Soft Tissue Differential Diagnosis Flashcards

1
Q
A

pseudomembranous candidiasis

  • multiple white plaques
  • wipes off leaving erythematous area
  • found commonly in immunocompromised patients
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2
Q
A

hyperplastic candidiasis

  • does not wipe off
  • leukoplakia appearance
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3
Q
A

atrophic candidiasis

  • aka erythematous candidiasis
  • clinically appears erythematous
  • can be seen with central papillary atrophy or median rhomboid glossitis or denture stomatitis (due to poor hygiene)
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4
Q
A
  • Bump on gums
  • location: lingual gingiva
  • has not displaced teeth
  • no radiographic calcifications
  • sessile, nodule, ulceration, erythema
  • firm
  • middle aged female
  • BUMP ON GUMS DIFFERENTIAL DIAGNOSES:
    1) pyogenic granuloma
    2) peripheral ossifying fibroma
    3) peripheral giant cell granuloma
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5
Q

What is the histology of a peripheral giant cell granuloma:

A

chocolate chip cookies (multinucleated giant cells)

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6
Q

Most common salivary gland tumor:

A

pleomorphic adenoma (AKA benign mixed tumor)

  • middle aged females
  • painless
  • slow growing
  • max of myoepithelial and ductal epithelial elements
  • ENCAPSULATED
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7
Q

Differential diagnosis for bump on gums:

A
  1. pyogenic granuloma (can occur on tongue)
  2. peripheral ossifying fibroma (exclusive to gingiva)
  3. peripheral giant cell granuloma (exclusive to gingiva)
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8
Q

How would you describe this type of inflammation?

What are some differential diagnoses that present with this type of inflammation?

A

Granulomatous inflammation;
(pattern of chronic inflammation)
(aggregates of epithelioid macrophages)
(multinucleated giant cells, mononuclear leukocytes, principle lymphocytes, and occasionally plasma cells - peripehrally)
(fibrosis variable)

Differential diagnosis:
1. crohns disease
2. deep fungal infections (ex: ccoccidiomycosis)
3. Tuberculous (caseous necrosis)

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9
Q

How would you describe this histological slide?

What disease is seen with this presentation?

A

granulation tissue; pyogenic granuloma

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10
Q

List the differential diagnosis to the following presentation

A
  1. chemical burn (aspririn)
  2. toothpaste allergy (SLS)
  3. cheek biting (trauma)
  4. psuedomembraneous candidiasis
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11
Q

Where is the most common intraoral-extranodal are for lymphoma?

A

hard palate

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12
Q

You see a bump on the hard palate, and upon palpation you note that tit is squishy and bogging. What is a good diagnosis?

A

lymphoma

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13
Q

Most common salivary gland tumor:

What is it comprised of histologically?

A

pleomorphic adenoma; myoepithal and ductal cells

(most common in palate)

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14
Q

Your patient presents with this histology:

A
  • monomorphic adenoma
  • most common location is upper lip
  • histology; unitform pattern single layered cords of columnar or cuboidal epithelium
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15
Q

A malignant salivary gland tumor (the low grade version of this mimics a mucocele)

A
  • Mucoepidermoid carcinoma
  • most common MALIGNANT salivary gland neoplasm
  • middle-aged females
  • clinically mistaken for a mucocele

Histology:
- mucous producing cells
- epidermoid (squamous) cells
- may be cystic and/or solid

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16
Q

You note this Swiss cheese histological appearance, automatically consider:

A
  • adenoid cystic carcinoma
  • BEST recognized salivary gland tumor
  • malignant
  • middle aged females
  • painful & slow growing

Histology:
- perineural & perivascular invasion
- myoepithelial & ductal cells
- cribriform pattern

17
Q

Histology
- deceptive uniform appearance
- different growth patterns
- perineural & perivascular invasion
- Indian filing

A

polymorphous low grade adenocarcinoma (PLGA)
- common malignant minor salivary gland neoplasm
- middle aged females
- favors palate

18
Q

If you see a salivary gland tumor in a kid (rare), it is most likely going to be:

A

mucoepidermoid carcinoma

  • most common malignant salivary gland neoplasm
  • middle-aged females
  • clinically mistaken for a mucocele
19
Q

You can see perineural & perivascular invasion in any tumor, but in the oral cavity it is most commonly seen in:

A
  1. adenoid cystic carcinoma
  2. PLGA
20
Q

Describe this lesion and give differential diagnosis:

A
  • sessile, ulcerated nodule located on dorsal of tongue
  • Differential diagnosis:
    1. pyogenic granuloma
    2. peripheral giant cell granuloma
21
Q

Describe this lesion and give a differential diagnosis:

A
  • submucosal mass, yellow, located on dorsal of tongue
  • differential diagnoses:
    1. fordyce granule
    2. mucocele
    3. squamous cell carcinoma (extremely rare to see squamous cell carcinoma on dorsal of tongue- MC ventral or lateral border)

Histology:
- overlying stratified squamous epithelium
- proliferation of psuedomembraneous hyperplasia
- large pinkish cells that have granular cytoplasm
- S100 stain = diffusely positive

  • This not a mucocele because there are no salivary glands on dorsal of tongue
  • Not fordyce granules because although they are yellow, they are small and multiple
  • malignancy of muscle?= sarcoma
  • benign growth of skeletal muscle?= arabdomioma
  • benign growth of connective tissue?= fibroma
  • nerve tissue benign tumor?= neuroma, schwannoma, & neurofibroma

actual diagnosis: granular cell tumor- most common on dorsal of tongue and a yellow-ish submucosal mass

22
Q

nodular blue-ish bump on tongue, rather than yellow. Location = dorsal of tongue:

A

lymphangioma

23
Q

If white lesion is bilateral, it will never be a ____ but can be ___ or ___

A

leukoplakia; lichen planus or oral hairy leukoplakia

24
Q

If a white lesion is unilateral it can be:

A
  1. leukoplakia
  2. hyperplastic candidiasis
  3. squamous cell carcinoma
  4. epithelial dysplasia
  5. carcinoma in situ
25
Q

If you notice an erythroplakia, the diagnosis options may be:

A
  1. squamous cell carcinoma
  2. epithelial dysplasia
  3. carcinoma in situ
26
Q

Case 1:
- ulcerated nodule located on dorsal of the tongue
- been present around 7 months
- painful
- only lesion present

  • differential diagnosis:
    1. erythematous multiforme
    2. pyogenic granuloma
    3. peripheral giant cell granuloma (ruled out because not found on tongue)

Histology: Granulation tissue

A

pyogenic granuloma

27
Q
A