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Opath 2 Midterms > Verrucal / Papillary Lesions > Flashcards

Verrucal / Papillary Lesions Flashcards

1
Q

It is composed of benign epithelium and amounts of supporting connective tissue

A

Squamous papilloma (oral warts)

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2
Q

The most common papillary lesions of the oral mucosa and accounts for approximately 2.5% of all oral lesions

A

Squamous papilloma / oral wart

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3
Q

What is an exophytic?

A

Growing outward beyond the surface epithelium

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4
Q

What is a wart

A

Papillary lesion that projects outward

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5
Q

What is verrucous

A

Flat and blunt, nob-like projections

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6
Q

The putative etiologic agent of papillomas of the upper aerodigestive tract, is a member of the papovirus group

A

HPV

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7
Q

It is a DNA virus containing a single molecule of double-stranded DNA compromising approximately 8000 nucleotide base pairs

A

HPV

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8
Q

HPV specifically infects ____ epithelial cells and establishes productive infection only in the ___ epithelium of the skin and mucosa

A

Basal epithelial cells

Stratified squamous epithelium

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9
Q

Replication of HPV occurs within the ___ of epithelial cells with the viral genome expressed in both early and late stages

A

Nuclei

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10
Q

Location of oral squamous papilloma

A

Vermillion portion of the lips

Intraoral mucosal site

Hard and soft palate and uvula

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11
Q

Accounts for approximately 1/3 of all lesions.

Measures less than 1cm

clinically asymptomatic

Pink to white exophytic granular or cauliflower-like surface alterations

A

Oral squamous papilloma

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12
Q

Solitary lesions are most common

A

Oral squamous papilloma

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13
Q

Oral warts are common in patients with ???

A

HIV particularly in patients treated with (HAART)

Human immunodeficiency virus

Highly active antiretroviral therapy

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14
Q

An exaggerated growth of benigh squamous epithelium

A

Oral squamous papilloma

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15
Q

Histologic architecture of oral squamous papilla may mimic the pattern of the ____ wart

A

Cutaneous

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16
Q

Histopathology of oral squamous papilloma

A

Exophytic

Finger-like projections extensions of epithelium

Supported by a well vascularized CT

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17
Q

HPV subtype of oral papilloma

A

HPV 2, 6, 11, 57

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18
Q

HPV subtype of focal epithelial hyperplasia

A

HPV 13, 32

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19
Q

HPV subtype of dysplastic wart

A

16, 18, others

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20
Q

HYV subtype of verruca vulgaris, skin

A

2, 4, 40, others

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21
Q

HPV subtype of flat wart

A

3, 10

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22
Q

HPV subtype of condyloma acuminatum

A

6, 11, others

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23
Q

HPV subtype of laryngeal papilloma

A

11

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24
Q

HPV subtype of conjunctival papilloma

A

11

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25
Q

HPV subtype of maxillary sinus papilloma

A

57

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26
Q

Nononcogenic subtypes

A

2, 6, 11 and 57

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27
Q

Common oral epithelial proliferation that is most caused by HPV

A

Papilloma

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28
Q

HPV lesion that is HIV-positive patients only

Only in oral mucosa

A

Dysplastic oral warts

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29
Q

DD of oral squamous papilloma

A

Verruciform xanthoma
Papillary hyperplasia
Condyloma acuminatum

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30
Q

Treatment of oral squamous papilloma

A

Surgical excision - treatment of choice
Or
Laser ablation

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31
Q

Prognosis of oral squamous papilloma

A

Recurrence is uncommon, except for patients infected with HIV

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32
Q

An angiogenital wart caused by HPV that may also involve the oral mucosa

A

Condyloma Acuminatum

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33
Q

Nucleus of cell is pyknotic, dense, created and raisin like

Periphery of nucleus has a clear cytoplasm

A

Koilocytes

34
Q

What is a koilocytes

A

Pyknotic nucleus and clear cytoplasm

35
Q

Is condyloma acuminatum an opportunistic infection?

A

Yes, increase incidence in HIV patients

36
Q

HPV subtypoe of condyloma acuminatum

A

6 and 11

37
Q

Condyloma acuminatum spread through?

A

Skin-to-skin contact
Skin-to-mucosa contact
Sexual transmission

38
Q

Soft, broad-based exophytic papillary growth that may be keratinized or nonkeratinized

A

Condyloma acuminatum

39
Q

Formation is a group of numerous pink nodules that grow and ultimately coalesce

A

Early condyloma acuminatum

40
Q

Papillary projections extending from the base of each lesions are covered by stratified squamous epithelium that is often parakeratotic but at times may be nonkeraatinized

A

Condyloma acuminatum

41
Q

Koilocytosis in condyloma acuminatum is usually found in where?

A

Upper level epithelial cells

42
Q

DD of condyloma acuminatum

A

Focal epithelial hyperplasia
Verruca vulgaris

43
Q

Treatment of condyloma acuminatum

A

Surgical excision may consists of:
- cryosurgery
- scalpel excision
- electrodesiccation
- laser ablation

NO ANTIVIRAL TREATMENT AVAILABLE

44
Q

Prognosis of condyloma acuminatum

A

Recurrences are common

45
Q

HPV subtype of focal epithelial hyperplasia

A

13 and 32

46
Q

Characterized by the presence of numerous nodular soft tissue masses distributed over the mucosal surfaces, escpecially the buccal mucosa, labial mucosa, tongue, and gingiva

A

Focal epithelial hyperplasia

47
Q

Lesion is similar in color with the surrounding mucosa

If in areas of occlusal trauma, may appear whitish because of keratinization

A

Focal epithelial hyperplasia

48
Q

Asymptomatic and incidenatl finding

= gender predilection
Wide age range

HIV px receiving HAART, multifocal distribution of lesions may be noted

A

Focal epithelial hyperplasia

49
Q

Consistent finding of focal epithelial hyperplasia

A

Acanthosis and parakeratosis

50
Q

Prominent clubbing and fusion of epithelial ridges

Enlarged ballooning cells with abnormal nuclear chromatin patterns within the spinous layer

A

Focal epithelial hyperplasia

51
Q

Chromatin are abnormal and seems to undergo mitosis or dividing

A

Mitosoid bodies (feh)

52
Q

Degenerating keratinocytes that simulate cells in mitoses

A

Mitosoid bodies

53
Q

DD of focal epithelial hyperplasia

A

Verruca vulgaris
Multiple squamous papillomas

54
Q

Treatment of focal epithelial hyperplasia

A

Surgical removal
Laser ablation

55
Q

Appears on the hard palate and is associated with a removable prosthesis

A

Papillary hyperplasia

56
Q

Associated with an ill fitting or loose denture that creates a potential space between the denture base and tissue

A

Papillary hyperplasia

57
Q

Organism that grows in papillary hyperplasia

A

Candida albicans

58
Q

Does papillary hyperplasia is associated with HPV infection?

A

No, it is not

59
Q

Cobblestone like appearance on hard palate regions
-Similar to nicotine stomatitis but no red dots

A

Papillary hyperplasia

60
Q

Commonly involved location of papillary hyperplasia

A

Mucosa of the palatal vault and less in the alveolar ridge or the palatal incline

61
Q

Numerou small exophytic fronds or papillary projections covered with intact parakeratotic stratified squamous epithelium

A

Papillary hyperplasia

62
Q

The epithelium of this lesion is supported by hyperplastic central cores of well vascularized stromal tissue

A

Papillary hyperplasia

63
Q

What does papillary hyperplasia mimics if severe

A

Squamous cell carcinoma

64
Q

Demonstrates pseudoepitheliomatous features

A

Papillary hyperplasia

65
Q

DD of papillary hyperplasia

A
  1. Multiple hamartoma syndrome ( Cowden’s syndrome)

Nicotine stomatitis
Darier’s disease
Benign fibroepithelial proliferations

66
Q

Patients with papillary hyperplasia usually have other stgmata of the syndrome, including ___ ___ ___

A

Hamartomatous papules of the skin
Benign and malignant breast lesions
Malignancies of the thyroid and kidney

67
Q

Treatment of papillary hyperplasia

A

Siurgical removal
Denture refabrication
Removal of appliance at bedtime and soaking in a weak disinfecting antifunal medium
Good oral hygiene

Topical antifungal

68
Q

An uncommon, benign oral mucosal lesion that occasionally may be found on the skin, typically on the genitalia

A

Verruciform xanthoma

69
Q

Gene muration of verruciform xanthoma

A

Exon 6 of the 3 beta-hydroxysteroid dehydrogenase (NSDHL)

70
Q

An incidental finding, most cases are whites, no gender predilection

Average age is 45yo

A

Verruciform xanthoma

71
Q

Flat or slightly raised, with a papillomatous or verrucous surface composed of parakeratinized epithelial cells

A

Verruciform xanthoma

72
Q

Papillary overgrowth
Invaginated crypts between paillary projections
Presence of foam cells or xanthoma cells within the epithelium

A

Verruciform xanthoma

73
Q

Characteristic of foam cells

A

Granular to flocculent cytoplasm that may contain periodic acid-schiff (PAS) positive, diastase-resistant granules or lipid droplets or both

74
Q

Immunihistochemical markers which identify the foam cells to be of monocyte/macrophage lineage is?

A

CD68 and CD163

75
Q

DD of verruciform xanthoma

A

Squamous papilloma
Pappilary squamous carcinoma
Verrucous carcinoma
Condyloma acuminatum

76
Q

Treatment for verruciform xanthoma

A

Conservative excision. No recurrence

77
Q

Size of verruciform xanthoma

A

More than 2cm

78
Q

Idiopathic or associated with gene mutation

A

Verruciform xanthoma

79
Q

Thickening of the epidermis caused by an increased number of squamous cells

A

Acanthosis

80
Q

HPV infects ___ squamous epithelium

A

Stratified squamous epithelium

Opath 2 Midterms (6 decks)

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