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Oral Disease for FINALS > Benign neoplasms and reactive lesions > Flashcards

Benign neoplasms and reactive lesions Flashcards

1
Q

Oral diseases affecting epithelium (6)

A

Reactive: mucoceles
Infective: focal epithelial hyperplasia, verruca vulgaris, papilloma
Neoplastic: squamous cell carcinoma, salivary gland tumours

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2
Q

Oral diseases affecting fibrous tissue (5)

A

Congenital/ developmental: gingival fibromatosis
Inflammatory: gingival hyperplasia
Reactive: pyogenic granuloma, fibrous hyperplasia, giant cell granuloma
Neoplastic: fibroma

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3
Q

Oral diseases affecting blood vessels (3)

A

Congenital/ developmental: haemangioma, lymphangioma

Neoplastic: angiosarcoma

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4
Q

Oral diseases affecting fat (1)

A

Neoplastic: lipoma

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5
Q

Oral diseases affecting nerves (4)

A

Reactive: traumatic neuoma
Neoplastic: neurofibroma, neurilemmona
Idiopathic: granular cell tumour

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6
Q

Oral diseases affecting muscle (3)

A

Neoplastic: rabdomyoma, leiomyoma, sarcomas

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7
Q

What is an epulis? (1)

A

A gingival swelling

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8
Q

Examples of localised epulides (5)

A 
Fibrous hyperplasia (fibro-epithelial polyp)
Pyogenic granuloma
Peripheral giant cell granuloma
Gingival cysts
Bohns nodules
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9
Q

Examples of generalised swellings of gingival tissue (6)

A 
Chronic hyperplastic gingivitis
Leukaemic infiltration
Endocrine related (puberty, pregnancy)
Crohn's disease
Gingival fibromatosis
Drug induced hyperplasia
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10
Q

Clinical features of fibrous epulis (fibrous hyperplasia) (5)

A 
Pedunculated or sessile
Same colour as normal mucosa
Firm
Painless unless traumatised
Caused by trauma: dentures, teeth orthodontic appliances
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11
Q

Fibrous hyperplasia: histological appearance (2)

A

Overgrowth of fibrous CT

Covered by hyperkeratinised stratified squamous epithelium

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12
Q

Management of fibrous hyperplasia (3)

A

Excision
Remove cause
Send for histopathological examination

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13
Q

Features of a pyogenic granuloma (6)

  • clinical
  • who if affects
A 
Red/ blue/ purple vascular growth
Sessile or pedunculated
Rapid growth
Soft, bleeds easily
Usually <40yrs
Common in pregnancy/ puberty (pregnancy epulis)
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14
Q

Causes of pyogenic granuloma (2)

A

Caused by trauma e.g. plaque, calculus, denture, orthodontic appliance
In pregnancy/ puberty hormonal induced exuberant repsonse to above

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15
Q

Pyogenic granuloma: histological appearance (2)

A

Overgrowth of very vascular granulation tissue (endothelial cells and fibroblasts)
Explains red colour seen clinically

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16
Q

Management of pyogenic granuloma (4)

A

Excision and remove cause
If patient is pregnant, improve oral hygiene and excise but may recur
Lesions may mature into dense fibrous tissue (fibrous epulis)
Also found at other sites in oral mucosa

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17
Q

Peripheral giant cell granuloma features (6)

A

Soft red/ blue sessile or pedunculated swelling
Usually anterior teeth, mandible > maxilla
Average <40yrs
Similar to pyogenic granuloma clinically
May cause superficial bone resorption
Only found on gingiva

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18
Q

Peripheral giant cell granuloma (5)

A

Vascular fibrous tissue
Numerous multinucleate giant cells
Haemorrhage
Histological diagnosis: giant cell lesion
-same as those arising in bone histologically e.g. central giant cell granuloma and hyperparathyroidism

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19
Q

Management of peripheral giant cell granuloma (3)

A

Determine whether lesions has arisen on gingiva or within bone and burst through cortical plate - rads
If arisen in bone differential diagnosis includes central giant cell granuloma and hyperparathyroidism
Excision
-curettage of underlying bone to prevent recurrence
-send for histopathological examination

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20
Q

Differential diagnosis of epulides (4)

A

Firm, mucosa coloured: fibrous epulis
Soft, red, red/ blue: pyogenic granuloma, giant cell granuloma
Pregnant/ puberty more likely pyogenic granuloma
Definitive diagnosis by excisional biopsy
EXCLUDE ABSCESS from tooth or gum: red/ yellow/ soft/ fluctuant

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21
Q

Hereditary generalised gingival swellings (1)

A

Gingival fibromatosis

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22
Q

Inflammatory generalised gingival swellings (1)

A

Chronic hyperplastic gingivitis

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23
Q

Hormonal generalised gingival swellings (1)

A

Endocrine related (puberty, pregnancy)

24
Q

Diet related generalised gingival swellings (1)

25
Drug related generalised gingival swellings (1)
Drug induced hyperplasia
26
Neoplastic generalised gingival swellings (2)
Leukaemic infiltration | Wegner's granulomatosis
27
generalised gingival swellings associated with GI tract disease (1)
Crohn's disease
28
Gingival fibromatosis features (5)
``` Hereditary (AD) Lifelong Pale pink, firm overgrowth May cover and submerge teeth May regrow after removal ```
29
Features of chronic hyperplastic gingivitis (2)
Associated with poor OH | Erythematous gingivae, bleed on probing
30
Hormonal related gingival hyperplasia features (3)
Puberty and pregnancy Exuberant response to plaque Red, erythematous, bleeds easily on probing
31
Diet related: gingival hyperplasia in scurvy - features (5)
``` Diet poor in vit C Failure to synthesise collagen Loss of teeth Inflammatory type hyperplasia Very rare in UK ```
32
Neoplastic: gingival hyperplasia associated with leukaemia - features (5)
``` Red, swollen gingivae May exude pus Ulceration Response in excess of amount of plaque May be associated with petechial haemorrhages, tiredness ```
33
Drug induced gingival hyperplasia associated with which drugs (3)
Cyclosporin (immunosuppressant) Nifedipine (antihypertensive) Phenytoin (anticonvulsant)
34
Drug induced gingival hyperplasia features (3)
Gingivae pale Lobulated surface Little inflammation
35
Drug induced gingival hyperplasia - histology (3)
Dense fibrous tissue Little inflammation Long epithelial rete redges
36
Management of drug induced gingival hyperplasia (3)
Surgical reduction Improve OH Change drug regime if possible
37
Features of Crohn's related gingival hyperplasia (4)
Labial swelling Apthous ulcers Mucosal tags Cobblestoning in GI tract
38
Differential diagnosis of generalised gingival hyperplasia (3)
Pale, un-inflamed gingivae: gingival fibromatosis or drug induced. Distinguish on duration and drug history Red, inflamed gingivae: inflammatory hyperplasia or hormonal induced. Distinguish by history Red, inflamed, pus, ulceration: leukaemia. Further investigations
39
Squamous cell papilloma features (4)
Benign neoplasm HPV driven White cauliflower like growth Pedunculated or sessile Common on palate
40
Squamous cell papilloma - histology (3)
Overgrowth of epithelium which is hyperkeratinised - hence white colour Surface thrown into fronds Vascular connective tissue core
41
Management of squamous cell papilloma (1)
Excision with a margin
42
Features of Heck's disease (5)
``` Multiple papillomas Caused by HPV 13+32 Multiple flat viral warts May resolve spontaneously/ excise Inuit/ central America ```
43
Fibrous hyperplasia - fibro-epithelial polyp - features (3)
Continued trauma Common on cheeks, tongue, lip Mucosal colours, firm nodule
44
Fibrous hyperplasia - fibro-epithelial polyp - histology (2)
Overgrowth of mature fibrous tissue | Stratified squamous epithelium
45
Pyogenic granuloma features (4)
Caused by trauma Red/ red-white Overgrowth of vascular granulation tissue Usually ulcerated
46
Traumatic neuroma features (4)
Haphazard overgrowth of nerve fibres Usually caused by trauma Mental foramen region Frequently painful
47
Features of lipoma (5)
``` Benign neoplasm Composed of fat Yellow/ pink Smooth surface Common on cheek and tongue ```
48
Management of lipoma (1)
Excision
49
Haemangioma features (6)
``` Hamartoma Choristoma Excess BVs Blue/ blue-purple colour Localised or diffuse May bleed excessively ```
50
Sturge-Weber syndrome characteristic features (4)
``` Port wine stain Varying degrees of mental retardation Seizures Glaucoma *present from birth (congenital)* ```
51
What is a lymphangioma (3)
Similar to haemangioma but an overgrowth of lymphatic vessels Paler colour clinically Cystic hygroma
52
What is a neural tumour (neurofibroma or neurilemmona) (4)
More deep seated Relatively rare Firm Mucosal coloured
53
What is a granular cell tumour (2)
Common on tongue | Neural origin?
54
What is a congenital epulis? (2)
Similar to granular cell tumour histologically but occurs in neonates
55
Differential diagnosis of mucosal swellings (6)
Cauliflower-like and white- squamous cell papilloma Smooth, mucosal coloured, related to denture, or other source of trauma- fibrous hyperplasia. Smooth, yellow- lipoma Red/red-white, related to trauma -pyogenic granuloma Red/blue- haemangioma, mucocoele Deep seated/ normal mucosa- neuroma, neural tumour, salivary gland tumour

Oral Disease for FINALS (34 decks)

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