Week 4 Flashcards
Can Leukoplakia be definitively Diagnosed via a biopsy?
NO, the Pathologist will simply say that it is a high probability, but the diagnosis can only be made by the clinician.
What is the most important about CLINICAL characteristics while LOOKING at the lesion for leukoplakia?
The margins are EXTREMELY well defined.
-No feathering, very distinct change from normal to “white”
Two broad categories for Leukoplakia?
How do you decide between them?
Homogenous and NON-Homogenous
The clinical look of the lesion.
Frictional keratosis has what clinical appearance that would NOT make it Leukoplakia?
Feathered margins! Not well defined.
Clinical look of homogenous Leukoplakia? (3)
- Smooth
- Cracked Mud
- Slightly opaque
Clinical look of NON-homogenous Leukoplakia? (3)
- Rough
- Very Opaque
- Ragged margins
Differential for Leukoplakia? (5)
- Frictional Keratosis
- Lichen Planus
- SLE
- Candida
- Hairy Leukoplakia (HHV-4)
Most to least common location of Leukoplakia? (3/5)
- Most common
- (2)
- (2)
- Vestibule (most common)
- Palate, Lip
- Tongue, FOM
Most common sites positive for malignancy? (5)
- FOM
- Tongue
- lip
- Palate
- Vestibule
Is the severity of Leukoplakia (malignant transformation) worse for those with risk factors (smoking) or without?
It is more often that when a Leukoplakia presents, that if there is not a risk factor, it is MORE likely to be malignant!
Proliferative Verrucous Leukoplakia.
-Who?
-
60-70 Y.o. Women (women over 40)
Proliferative Verrucous Leukoplakia
-Clinical presentation?
- Multiple NON-homogenous white plaques
2. Recurring plaques
Proliferative Verrucous Leukoplakia
-Malignancy rates
80-100% Transformation to Cancer
Fraction of the Epithelium that is dysplastic to Term as Mild, moderate, severe, and In Situ?
Mild-33%
Mod-50%
Sev-66%
In Situ- 100%
Most white lesions have this descriptive characteristic (morphology)?
Most white lesions are PLAQUES