Soft Tissue Differential Diagnosis Flashcards
pseudomembranous candidiasis
- multiple white plaques
- wipes off leaving erythematous area
- found commonly in immunocompromised patients
hyperplastic candidiasis
- does not wipe off
- leukoplakia appearance
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)
- 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
What is the histology of a peripheral giant cell granuloma:
chocolate chip cookies (multinucleated giant cells)
Most common salivary gland tumor:
pleomorphic adenoma (AKA benign mixed tumor)
- middle aged females
- painless
- slow growing
- max of myoepithelial and ductal epithelial elements
- ENCAPSULATED
Differential diagnosis for bump on gums:
- pyogenic granuloma (can occur on tongue)
- peripheral ossifying fibroma (exclusive to gingiva)
- peripheral giant cell granuloma (exclusive to gingiva)
How would you describe this type of inflammation?
What are some differential diagnoses that present with this type of inflammation?
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)
How would you describe this histological slide?
What disease is seen with this presentation?
granulation tissue; pyogenic granuloma
List the differential diagnosis to the following presentation
- chemical burn (aspririn)
- toothpaste allergy (SLS)
- cheek biting (trauma)
- psuedomembraneous candidiasis
Where is the most common intraoral-extranodal are for lymphoma?
hard palate
You see a bump on the hard palate, and upon palpation you note that tit is squishy and bogging. What is a good diagnosis?
lymphoma
Most common salivary gland tumor:
What is it comprised of histologically?
pleomorphic adenoma; myoepithal and ductal cells
(most common in palate)
Your patient presents with this histology:
- monomorphic adenoma
- most common location is upper lip
- histology; unitform pattern single layered cords of columnar or cuboidal epithelium
A malignant salivary gland tumor (the low grade version of this mimics a mucocele)
- 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
You note this Swiss cheese histological appearance, automatically consider:
- adenoid cystic carcinoma
- BEST recognized salivary gland tumor
- malignant
- middle aged females
- painful & slow growing
Histology:
- perineural & perivascular invasion
- myoepithelial & ductal cells
- cribriform pattern
Histology
- deceptive uniform appearance
- different growth patterns
- perineural & perivascular invasion
- Indian filing
polymorphous low grade adenocarcinoma (PLGA)
- common malignant minor salivary gland neoplasm
- middle aged females
- favors palate
If you see a salivary gland tumor in a kid (rare), it is most likely going to be:
mucoepidermoid carcinoma
- most common malignant salivary gland neoplasm
- middle-aged females
- clinically mistaken for a mucocele
You can see perineural & perivascular invasion in any tumor, but in the oral cavity it is most commonly seen in:
- adenoid cystic carcinoma
- PLGA
Describe this lesion and give differential diagnosis:
- sessile, ulcerated nodule located on dorsal of tongue
- Differential diagnosis:
1. pyogenic granuloma
2. peripheral giant cell granuloma
Describe this lesion and give a differential diagnosis:
- 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
nodular blue-ish bump on tongue, rather than yellow. Location = dorsal of tongue:
lymphangioma
If white lesion is bilateral, it will never be a ____ but can be ___ or ___
leukoplakia; lichen planus or oral hairy leukoplakia
If a white lesion is unilateral it can be:
- leukoplakia
- hyperplastic candidiasis
- squamous cell carcinoma
- epithelial dysplasia
- carcinoma in situ
If you notice an erythroplakia, the diagnosis options may be:
- squamous cell carcinoma
- epithelial dysplasia
- carcinoma in situ
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
pyogenic granuloma
