keratocyst (OKC)

A

WD, smooth and CB, UL, RL between teeth. Smetimes ML. resemnbles other cytsts, Rx descriotion not diagnostic

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6
Q

nevoid basal cell carcinoma syndrome “Gorlin syndrome”

A

Multiple basal cell ca’s, multiple OKCs, palmar/plantar pits, calcified cerebri, enlarged head circumference, Rib anomalies, ocular hypertelorism, spina bifida occulta

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6
Q

histology

nevoid basal cell carcinoma syndrome “Gorlin syndrome”

A

Jaw cysts present in 75% of patients

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7
Q

orthokeratinized odontogenic cyst

A

Orthokeratin WITHOUT nuclei, prominent granular cell layer, basal cell layer NOT PALISADED and less hyperchromatic

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7
Q

histology

orthokeratinized odontogenic cyst

A

Posterior mandible, unerupted 3rd molars, UL, RL. Resembles DC

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8
Q

lateral periodontal cyst

A

Focal nodular thickenings (epithelial plaques), lined by uniformly flattened squamous cells, swirl appearance

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8
Q

histology

lateral periodontal cyst

A

WD, CB, RL lateral to the roots of VITAL teeth

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9
Q

gingival cyst of the newborn

A

Multiple whitish papules on mucosa overlying alveolar process on a newborn (<3mos). Derived from rests of dental lamina, Keratin-filled cysts lined by parakeratotic stratified squamous epithelium.

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9
Q

histology

gingival cyst of the newborn

A

N/A

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10
Q

gingival cyst of the adult

A

Fluid-filled swelling of the facial gingiva or alveolar mucosa, blue/gray tint, md premolar/anteriors. Derived from rests of dental lamina, soft tissue counterpart of lateral periodontal cyst, focal nodular thickenings

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10
Q

histology

gingival cyst of the adult

A

Usually not seen on radiograph due to soft-tissue nature

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11
Q

calcifying odontogenic cyst (Gorlin cyst or dentinoGENIC ghost cell tumor)

A

Ghost cells (outline, but no nuclei), dystrophic calcification of ghost cells (RO’s), ghost cell keratinization, epithelium similar to enamel organ and ameloblastoma, loose stellate/spindle cells, columnar cells

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11
Q

histology

calcifying odontogenic cyst (Gorlin cyst or dentinoGENIC ghost cell tumor)

A

WD, UL, RL with or without RO’s or Cal’s.

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12
Q

Glandular odontogenic cyst (sialo-odontogenic cyst)

A

Derived from rests of dental lamina, lined by stratified squamous epithelium with cililated columnar shape, small microcysts and clusters of mucous cells in cystic lining

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12
Q

histology

Glandular odontogenic cyst (sialo-odontogenic cyst)

A

WD, SB, UL or ML, RL. Anterior mandible

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13
Q

Carcinoma Arising in odontogenic cysts

A

Well-differentiated SCC

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13
Q

histology

Carcinoma Arising in odontogenic cysts

A

Irregular and ragged margins of a RL defect

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14
Q

inflammatory cysts - 3

A

APC (periapical cyst or radicular cyst). RC. BBC.

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14
Q

histology

inflammatory cysts - 3

A

Apical periodontal cyst. Residual cyst. Buccal bifurcation cyst.

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15
Q

Apical periodontal cyst (periapical cyst or radicular cyst)

A

NON-VITAL TOOTH. Derived from rests of Malassez, SSEpi exhibiting exocytosis and spongious, may have cholesterol clefts, dystrophic calcifications

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15
Q

histology

Apical periodontal cyst (periapical cyst or radicular cyst)

A

WD, CB, UL, RL in periapical area (classical) or interproximal area. May be along lateral aspect of the root

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16
Q

residual cyst

A

Persistent APC after infected tooth has been extracted. Same histo as APC

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16
Q

histology

residual cyst

A

WD, CB, RL at extraction site

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17
Q

buccal bifurcation cyst

A

Buccal of mandibular 1st molars, buccal enamel extension leads to pocket, “Site Specific” paradental cyst

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17
Q

histology

buccal bifurcation cyst

A

WD, UL, RL at buccal bifurcation

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18
Q

Non-odontogenic cysts

A

ABC. FOBMD. STBC. ScC. Idiopathic osteosclerosis. CGCG.osteoma. Chondroma.

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18
Q

histology

Non-odontogenic cysts

A

aneurysmal bone cyst. Focal osteoporotic bone marrow defect. Simple traumatic bone cyst. Surgical ciliated cyst. Idiopathic osteosclerosis. Central Giant cell Ganuloma. Osteoma. Chrodroma.

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19
Q

aneurysmal bone cyst

A

Blood-filled spaces lined by connective tissue septa, multinucleated giant cells

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19
Q

histology

aneurysmal bone cyst

A

UL or ML, RL with cortical expansion and thinning

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20
Q

focal osteoporotic bone marrow defect

A

Normal bone marrow, hematopoietic progenitor cells, fat cells. Stimulates an intraosseous neoplasm in an extraction socket

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20
Q

histology

focal osteoporotic bone marrow defect

A

RL with fine trabeculations, circumscribed with ill-defined borders

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21
Q

simple traumatic bone cyst

A

Thin connective tissue with reactive bone, NO epithelium (NOT a true cyst)

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21
Q

histology

simple traumatic bone cyst

A

WD, RL, irregular borders, UL, maybe ML, no tooth displacement or root resorption

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22
Q

surgical ciliated cyst

A

Lined by respiratory epithelium, intrabony cyst caused by implantation of sinus epithelium

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22
Q

histology

surgical ciliated cyst

A

WD, RL in close proximity, but separate from the maxillary sinus

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23
Q

idopathic osteosclerosis

A

Area of hematopoietic marrow, dense lamellar bone with scant fibro-fatty marrow, NOT pathological

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23
Q

histology

idopathic osteosclerosis

A

RL area with fine trabeculations

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24
Q

central giant cell granuloma

A

Multinuclated giant cells with plump proliferating mesenchymal cells, RBC extravasation

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24
Q

histology

central giant cell granuloma

A

WD, but NOT corticated, UL or ML, RL defect, anterior mandible

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25
Q

osteoma

A

Associated with Gardner Syndrome, progressive shift in patient occlusion and deviation of midline. Mature compact or cancellous bone

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25
Q

histology

osteoma

A

Slowly growing masses on surface of mandible/maxilla

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26
Q

chrondroma

A

Composed of mature hyaline cartilage, located on short trabecular bones of the hands and feet

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26
Q

histology

chrondroma

A

N/A

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27
Q

epithelial odontogenic tumors - 8

A

Ameloblastoma, conventional solid or multicystic ameloblastoma, unicystic ameloblastoma, peripheral ameloblastoma(extraosseaous), malignant ameloblastoma, ameloblastic carinoma, calcifying epithelial odontogenic tumor (pindborg tumor)

27
Q

histology

epithelial odontogenic tumors - 8

A

ameloblastoma. Conventional solid or multicystic ameloblastoma. Unicystic ameloblastoma. Peripheral ameloblastoma (extraosseous). Malignant ameloblastoma. Ameloblastic carcinoma. Adenoatoid odontogenic tumor. Calcifying epithelial odontogenic tumor (pindborg).

28
Q

ameloblastoma

A

Most common clinically significant odontogenic tumor. Slow growing, locally invasive, usually benign , painless swelling covered by oral mucosa

28
Q

histology

ameloblastoma

A

RL, UL early, ML later, expansion, tooth displacement, might resorb roots

29
Q

conventional solid or multicystic ameloblastoma

A

86% of Ameloblastomas. Islands of odontogenic epithelium, core resembles stellage reticulum of enamel organ, peripheral columnar cells with REVERSE POLARITY of nuclei

29
Q

histology

conventional solid or multicystic ameloblastoma

A

ML, RL lesion with “soap bubble” or honeycomb appearance, B/L cortical expansion, root resorption of teeth adjacent to the tumor.

30
Q

unicystic ameloblastoma

A

13% of Ameloblastomas: Luminal: basal layer columnar/cuboidal cells with hyperchromatic nuclei, reverse polarity, basilar cytoplsmic vacuolization. Intraluminal/Plexiform: one or more nodules of ameloblastomas project from cystic lining into lumen. Mural: fibrous wall of the cyst infiltrated by typical follicular or plexiform ameloblastoma

30
Q

histology

unicystic ameloblastoma

A

circumscribed RL, may/may not be around the crown. Can resemble DC.

31
Q

peripheral ameloblastoma- extraosseous

A

1% of Ameloblastomas

31
Q

histology

peripheral ameloblastoma- extraosseous

A

na

32
Q

ameloblastic carcinoma

A

Ameloblastoma in primary tumor and metastatic deposits

32
Q

histology

ameloblastic carcinoma

A

na

33
Q

malignant ameloblastoma

A

Ameloblastoma that has cytologic features of malignancy in the primary tumor, in a recurrence, or in any metastatic deposit

33
Q

histology

malignant ameloblastoma

A

na

34
Q

adenomatoid odontogenic tumor

A

Thick fibrous capsule, duct-like epi structures lined by cuboidal columnar cells, nuclei polarized AWAY from central spaces, all cells are epithelial

34
Q

histology

adenomatoid odontogenic tumor

A

WD, CB, UL, RL invoving crown of unerupted tooth (below CEJ), tooth displacement, snowflake cal’s

35
Q

califying epithelial odontogenic tumor (pindborg)

A

Large cells with nuclei (different from COC), expansile, painless swelling. Congo Red test + for Amyloid proteins . Concentric Liesegang Ring Calcifications

35
Q

histology

califying epithelial odontogenic tumor (pindborg)

A

WD or Ill-defined, UL or ML RL with flecks of RO’s, strong tooth displacement, honeycomb appearance

36
Q

ectomesenchyme odontogenic tumors

A

Central odontogenic fibroma. Peripheral odontogenic fibroma. Odontogenic myxoma. Cementoblastoma.

36
Q

histology

ectomesenchyme odontogenic tumors

A

central odontogenic fibroma. Peripheral odontogenic fibroma. Odontogenic myoma. Cementoblastoma.

37
Q

Central odontogenic fibroma

A

Hyperplastic dental follicle

37
Q

histology

Central odontogenic fibroma

A

WD, UL (early)/ML (late), RL associated with periradicular areas of erupted teeth, root resorption

38
Q

peripheral odontogenic fibroma

A

Soft tissue counterpart of central odontogenic fibroma.Slow-growing, sessile mass covered by normal mucosa

38
Q

histology

peripheral odontogenic fibroma

A

Similar to peripherial ossifying fibroma

39
Q

odontogenic myxoma

A

Haphazardly arranged stellate, spindle-shaped and round cells, glycosaminoglycans, no capsule, jelly-like. Locally aggressive, jaw lesion only with painless swelling

39
Q

histology

odontogenic myxoma

A

UL or ML, Irregular/scalloped margins, thin, wispy trabeculae of residual bone, “step ladder” pattern, rare root resorption, soap bubble appearance

40
Q

cementoblastoma

A

Slow-growing, dentin-resorbing (not hypercementosis), strongly active osteoblastic activities

40
Q

histology

comentoblastoma

A

WD, RO (density of cementum), RL halo, attached to root of affected tooth, resorbed root

41
Q

Mixed odontogenic tumors (odontogenic epithelium and ecomesenchymal elements)

A

ameloblastic fibroma. Ameloblastic fibrosarcoma. Ameloblastic fibro-odontoma. Compound odontoma. Complex odontoma.

41
Q

histology

Mixed odontogenic tumors (odontogenic epithelium and ecomesenchymal elements)

A

ameloblastic fibroma. Ameloblastic fibrosarcoma. Ameloblastic fibro-odontoma. Compound odontoma. Complex odontoma

42
Q

ameloblastic fibroma

A

Narrow cords of odontogenic epithelium anastomosing, peripheral nuclear palisading columnar cells

42
Q

histology

ameloblastic fibroma

A

WD, UL or ML, RL extending from superior part of the tooth follicle (NOT CEJ) of an unerupted tooth

43
Q

ameloblastic fibrosarcoma

A

Malignant counterpart of ameloblastic fibroma

44
Q

ameloblastic fibro-odontoma

A

Disorganized tooth structure, same histo as ameloblastic fibroma,

44
Q

histology

ameloblastic fibro-odontoma

A

WD, CB, RL defect with variable amt of calcified material with the radiodensity of tooth structure

45
Q

compound odontoma

A

Multiple tooth-like structures, anterior maxilla

45
Q

histology

compound odontoma

A

Collection of ROs (tooth-like structures) surrounded by a narrow RL zone

46
Q

complex odontoma

A

Conglomerate mass of enamel and dentin, NO resemblance to a tooth, may cause impaction

46
Q

histology

complex odontoma

A

Calcified mass with radiodensity of tooth structure surrounded by RL halo

47
Q

histology

Three categories of fibro-osseous lesions in the jaw (normal bone replaced with excessive proliferation of fcellular fibrous CT)

A

fibrous dysplasia. Reactive/dysplastic lesions in alveolous (tooth bearing areas of the jaw) or? Cemento-osseous dysplasia. Fibro-osseous neoplasms.

48
Q

name 7 fibro-osseous lesions of the jaw

A

Monostotic fibrous dysplasia of the jaw. Polyostotic dysplasia of the jaw. Focal-cemento-osseous dysplasia. Periapical cemento-posseous dysplasia. Florid cemento-osseous dysplasia. Ossifying/cementifying fibroma. Osteoblastoma (and osteoid osteoma)

48
Q

histology

name 7 fibro-osseous lesions of the jaw

A

FIBROUS DYSPLASIA: monostatic fibrous dysplasia of the jaws. Polyostotic fibrous dysplasia of the jaws. REACTIVE/DYSPLASTIC LESION OF THE ALVEOLOUS AND CEMENTO-OSSEOUS DYSPLASIA: Focal cemento-osseous dysplasia (FCOD). Periapical cemento-osseous dysplasia (PCOD). Florid cemento-osseous dysplasia (FOD, FLCOD). FIBRO-OSSEOUS NEOPLASMS (2): Ossifying/cementifying fibroma. osteoblastoma and osteoid osteoma.

49
Q

FD: monostotic fibrous dysplasia of the jaw

A

single bone, max>mandib, young F, poorly calcified bone trabeculae arranged in a disorganized pattern

49
Q

histology

FD: monostotic fibrous dysplasia of the jaw

A

Fine “ground glass” opacification, not well-demarcated

50
Q

FD: polyostotic fibrous displasia of the jaw

A

two or more bones, café au lait spots, jaffe-lichtenstein syndrome, McCume-albright syndrome (sexual precosity)

50
Q

histology

FD: polyostotic fibrous displasia of the jaw

A

Early: RL, WD, UL. Late: ROs take on numerous shapes and sizes, borders blend with bone. Bone exp, tooth displacement, root resorption, obliteration of max sinus.

51
Q

R/DL, COD: focal cemento-osseous dysplasia (FCOD)

A

anywhere in jaw, singl-site involved, asymptomatic, small

51
Q

histology

R/DL, COD: focal cemento-osseous dysplasia (FCOD)

A

Mixed RL/RO, thin RL rim

52
Q

R/DL, COD: periapical cemento-osseous dysplasia (PCOD)

A

VITAL TEETH, asymptomatic pt, scpecules of bone and some cementum-like hard tissues

52
Q

histology

R/DL, COD: periapical cemento-osseous dysplasia (PCOD)

A

Uncircumscribed zones of RL involving periapical region of anterior mandible.

53
Q

R/DL, COD: florid cemento-osseous dysplsia (PLCOD, FOD)

A

VITAL TEETH, multifocal involvement, not limited to anterior mandible, bilateral symmetry involvement, simple bone cyst may be present, osteomyolitis due to reduced valscularity

53
Q

histology

R/DL, COD: florid cemento-osseous dysplsia (PLCOD, FOD)

A

Multiple, WD, lobular, <3m, RL with some ROs, bilateral and symmetric, no tooth resorption, hypercementosis, increased bone density

54
Q

FON: ossifying/cementifying fibroma

A

painless swelling with obvious facial asmmatry, jaw expansion, tooth displacement, asymmtomatic

54
Q

histology

FON: ossifying/cementifying fibroma

A

WD, UL w/varying levels of RO (RL, Mixed or RO), CB (diff from later stage fibrous dysplasia), root resorption

55
Q

FON: obsteoblastoma and osteoid osteoma

A

benign bone tumors occasionally seen in the haw, histo identical to OSTEOBLASTOMA

55
Q

histology

FON: obsteoblastoma and osteoid osteoma

A

N/A

56
Q

Malignant bone tumors- 3

A

Osteosarcoma. Chondrosarcoma. Metatstatic tumors of the jaw.

56
Q

histology

Malignant bone tumors- 3

A

osteosarcoma. Chondrosarcoma. Metastatic tumors of the jaws.

57
Q

clinical findings of bone malignancies (2)

A

redness and bleeding of gingiva. Persistent, non-healing ulcers

57
Q

histology

clinical findings of bone malignancies (2)

A

clinical findings of bone malignancies: 1. redness and bleeding of gingiva. 2. persistent, non-healing ulcer.

58
Q

general RG findings of bone malignancies (8)

A

superficial horizontal resorption. Erosion of bony SF. RL with ill-defined bornders and ragged Ros. Pathologival fractures. Opacification of sinus. Destruction of sinus walls. Floating teeth. Root resorption.

58
Q

histology

general RG findings of bone malignancies (8)

A

general RG findings of bone malignancies: 1. superficial horizontal resorption. 2. erosion of bony SF. 3. RL with ill-defined borders and ragged Ros. 4. pathological fractures. 5. opacification of the sinus. 6. destruction of the sinus walls/floor. 7. floating teeth. 8. root resorption.

59
Q

other malignancies of the jaws and O.C. (3)

A

leukemia. Burkitt’s lymphoma. Multiple myeloma.

59
Q

histology

other malignancies of the jaws and O.C. (3)

A

leukemia. Burkitt’s lymphoma. Multiple myeloma.

60
Q

osteosarcoma

A

malignancy of mesenchymal cells, central lesion. “bad cells, bad bone” malignant cartilage and bone

60
Q

histology

osteosarcoma

A

Ill-defined and indistinct peripheral border, classic sunburst appearance (periosteal reaction), widening of PDL, elevation of bone height ABOVE CEJ, perforation, exp of cortical margins

61
Q

chomdrosarcoma

A

maignancy Chx by formation of cartilage and no bone

61
Q

histology

chomdrosarcoma

A

RL process with poorly defined borders

62
Q

metastatic tumors of the jaws

A

MOST COMMON malignancy of the jaw, from BREAST, PROSTATE, LUNG, KIDNEY carcinomas

62
Q

histology

metastatic tumors of the jaws

A

Ill-defined, “moth eaten”, destructive margins, irregular shape, destruction of lamina dura, tooth mobility, “floating teeth,” RL defects

63
Q

leukemia

A

acute (50-60yo), gingival infiltration, swelling, perio disease

63
Q

histology

leukemia

A

Destruction of alveolar bone, loss of lamina dura, loosening of teeth, ill-defined RLs

64
Q

burkitt’s lymphoma

A

african form has jaw involvement, 5-12yo, loosening, displacement, premature eruption

64
Q

histology

burkitt’s lymphoma

A

Jaw expansion, single or multiple RL foci in molar region, ill-defined borders, perforation, destruction, displacement of B/L corticies

65
Q

multiple myeloma

A

weakness and pain, pathologic fractures, multiple bone involved (%14 JAWS), mobility and migration of teeth, bence-jones protein urine

65
Q

histology

multiple myeloma

A

Multiple, small, WD, non-corticated RLs, uni- or bilateral, skull often involved, “punched-out”

66
Q

benign odontogenic tumors of the jaw

A

Fibroma: Ossifying fibroma, Fibromyxoma

Osteoma: Osteoid osteoma, Osteoblastoma
Chondroma: Chondroblastoma, Chondromyxoid fibroma, Osteochondroma
Hemangioma

Giant cell tumor: Giant cell reparative granuloma, Brown tumor of hyperparathyroidism, Cherubism

Histiocytosis: Benign fibrous histiocytoma
Neuroma: Neurofibroma, Schwannoma

Lymphangioma

67
Q

odontogenic jaw tumors

A

Ameloblastoma

  • Ameloblastic fibroma
  • Ameloblastic myxoma
  • Ameloblastic odontoma

Calcifying epithelial odontogenic tumor (Pindborg)
Ameloblastic adenomatoid tumor
Myxoma
Odontoma
Cementoma

68
Q

tumor-like diseases of the jaw

A
  • Fibrous dysplasia
  • Paget’s disease of bone
  • Florid osseous dysplasia
  • Osteopetrosis
69
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Opath II block 5 (2 decks)

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