Benign Mesenchymal Tumors - part I

Question 1

tissue of mesoderm origin

Answer 1

1. fibrous
2. adipose
3. nerve
4. blood
5. lymph
6. muscle

Question 2

fibrous benign mesenchymal tumors

Answer 2

1. fibroma
2. inflammatory fibrous hyperplasia
3. inflammatory papillary hyperplasia
4. pyogenic granuloma
5. peripheral giant cell granuloma
6. peripheral ossifying fibroma

Question 3

what causes fibroma (irritation fibroma)?

Answer 3

collagen deposition secondary to trauma

Question 4

T/F: true fibromas are neoplasms, but controversy as to whether irritation fibromas are

Answer 4

true

Question 5

what are considered fibromas?

Answer 5

1. frenal tag

2. retrocuspid papilla

Question 6

where does fibromas affect?

Answer 6

buccal mucosa and tongue (but potentially any mucosal surface)

Question 7

clinical features of fibroma

Answer 7

1. smooth or slightly papillary surface
2. dome-shaped
3. sessile or pedunculated
4. most 1.5 cm or less
5. may ulcerate if traumatized
6. asymptomatic unless traumatized

Question 8

frental tag

Answer 8

small, innocuous growth easily diagnosed clinically

Question 9

tx for frenal tag

Answer 9

none necessary

Question 10

retrocuspid papilla

Answer 10

bilateral papular lesions on the gingiva lingual to the mandibular canines

Question 11

histopathologic features of fibroma

Answer 11

nodular mass of dense fibrous CT

Question 12

tx of fibroma

Answer 12

conservative excision

Question 13

T/F: recurrence of fibroma is rare

Answer 13

true

Question 14

what is inflammatory fibrous hyperplasia (IFH) also known as?

Answer 14

1. denture epulis
2. epulis fissuratum
3. denture-induced fibrous hyperplasia

Question 15

clinical features of IFH

Answer 15

1. flange of ill-fitting denture

2. may have central fissure/ulcer

Question 16

histopathologic features of IFH

Answer 16

fibrovascular CT covered by stratified squamous epithelium

Question 17

tx of IFH

Answer 17

1. conservative excision

2. remake denture

Question 18

prognosis of IFH

Answer 18

excellent if appropriately treated

Question 19

what is inflammatory papillary hyperplasia (IPH) also known as?

Answer 19

denture papillomatosis - may have superficial candidiasis

Question 20

what causes IPH?

Answer 20

1. ill-fitting maxillary denture
2. poor denture hygiene
3. wearing denture 24/7

Question 21

clinical features of IPH

Answer 21

1. numerous asymptomatic red/erythematous papules

2. central region of hard palatal mucosa

Question 22

IPH affects the central region of hard palatal mucosa due to what?

Answer 22

1. maxillary denture
2. high palatal vault
3. habitual mouth breathers

Question 23

histopathologic features of IPH

Answer 23

1. papillary surface

2. edema (accumulation of fluid in the extracellular spaces of a tissue)

Question 24

tx of IPH

Answer 24

1. topical or systemic antifungal therapy
2. removal of the denture may allow the erythema and edema to subside
3. excise hyperplastic tissue before fabricating a new denture

Question 25

prognosis of IPH

Answer 25

good after tx if pt keeps denture out and keeps it clean

Question 26

reactive lesion

Answer 26

exuberant response to local irritation or trauma (hyperplastic granulation tissue)

Question 27

T/F: pyogenic granuloma is a reactive lesion

Answer 27

true

Question 28

when does pyogenic granuloma frequently occur?

Answer 28

during pregnancy "pregnancy tumor"

Question 29

T/F: pyogenic granuloma is neither "pyogenic" nor a "granuloma"

Answer 29

true

Question 30

T/F: pyogenic granuloma is unrelated to an infection

Answer 30

true

Question 31

T/F: pyogenic granuloma is not a true granuloma

Answer 31

true

Question 32

clinical features of pyogenic granuloma

Answer 32

1. rapid growth 2. painless 3. red 4. often ulcerated 5. any body surface 6. bleeds easily

Question 33

what are the most common intraoral sites for pyogenic granuloma?

Answer 33

gingiva

Question 34

what are the intraoral sites for pyogenic granuloma?

Answer 34

1. gingiva 2. lips 3. tongue

Question 35

if something is growing out of a socket, what are the 3 options?

Answer 35

1. epulis granulomatosa 2. lymphoma 3. metastatic disease

Question 36

what is epulis granulomatosa also known as?

Answer 36

liver clot

Question 37

histopathologic features of pyogenic granuloma

Answer 37

vascular granulation tissue

Question 38

vascular granulation tissue histopathologically

Answer 38

proliferation of fibroblasts and new thin-walled capillaries and inflammatory cells (plasma cells, lymphocytes) in a loose extracellular matrix

Question 39

tx of pyogenic granuloma

Answer 39

excise, remove irritants

Question 40

T/F: pyogenic granuloma recurs

Answer 40

true (15% recur)

Question 41

T/F: peripheral giant cell granuloma is a reactive lesion

Answer 41

true

Question 42

clinical features of peripheral giant cell granuloma

Answer 42

1. painless | 2. dusky purple-red

Question 43

where does peripheral giant cell granuloma only affect?

Answer 43

only on gingiva of alveolar ridge, including edentulous ridge

Question 44

radiographic features of peripheral giant cell granuloma

Answer 44

cupping of underlying bone sometimes is seen

Question 45

histopathologic features of peripheral giant cell granuloma

Answer 45

granulation tissue with numerous benign multinucleated giant cells

Question 46

tx of peripheral giant cell granuloma

Answer 46

excise, remove irritants

Question 47

T/F: peripheral giant cell granuloma will recur

Answer 47

true, 15% recur

Question 48

T/F: peripheral ossifying fibroma is a reactive lesion

Answer 48

true

Question 49

clinical features of peripheral ossifying fibroma

Answer 49

1. painless 2. firm 3. coral-pink 4. may be ulcerated

Question 50

where does peripheral ossifying fibroma occur?

Answer 50

found only on the gingiva

Question 51

histopathologic features of peripheral ossifying fibroma

Answer 51

1. cellular fibrous CT | 2. variable amounts of calcification

Question 52

tx of peripheral ossifying fibroma

Answer 52

excise, remove irritants

Question 53

T/F: peripheral ossifying fibroma recurs

Answer 53

true, 15% recur

Question 54

which fibrous lesions are "bumps on the gums"?

Answer 54

"3 P's" 1. pyogenic granuloma 2. peripheral giant cell granuloma 3. peripheral ossifying fibroma