Warts, polyps, epulides and vascular anomalies Flashcards

1
Q

Fibrous nodules

A

soft tissue lesion

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2
Q

fibrous nodules aetiology

A

aetiology –> chronic minor trauma, chronic low grade infection

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3
Q

fibrous nodules pathology

A

initially inflamed fibrous tissue
once matured, dense collagenous tissue

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4
Q

fibrous nodules cf

A

well circumscribed
solid and raised
can form on mucosa close to the line of the occlusion
denture-induced

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5
Q

fibrous nodules presentations

A
  1. Fibroepithelial polyp
  2. Fibrous epulis
  3. Denture induced hyperplasia
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6
Q

fibrous nodules management

A

remove stimulus
excisional biopsy

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7
Q

Papilloma

A

oral lesion

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8
Q

Papilloma aetiology

A

HPV 6 and 11
transmitted from cutaneous or genital warts

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9
Q

Papilloma cf

A

painless
single/multiple
exophytic
cauliflower like appearance

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10
Q

Papilloma - pathology

A

SSE
Supported vascular CT
Keratinised

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11
Q

Papilloma - management

A

not considered to be pre malignant
excision
cryotherapy
if multiple consider potential for underlying immunodeficiency
management of skin lesion elsewhere

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12
Q

Pyogenic granuloma CF

A

Painless
Pedunculated
Red and inflamed
Commonly on gingiva
assoc with pregnancy epulis

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13
Q

Pyogenic granuloma aetiology

A

local low grade irritation
hormonal changes
trauma

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14
Q

Pyogenic granuloma pathology

A

hyperplastic lesion
dilated capillaries in loss ct stroma
mature lesions more fibrous with variable inflammation

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15
Q

Pyogenic granuloma management

A

excision
remove causative factors
pregnancy epulis : delay excision where possible until post partum
Improve oral hygiene

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16
Q

Giant cell granuloma

A

uncommon lesion
20-40 yrs
tooth bearing areas – ant mandible
2f;1m

17
Q

GCG classification

A

central – reparative granuloma
peripheral – giant cell epulis

18
Q

GCG CF

A

Bony swelling
Erode through cortical plate
Loosening of teeth
Purple gingival swelling
Ulceration/inflammation of overlying mucosa

19
Q

CGCG Radiographic features

A

extent - large
quality – radiolucent, bubble appearance
margin – localised with ill defined edges
adjacent anatomy – perforate alveolar bone and extend into the mouth. may resorb/displace adjacent roots

20
Q

CGCG histopathology

A

Multiple multinucleated giant cells
stroma of plump spindle shaped cells
highly vascular
areas of old and new haemorrhage
large cystic blood filled spaces
new bone deposits at margins
similar in appearance to brown tumour of hyperparathyroidism and aneurysmal bone cyst

21
Q

CGCG management

A

excision of soft tissue lesion and curettage underlying bone
recurrence 15%
larger lesions – resection
corticosteroids/calcitonin/interferon alpha/bisphosphonates
may be linked to Noonan syndrome – ptpn11 gene mutation, cardiac abnormalities etc

22
Q

Central v Peripheral GCG

A

Peripheral has local irritants for its aetiology whereas central has no known.

Central and Peripheral are both non-neoplastic.

PGCG is located on gingiva and alveolar ridge. CGCG is intra-osseous.

PGCG is a little aggressive whereas CGCG is aggressive.

PGCG is slow growth whereas CGCG is rapid.

Bone resorption occurs CGCG.

Dental involvement involved CGCG.

Treatment is surgical in both conditions.

23
Q

Hyperparathyroidism

A

Brown’s tumour
Parathyroid hormone overproduction (mobilise calcium from skeleton/raises plasma calcium)
F>M
Elderly
Incidental finding
Xerostomia

24
Q

Hyperparathyroidism: RF

A

Minimal bony changes
Adv cases – reduced bone density/loss of trabecular bone/loss of lamina dura/brown tumour

25
Brown's tumour
Cyst like radiolucency Uni or multilocular
26
Hyperparathyroidism TX
Correction of underlying lesion
27
Vascular malformation
seemingly disorganised vessels
28
vascular malformation aetiology
defects in vasculogenesis/angiogenesis structural defect in blood vessels congenital present at birth but may go unnoticed M:F usually grows at a rate proportional to body
29
vascular malformation cf
raised or flat soft - may become firm with time due to thrombus or calcification deep red/bluish colour size varies blanch with pressure affecting tongue may impact on movement
30
management of vascular malformation
excision laser surgery cryotherapy radiation therapy corticosteroids - topical/intralesional
31
vascular malformations - syndromes
Sturge Weber -- Encephalotrigeminal Angiomatosis/haemangiomas of face affection trigeminal divisions Osler rendu weber -- hereditary haemorrhagic telangiectasia (HHT)
32
Haemangioma
similar to vascular malformation aetiology - benign vascular tumour/abnormal endothelial cell proliferation classification - central/capillary/cavernous/arterial
33
Purpura
bleeding into skin or mucous membranes results in petechia or ecchymoses spontaneous gingival bleeding purpura can forma at any site of trauma underlying platelet disorder