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Oral Pathology > Bone Pathology > Flashcards

Bone Pathology Flashcards

1
Q

What four things are characteristic of benign bone neoplasms?

A

1-Asymptomatic
2-Grows slowly and by expansion: displaces teeth and expands the cortex
3-Symmetrical (corticated radiolucency rim)
4-Does not metastasize

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2
Q

What 7 things are characteristic of malignant bone neoplasms?

A

1-Usually symptomatic
2-Grows more rapidly
3-Invades and destroys adjacent structures (cortex)
4-Often asymmetrical (non-corticated radiolucency)
5-Ragged or poorly defined margins and destroys cortex
6-Laying down bone outside the cortex
7-Capable of metastasis

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3
Q

What heritable disorder is a defect in type I collagen, is the most common type of inherited bone disease and can result in bowing bone structure as well as wormian bones in the skull?

A

Osteogenesis Imperfecta

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4
Q

What are 6 symptoms or signs of Osteogenesis Imperfecta?

A 
1-Bone fragility
2-Blue sclera
3-Altered teeth- opalescent teeth
4-Hearing loss (hypoacusis)
5-Long bone & spine deformities
6-Joint hyperextensiblity
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5
Q

AKA Marble bone disease, what condition results from a defect in remodeling causing failure of normal osteoclastic resorption?

A

Osteopetrosis

*appears as very radiopaque bone in radiographs. Hard to visual roots

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6
Q

Which clinical pattern of Osteopetrosis is discovered at birth, results in marrow failure, frequent fractures, cranial nerve compression, facial deformities, and delayed tooth eruption?

A

Infantile Osteopetrosis (aka malignant osteopetrosis)

*most die in first decade of life

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7
Q

Which clinical pattern of Osteopetrosis is discovered later in life and is less severe?

A

Adult Osteopetrosis (AKA benign osteopetrosis)

*40% are asymptomatic

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8
Q

What syndrome is characterized by supernumerary impacted teeth and clavicle abnormalities?

A

Cleidocranial Dysplasia

*delay/failure of permanent tooth eruption

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9
Q

A non-pathologic area of hematopoietic marrow that produces a radiolucency is called?

A

Focal Osteoporotic Marrow Defect

*incisional biopsy necessary for diagnosis

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10
Q

A focal area of increased radiodensity that is of unknown cause and cannot be attributed to anything else is called?

A

Idiopathic osteosclerosis

*NO cortical expansion, 90% in mandible, No corticated rim

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11
Q

What are three things Idiopathic Osteosclerosis could be confused with?

A

1-Condensing osteitis, which is associated with an infection
2-Focal cemento-osseous dysplasia, which will have a radiolucent rim
3-Cementoblastoma, which will be fused with the tooth

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12
Q

What condition results from abnormal resorption and deposition of bone causing distortion and weakening of affected bones causing bone pain?

A

Paget’s Disease of bone

*usually near joints. Maxilla more often than mandible

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13
Q

What are 4 commonly affected bones in Paget’s disease?

A

1-vertebrae
2-Pelvis
3-Skull (circumference)
4-Femur

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14
Q

An enlargement of the middle 1/3 of the face in Pagets disease is called?

A

Leontiasis ossea, or lionlike facial deformity

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15
Q

What serum test results would you expect in a patient with Paget’s disease?

A

High serum alkaline phosphatase levels with Normal calcium and phosphorus levels

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16
Q

What is a complication of Paget’s disease that occurs in up to 10%?

A

Malignant bone tumor (Osteosarcoma)

*very aggressive. commonly in pelvis or long bones

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17
Q

What is considered a non-neoplastic lesion, frequently crosses the midline of anterior jaw and is a radiolucency, with a multilocular noncorticated margin?

A

Central Giant Cell Granuloma

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18
Q

What two conditions have identical histopathology to Central Giant Cell Granuloma?

A

1-Brown tumor of hyperparathyroidism
2-Cherubism

*Treatment is curettage

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19
Q

What developmental condition causes plump-cheeks, eyes upturned to heaven and typically progresses until puberty and slowly regresses?

A

Cherubism

*Mutilocular bilateral radiolucency

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20
Q

Also known as a simple bone cyst, what lesion presents as a scalloped radiolucency involving several teeth?

A

Traumatic Bone Cyst

*Cyst is a misnomer because lesion does not have epithelial lining

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21
Q

What is the theory for why a Traumatic bone Cyst forms?

A

Trauma to bone causes fracture resulting in intraossesous hematoma. Hematoma does not repair and liquefies resulting in defect

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22
Q

An intraosseous accumulation of blood-filled spaces surrounded by connective tissue that presents clinically as a rapidly formed swelling and a “blow out” radiographic appearance is likely?

A

Aneurysmal bone cyst

  • Looks like a blood soaked sponge
23
Q

What are the three main types of Fibro-Osseous lesions?

A

1-FIbrous dysplasia
2-Cemento-osseous dysplasia (3 types)
3-Ossifying fibroma

24
Q

What tumor-like condition is characterized by replacement of normal bone by fibrous connective tissue intermixed with bone?

A

Fibrous Dysplasia

25
Q

Fibrous dysplasia can be monostotic (1 bone) or polysostotic (multiple bones), What two syndromes are polyostotic fibrous dysplasias?

A

1-Jaffe-Lichtenstein Syndrome

2-McCune-Albright Syndrome

26
Q

Which type of Fibrous dysplasia accounts for 80% of all cases and appears as an ill defined, ground glass opacification radiographically?

A

Monostotic Fibrous Dysplasia

27
Q

Which type of fibrous dysplasia can involve up to 75% of the skeleton, and tends to stabilize and stop growing at skeletal maturity?

A

Polyostotic Fibrous Dysplasia

28
Q

What syndrome is characterized by Polyostotic fibrous dysplasia and Café au lait spots (coast of Maine, jagged)?

A

Jaffe-Lichtenstein syndrome

29
Q

What syndrome is characterized by Polyostotic fibrous dysplasia, Café au lait spots (coast of Maine)
and multiple endocrinopathies?

A

McCune-Albright Syndrome

*Sexual precocity is the most common endocrinopathy

30
Q

What occurs in tooth-bearing areas of the jaw and is the most common fiber-osseous lesion encountered in clinical practice?

A

Cemento-Osseous Dysplasia

31
Q

What are the three types of Cemento-Osseous Dysplasia?

A

1-Focal- usually 1st molar in mandible
2-Periapical
3-Florid

32
Q

Which type of Cemento-osseous Dysplasia Exhibits single sight involvement most commonly in the posterior mandible near 1st molar and appears as a mixed RL and RO radiographic pattern?

A

Focal Cemento-Osseous Dysplasia

*90% are women in 40’s (Caucasian)

33
Q

Which type of Cemento-osseous Dysplasia involves the periapical region of the anterior mandible, or which early lesions may look like multiple periapical granuloma/cyst?

A

Periapical Cemento-Osseous Dysplasia

*Most commonly female african americans. later lesions are mixed RO-RL radiographically

34
Q

Which type of Cemento-osseous Dysplasia has Multiple focal involvement not limited to the anterior mandible and tends to be bilateral/symmetrical?

A

Florid Cemento-osseous Dysplasia

*90% female, 90% African American

35
Q

Of the three Cemento-Osseous Dysplasias, may need to be biopsied?

A

Focal Cemento-osseous dysplasia

*Florid and Periapical do not need biopsy or intervention

36
Q

What lesion is a true neoplasm with significant growth potential made of bone and cementum typically in the mandible with a characteristic downward bowing of the inferior cortex?

A

Ossifying fibroma

*more common in Females and in the Mandible

37
Q

What lesion is typically found in males more than females and in the maxilla more than the mandible?

A

Juvenile (Active) Ossifying Fibroma

*RL with central RO

38
Q

Benign tumors of mature bone that are well circumscribed masses that exhibit continued growth are called?

A

Osteoma

39
Q

What are three main characteristics of Gardner’s syndrome?

A

1-Bowel Polyps (Will turn into adenocarcinoma)
2-Skeletal abnormalities (osteomas)
3-Dental abnormalities (supernumerary, impacted teeth, odontomas)

40
Q

Osteoid osteomas are __________ than 2 cm; osteoblastomas are _______

A

SMALLER, LARGER

41
Q

Which bone condition is a rare lesion in the jaws that can be well-defined or ill-defined radiolucency with radiopacities, is usually between 2-4 cm and that is NOT relieved by aspirin?

A

Osteoblastoma

42
Q

Which bone condition is very rare in jaws but and is a small (less than 1 cm) well-circumscribed lesion with a radiolucent defect-rim with a target like appearance that causes nocturnal pain relieved by aspirin?

A

Osteoid Osteoma

43
Q

An odontogenic neoplasm of cementoblasts appearing as a radiopacity fused to one or more roots 75% or which arise in the mandible, (almost always in the molar/premolar region) are called?

A

Cementoblastoma

44
Q

What non-neoplastic condition most commonly affects large joints as well as the TMJ and show loose bodies called joint mice near the joint on a radiograph?

A

Synovial Chondromatosis

45
Q

What Mesenchymal malignancy is the most common type of malignancy originating in bone (excluding hematopoietic)?

A

Osteosarcoma

*extragnathic occur between 10-20 yrs old and after 50. Ave age 33 for the jaw

46
Q

What are three characteristics of Osteosarcomas radiographically?

A
  • Spiking resorption around and on roots (widening of PDL)
  • Sunburst appearance in 25%
  • Codman’s traingle (periosteum)
47
Q

Which Osteosarcomas have the best prognosis?

A

Long bones (80%

*Jaw lesions are between 30-70%

48
Q

A malignant bone tumor of cartilage is called?

A

Chondrosarcoma

49
Q

What condition is a primary malignant tumor of bone-hematologic, is the 3rd most common osseous neoplasm (after osteosarc & chondrosarc) and is caused by a translocation on 11 and 22?

A

Ewing Sarcoma

*onionskin periosteal reaction

50
Q

What conditions is the most common form of cancer involving bone?

A

Metastatic Tumors to the Jaws

*Stage IV disease. poor 5 year survival

51
Q

What are 5 common origins of gnathic metastasis?

A 
1-Breast 
2-Lung	
3-Thyroid
4-Prostate
5-Kidney
52
Q

When the inferior alveolar never is involved in metastasis is can cause a pattern of anesthesia termed?

A

Numb-chin syndrome

53
Q

How do Metastatic Tumors of the jaw appear like on radiographs?

A
  • Ill-defined (moth eaten) borders

- widening PDL

Oral Pathology (18 decks)

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