Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral medicine > benign lesions of the oral mucosa > Flashcards

benign lesions of the oral mucosa Flashcards

1
Q

are most congenital/hereditary or acquired?

A

some congenital/hereditary but majority are acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

epithelial origin lesions

A

papilloma

drug-induced gingival overgrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

lamina propria origins

A 
traumatic fibroma
pyogenic granuloma
peripheral GC granuloma
mucocele
lipoma
haemangioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

papilloma aetiology

A

neoformation epithelial origin

HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

clinical papilloma

A 
hairy like elongated lesion
single/multiple
white/pinkish
pedunculated/sessile
no malignant potential
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

tx papilloma

A

surgical - may recur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

another name for traumatic fibroma

A

fibroepithelial polyp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

location of traumatic fibroma

A

usually buccal mucosa, lips, tongue

NOT gingiva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

traumatic fibroma aetiology

A

accidental biting
chronic irritation
trauma/infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

traumatic fibroma clinical presentation

A 
dome-shaped
soft
same colour as surrounding mucosa, can be keratinised
sessile/pedunculated
can be ulcerated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a traumatic fibroma called if on gingivae?

A

epulis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

traumatic fibroma tx if excessive dimension

A

surgically remove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

traumatic fibroma histology

A

fibrous tissue
covered by keratinised SSE
- buccal mucosa NK: paler cells (store glycogen)
- to withstand trauma
- atrophic - thinner than normal epithelium
collagen fibres, fibroblasts, a few chronic inflammatory cells
- relatively acellular CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

drugs responsible for drug-induced gingival overgrowth

A

anticonvulsants - phenytoin
immunosuppressants - cyclosporin
Ca channel blockers - nifedipine, amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical presentation drug-induced gingival overgrowth

A 
enlargement 1-3m of taking drug
entire U and L gingiva
more severe anterior regions
starts from ID papilla
may cover a portion or entire tooth crown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drug-induced gingival overgrowth consequences

A

may prevent OH
painful eating
disfigurement
impair QOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

drug-induced gingival overgrowth tx

A

liase w physician: discontinuation of drug and switch to another
professional OH and CHX rinse
gingivectomy
if med not stopped may recur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

pyogenic granuloma aetiology

A

benign, vascular, reactive?
aetiology unknown
- seems constant insults may lead to rapid proliferation of capillaries w a friable and lobulated aspect
hormonal factors - associated with pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

clinical presentation pyogenic granuloma

A

begins small red papule
then red pedunculated exophytic lesion
surface often friable and ulcers - bleeding
often gingival margin (vascular epulis) and tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pyogenic granuloma consequences

A

no malignant potential but complications - ulceration, bleeding, secondary infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pyogenic granuloma tx

A

surgical (but may recur)

also to stop angiomatous proliferation or to rule out chancre, carcinoma or kaposi-sarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

peripheral giant cell granuloma/GC epulis aetiology

A

usually described as reaction to chronic local factors
- supra/subgingival dental biofilm
- ill fitting Rxs
- dentures
- associated to implants
unknown aetiology - seems to come from PDL, or periosteum, or persistence of cells from PDL after tooth ext

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

peripheral giant cell granuloma/GC epulis clinical

A 
younger pts
anterior
exophytic
smooth
red/purple
firm/elastic consistency
freq asymptomatic except if surface ulcerated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

peripheral giant cell granuloma/GC epulis radiographic

A

resorption alv bone
widening PDL space
rarely RR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

peripheral giant cell granuloma/GC epulis histology

A

MN GCs with background of GT
mononuclear stromal cells and extravased rbcs, v cellular
sharply demarcated but no fibrous capsule surrounding
hyperlastic SSE - parakeratinised
red cell areas - haemorrhage
- haemosidrin - brown
GCs might be macrophages joined together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

peripheral giant cell granuloma/GC epulis tx

A

conservative excision with PD therapy
but high chance of recurrence

exclude systemic disease

  • raised PTH
  • low vit D in diet
  • malabsorption
  • renal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CGCG (bony)

A

uncommon
found only in tooth bearing regions of jaws
most common in mandible 20-30yrs
may mimic malignant neoplasm
can erode through cortical bone - domed purplish mucosal swelling
may have haemosidrin due to new and old haemorrhages (v vascular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

mucocele aetiology

A

lesion caused by disruption of salivary flow from minor salivary glands origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

types of mucoceles

A

extravasation
- collection of saliva in CT following trauma to ducts
retention
- accumulation of saliva within ductal system due to obstruction of the salivary ducts
ranula
- from major salivary gland origin, occur on FOM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

mucocele clinical

A

soft neoformations
usually L lip and buccal mucosa
colour from normal mucosa to light blue/white
tend to be larger and smaller periodically
- may want to wait 2-3m to see if it gets larger. Bursts and recurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

mucocele tx

A

surgical removal inc underlying minor salivary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

mucocele histology

A 
wall of GT
lined by compact layer of macrophages
saliva in lumen
foam cells
 - some macrophages break off into cyst to try and absorb saliva - become large foam cells
cystic cavity
33
Q

lipoma aetiology

A

uncertain
hereditary/endocrine/trauma/infections?
genetic, Gardner syndrome

34
Q

lipoma definition

A

neoplasm from adipose tissue

35
Q

lipoma clinical

A

submucosal mobile yellowish to pinkish soft to fibrous long-lasting swellings
covered by normal oral mucosa
as gets bigger may ulcerate
buccal mucosa and tongue most common

36
Q

lipoma histology

A

adipose tissue

37
Q

lipoma tx

A

usually none
but if painful/growing SR
recurrences uncommon

38
Q

white sponge naevus aetiology

A

congenital/hereditary

thought to be due to mutations in genes responsible for making keratin and also shedding mucosa

39
Q

white sponge naevus clinical

A

asymptomatic

affects NKSSE - buccal mucosa, ventral tongue, FOM, SP

40
Q

white sponge naevus histology

A

normally don’t biopsy
parakeratosis with intracellular oedema in keratin layer
acanthosis

41
Q

white sponge naevus tx

A

none

42
Q

how oral mucosa reacts to trauma depends on:

A

irritation
time (how long and how many times)
person (genetics)

reactions may be in form of:

  • inflammation
  • keratosis
  • ulceration
  • fibrous tissue formation
  • vesicles and bullae
  • other types
43
Q

epulis

A

any ST swelling on gingiva

44
Q

parakeratinised

A

when keratin contains remains of nuclei

45
Q

orthokeratinised

A

no nuclei remnants in keratin

46
Q

haemangioma aetiology

A

benign, enlarged vascular tumour
develops due to abnormal proliferation of blood vessels
- endothelial cells
usually present at birth - developmental hamartoma
- tends to grow first 6m of life
- then shrinks as becomes fibrotic
blood present within vessels and is in continuation with circulation of rest of body
hamartoma composed of vascular tissue

47
Q

haemangioma presentation

A

painless, smooth/lobulated, sessile/pedunculated soft mass
red/blue/purple
blanching effect - pressure causes disappearance, when released fill up slowly again

48
Q

haemangioma histology classification

A

capillary: small capillaries lined by a single layer of endothelial cells supported in a CT stroma
cavernous: large, thin-walled vessels, or sinusoids lined by epithelial cells, separated by thin CT layer

49
Q

haemangioma tx

A

usually none, can undergo spontaneous regression

small % - tx with surgery, laser, intralesional injection of fibrosing agent

50
Q

herpes simplex/PHG

A 
inflammation/formation of vesicles which easily rupture and can coalesce
don't biopsy
ballooning degeneration
 - operlant colour
 - large size
 - may fuse
51
Q

fibrous epulis cause

A

reaction to trauma - form of chronic inflammation

- will recur if don’t address cause

52
Q

fibrous epulis clinical

A 
mainly fibrous tissue
firm pink ST swelling
keratinised
areas of ulceration
most common posterior gingivae
53
Q

fibrous epulis histology

A

SSE - hyperplastic or ulcerated, parakeratinised
ulceration
- break in continuity of epithelium
- surface zone distinctly pink/yellow, base fibrin
- zone just beneath ulceration highly cellular and vascular (GT)
mass of GT
- 1st stage of healing
- capillaries, fibroblasts, macrophages, plasma cells, neutrophils, lymphocytes
LP - white
- papillae project upwards into epithelium
- rete pegs - epithelial, project downwards into LP
metaplastic bone formation
- reprogramming of mesenchymal SCs that are present -
produce bone
- reaction to chronic low grade irritation/trauma
- tissue may feel “gritty” when remove
- uniform pink staining areas
- less cellular

54
Q

fibrous epulis tx

A

surgical removal
scaling
OHI

55
Q

vascular epulis presentation

A

gingivae (if not on gingivae pyogenic granuloma - same)

lots of bv’s - bleeds lots

56
Q

vascular epulis aetiology

A

thought to be exaggerated response of tissue to some sort of chronic trauma
pregnancy? - most commonly found - pregnancy epulis
- and changing OCP
- delay removal until after birth - becomes fibrotic and smaller so easier to remove

57
Q

vascular epulis outcome

A

fairy simple to remove but may recur if inflammation/subgingival calculus isn’t txed

58
Q

vascular epulis histology

A 
base has epithelium (darkest bit)
 - remove base or recurrence likely
 - pedunculated/sessile
no epithelium on surface - ulcerated
 - red (inflammation) and yellow (fibrin) surface
 - get fibrin from fibrinogen - part of clotting process after 
   bleeding
vascular loose CT - GT
 - neutrophils
 - lots of bv's - can bleed into GT
 - fibroblasts
 - macrophages
 - plasma cells
59
Q

GC epulis/granuloma - ruling out underlying bone lesion

A

radiograph as look the same histologically as other GC lesions
- osteitis fibrosa cystica (brown tumour) in
hyperparathyroidism
- central GC granuloma: grows along jaw in AP direction,
causes erosion of alveolar bone, pops out and sits on
gingiva as GC epulis - esp if lesion keeps recurring
suspect this
- OFG
- TB
- sarcoidosis
- foreign body GC granuloma (e.g. suture or amalgam)

60
Q

denture-induced hyperplasia

A

fibrous overgrowth
trauma from denture flange
if fix denture it may resolve but may need surgical removal

61
Q

leaf fibroma

A

on hard palate (get squashed by denture)

62
Q

papillary hyperplasia of palate

A

pseudo-epitheliomatous hyperplasia - GT, covered on surface by hyperplastic keratinised SSE - groups of epithelial cells
denture associated

63
Q

what condition is haemangioma associated with?

A

Sturge-Weber syndrome

  • can involve oral mucosa/alv bone
  • can rarely affect brain meninges - epilepsy
  • distribution of lesions corresponds to area innervated by branches of CN5 - don’t cross midline
64
Q

hamartoma

A

tumour-like overgrowth of tissues which are normally found at the site
growth usually limited to a certain period, not lesions of continued growth - distinguishes from neoplasm

65
Q

vascular malformation

A

same as haemangioma but appears later on (though present at birth)
- atrophy/trauma/calcification may make them visible

66
Q

atrophy

A

thinning of the epithelium

- skin may appear dry and wrinkled

67
Q

causes of atrophy

A

age
nutritional deficiency - iron, vit B12, folate
chronic sun exposure
inflammatory and neoplastic skin diseases
- cutaneous T cell lymphoma
- lupus erythematosus
long term use of potent topical CS

68
Q

consequence of atrophy

A

predisposes to infection - protective fct down

69
Q

histology of an ulcer

A

epithelium hyperplastic and keratinised
break in continuity of epithelium - ulcer
surface of ulcer - fibrin with inflammatory cells and necrotic tissue, yellow
base - GT moves up and new bv’s
deep to that zone of inflammatory cells - plasma cells
epithelium at margins
- comes to abrupt end
- atrophic and keratinised with inflammatory cells present in the epithelium

70
Q

what do keratosis and hyperplasia in an ulcer suggest?

A

that there has been frictional irritation and therefore the chronic irritation at the point where the epithelium has broken down has exceeded the epithelial capacity to react

71
Q

white edge to an ulcer

A

keratin - can occur when get trauma to a NK surface - forms keratin to try and protect itself - frictional keratosis

72
Q

non-specific ulcer

A

no characteristic features to diagnose it as anything else

  • not malignant
  • can be aphthous, traumatic etc
73
Q

types of oral mucosa

A

masticatory
gustatory (specialised)
lining - NK

74
Q

types of ulceration

A 
trauma
ROU
 - RAS
 - infections
 - secondary to systemic disease
carcinoma
75
Q

env causes of ulceration

A 
trauma
allergy
smoking
infection
stress
76
Q

what often causes a papilloma?

A

HPV 6 and 11

77
Q

histology of papilloma

A 
hyperkeratotic surface
papillary (finger-like) projections
projections have fibrovascular CT cores
SSE covers cores
no dysplasia
78
Q

condyloma acuminatum

A

wart
HPV 6, 11, 16 and 18
tongue and palate

79
Q

condyloma acuminatum histology

A

acanthotic and sometimes hyperkeratotic epithelium with occasional koilocytosis

Oral medicine (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions