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Oral Pathology > Epithelial Pathology II > Flashcards

Epithelial Pathology II Flashcards

1
Q

What is the definition for a leukoplakia?

A

An intraoral white plaque that does not rub off and cannot be identified as any well known entity

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2
Q

What are 5 lesions that may appear like a leukoplakia but do rub off?

A 
1-Materia Alba
2-White coated tongue
3-Burn (thermal, chemical, cotton roll, etc.)
4-Pseudomembranous candidiasis
5-Sloughing from toothpaste
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3
Q

What are 6 possible cause of a leukoplakia?

A 
1-Tobacco
2-Alcohol (Synergistic with Tobacco)
3-Sanguinaria (Max vestibule, herbal toothpaste)
4-UV radiation (lower lip)
5-Microorganisms
6-Trauma
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4
Q

What 3 places are 70% of leukoplakias found?

A

1-Lip vermilion
2-Buccal mucosa
3-Gingiva

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5
Q

What 3 places are 90% of dysplastic or carcinoma leukoplakia found?

A

1-Lip vermilion
2-Lateral/ventral tongue
3-Floor of mouth

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6
Q

Red patch that cannot be diagnosed as any other condition is called what?

A

Erythroplakia

*True erythroplakias are never completely benign

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7
Q

A mixed Red and white plaque is called what?

A

Erythroleukoplakia

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8
Q

What high-risk form of leukoplakia is characterized by multiple keratotic plaques with roughened surface projections?

A

Proliferative verrucous leukoplakia (PVL)

*No association with tobacco use

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9
Q

What is the first step in arriving to a definitive diagnosis for a leukoplakia?

A

Biopsy

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10
Q

when alterations are limited to the lower 1/3 of the biopsy it is?

A

Mild dysplasia

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11
Q

When alterations are limited to the lower ½ of the biopsy it is?

A

Moderate dysplasia

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12
Q

When alterations are present above the lower ½ of the biopsy it is?

A

Severe dysplasia

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13
Q

When alterations are present throughout the epithelium it is called?

A

Carcinoma in situ

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14
Q

What are the 3 most common locations for an erythroplakia?

A

1-Floor of mouth
2-Ventral tongue
3-Soft palate

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15
Q

When the Lesion appears as a thin, gray or white plaque with a border that blends into surrounding mucosa (wavy looking texture) it is likely?

A

Smokeless tobacco Keratosis

*if lesions remain 6 weeks after habit is stopped, biopsy required

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16
Q

A chronic, progressive, scarring, high-risk precancerous condition of the oral mucosa linked to chronic placement of betel quid or paan is called?

A

Oral Submucous Fibrosis

*Typically in indian culture. On buccal mucosa, retromolar areas and soft palate

17
Q

A white keratotic change on the palate due to heat, is not premalignant and has Punctate red centers are because of minor salivary glands is likely what?

A

Nicotine Stomatitis

*Reverse Smoking looks similar and is potentially malignant

18
Q

What common cutaneous premalignant lesion caused by cumulative UV radiation results in scaly, irregular plaques?

A

Actinic Keratosis

*Usually over 40 yrs old, approx. 10% will progress to SCCA in 2 yrs

19
Q

What common premalignant alteration of the lower lip vermilion results from long-term exposure to UV light?

A

Actinic Cheilosis

*Usually Induration (firm to the touch), Thickening (leukoplakia), and Ulceration

20
Q

What syndrome is associated with iron-deficiency and has an increased risk for SCC?

A

Plummer-Vinson Syndrome

21
Q

What are the 4 most common sites of intraoral SCC?

A

1-Tongue (Posterior lateral or ventral)
2-Floor of mouth
3-Soft palate
4-Gingiva

22
Q

How does metastatic SCC typically spread?

A

Lymphatics

23
Q

What are 4 descriptors for the way involved cervical lymph nodes will present?

A

1-Firm to stony hard
2-Painless
3-Enlarged
4-Fixed

24
Q

What staging system is used as the best indicator of patient prognosis?

A

TNM system

*guides treatment for intraoral carcinoma

25
Q

Which letter of the TNM system represents the size of primary local tumor in centimeters?

A

T

26
Q

Which letter of the TNM system represents Involvement of local lymph nodes?

A

N

27
Q

Which letter of the TNM system represents Distant metastasis?

A

M

28
Q

What system uses histologic features to classify tumors?

A

Grading

29
Q

AKA Snuff Dipper’s cancer what low-grade variant of oral SCC can be caused by smokeless tobacco and appears as a cauliflower-like mass?

A

Verrucous Carcinoma

*Surgical excision w/o neck dissection, 90% disease free

30
Q

Malignancies that arise from the lining epithelium of the nasopharynx and are associated with EBV infection and consumption of N-nitrosamines (salty fish) are called?

A

Nasopharyngeal Carcinoma

*Most prevalent in chinese men. First sign in half of patients is cervical lymph node metastasis

31
Q

Which cancer is the most common of all cancers, locally invasive and slow spreading and result from UV radiation?

A

Basal Cell Carcinoma

32
Q

What is the most common form of Basal Cell Carcinoma?

A

Nodular (noduloulcerative)

*telangiectatic blood vessels usually seen

33
Q

What surgery depends on the size and location of the basal cell carcinoma and involves progressively scooping out lesion and freezing sections for analysis?

A

Mohs Micrographic surgery

34
Q

Which lesion is a Malignant neoplasm of melanocytic origin or which acute UV radiation is a major causative factor?

A

Melanoma

*3rd most common skin cancer, but accounts for the most deaths

35
Q

What are the two directional patterns of growth for Melanomas?

A

1-Radical (Horizontal spread, flat lesion)

2-Vertical (invade underlying CT)

36
Q

What are the components of the ABCDE system to describe clinical features of melanoma?

A 
1-Asymmetry
2-Border irregularity
3-Color variation
4-Diameter greater than 6 mm (roughly the end of an eraser)
5-Evolving lesions
37
Q

What system is used to classify the depth of invasion as it correlates with prognosis of melanoma?

A

Clark’s Classification for cutaneous melanoma

38
Q

What are 3 key points about determining prognosis for melanoma?

A

1-Ulceration is an adverse prognostic indicator for cutaneous melanomas
2-Ulceration has not been proven to be a prognostic indicator in mucosal melanomas
3-Any invasion more than 0.5 mm in oral mucosal melanoma has poor prognosis

39
Q

What are the 4 areas with the worst prognosis for melanoma? BANS

A

1-Back (Interscapular area of the)
2-Arm (Posterior upper)
3-Neck(Posterior & lateral)
4-Scalp

Oral Pathology (18 decks)

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