Connective Tissue Lesions

Question 1

Most common benign tumor of the oral cavity

Answer 1

Fibroma

Question 2

Fibroma also called

Answer 2

Irritation fibroma
Traumatic fibroma

Question 3

Most common site for fibroma

Answer 3

Buccal mucosa near the occlusal plane - cheek biting

Labial mucosa
Tongue
Gingiva

Question 4

Denture induce fibrous hyperplasia of oral mucosa related to the chronic trauma produced by an ill fitting denture

Answer 4

Denture fissuratum
Denture epulis

Question 5

Common site for denture epulis

Answer 5

Facial aspect of alveolar ridge

Question 6

Difference between peripheral fibroma and fibroma

Answer 6

Fibroma is seen in buccal mucosa and tongue commonly

Peripheral is commonly seen on gingiva

Question 7

Reactive gingival growth identical to peripheral fibroma but contains calcified islands within the fibrous tissue

Answer 7

Peripheral ossifying fibroma

Question 8

Firm slow growing sessile gingival mass covered by normal appearing mucosa commonly found on the facial gingiva of mandible containing stands of ODONTOGENIC epi within the CT

Answer 8

Peripheral odontogenic fibroma

Question 9

Drugs contributing in gingival hyperplasia

Answer 9

Phenytoin
Cyclosporin
Nifedipine
Diltiazem
Amlodipine
Verapamil

Question 10

Benign vascular smooth muscle tumor

Answer 10

Leiomyoma

Question 11

Intraoral sites for leiomyoma

Answer 11

Lips
Tongue
Palate
Cheek

Question 12

Malignant neoplasm of smooth muscle, presents as enlarging ulcerated mass that may or may not be painful intraorally

Answer 12

Leiomyosarcoma

Question 13

Granular cell tumor also known as

Answer 13

Granular cell myoblastoma

Question 14

Intraoral site for granular cell tumor/myoblastoma

Answer 14

Dorsal surface of the tongue
Buccal mucosa

Question 15

Age predilection in granular cell tumor

Answer 15

Female
4th to 6th decade of life

Question 16

Granular cell tumor may be mistaken for SCC because

Answer 16

Pseudo epitheliumatous hyperplasia of the overlying oral epi specially on the tongue

Question 17

Soft tissue tumor in on the max alveolar ridge of newborn females

Answer 17

Congenital epulis of newborn

Question 18

Autoimmune disease involving deposition of large amounts of dense collagen 1 and 3

Answer 18

Systemic sclerosis
Scleroderma

Question 19

Features of scleroderma

Answer 19

Females
30-50 yrs of age
2 forms
Limited - no internal organs involved
Diffuse - skin along with heart kidney BB joints etc involved
Pulmonary fibrosis - Leading to pulmonary hypertension and HF

Question 20

Smooth mask like face, fibrosis of fingers claw like fingers
Atrophic nasal alae
Pinched app giving MOUSE FACE LOOKS

Answer 20

Scleroderma
Systemic sclerosis

Question 21

Oral manifestations of systemic sclerosis

Answer 21

Microstomia
Trismus
Purse string app
Dysphagia
Xerostomia
Firm hypomobile tongue
Loss of attached gingiva
Recession
Diffuse widening of PDL
Mand resorption

Question 22

Generalised widening of PDL
Bilateral resorption of Condyles

Answer 22

Systemic sclerosis

Question 23

Common intraoral site for lipoma

Answer 23

Buccal mucosa
Buccal vestibule
Tongue
Floor of the mouth

Question 24

Traumatic neuroma

Answer 24

Reactive proliferation after nerve damage
Trauma to peripheral nerve

Question 25

Smooth surface non ulcerated nodules usually seen in the mental foramen area Tongue Lower lip with a history of trauma (extraction) followed by tenderness with digital pressure

Answer 25

Traumatic neuroma

Question 26

Benign neoplasm derived from a proliferation of SCHWANN cells of nerve sheath

Answer 26

Schwannoma (neurilemmoma)

Question 27

Features of schwannoma

Answer 27

Found in young adults Common site dorsal surface of tongue Slow growing encapsulated asymptomatic submucosal mass Pushes the nerve aside

Question 28

Microscopic patterns of schwannoma

Answer 28

Antoni A - spindle cells organised in palisaded pattern around acellular eosinophillic zones called VEROCAY BODIES Antoni B: spindle cells haphazardly distributed in a delicate fibrillar microcytic matrix

Question 29

Most common benign peripheral nerve neoplasm

Answer 29

Neurofibroma

Question 30

Neurofibroma originates from?

Answer 30

Schwann cells Perineural fibroblasts

Question 31

Presentation of neurofibroma

Answer 31

Solitary lesions Multiple lesions in neurofibromatosis type 1

Question 32

Neurofibromatosis 1 also knows as

Answer 32

Von recklinghausen’s disease of skin

Question 33

Features of solitary neurofibroma

Answer 33

Common in young adults Slow growing painless soft lesions Small nodules to large mass Tongue and buccal mucosa

Question 34

Features of neurofibromatosis type 1

Answer 34

Inherited autosomal dominant associated with multiple neurofibromas of the OC and skin Cafe au lait spots Iris freckling - lisch nodules Axillary freckling

Question 35

Crowe sign Lisch nodules present in

Answer 35

Neurofibromatosis type 1 Von recklinghausens disease of skin

Question 36

Which gene is involved in neurofibromatosis type 1

Answer 36

NF1 gene

Question 37

Most common type if neurofibromatosis

Answer 37

Vin recklinghausens disease of skin - neurofibromatosis type 1

Question 38

Systemic complications of neurofibromatosis type 1

Answer 38

Hypertension Pheochromocytoma CNS tumors Mental deficiency Seizures

Question 39

intraoral manifestations involved in von recklinghausens disease of skin

Answer 39

Enlargement of fungiform papillae Resulting in tongue enlargement Unilocular or multilocular radiolucencies Enlargement of mand foramen, mand canal Increased bone density Increased coronoid notch dimension

Question 40

Neurofibromatosis type 1 may be associated with

Answer 40

Malignant transformation- neurofibrosarcoma Or Malignant schwannoma

Question 41

Rare inherited disorder characterized by tumkrs or hyperplasia of neuroendocrine tissues

Answer 41

Multiple endocrine neoplasia MEN syndrome

Question 42

Types MEN syndrome

Answer 42

MEN 1: tumor hyperplasia of pulmonary gland, parathyroid gland, pancrease and adrenal cortex MEN 2: subtype 2A sipple syndrome - parathyroid hyperplasia or adenoma Medillary CA of thyroid, pheochromocytoma of the adrenal medulla Pancreas not involved MEN 3: subtype men 2B-

Question 43

Which type of MEN has oral manifestation

Answer 43

MEN 3

Question 44

Oral manifestations of MEN type 3

Answer 44

Mucucutaneous neuromas Oral mucosal neuromas - asymptomatic nodules on the lips, ant tongue, buccal mucosa, gingiva and palate

Question 45

Patient presented with multiple asymptomatic nodules in lips and tongue

Answer 45

oral mucosal neuromas in MEN 3

Question 46

What is the significance of removing thyroid gland as a prophylactic treatment in MEN 3

Answer 46

High risk of medullary carcinoma of the thyroid

Question 47

Benign hamartomas of the lymphatic vessels develops on the skin and MM

Answer 47

Lymphangioma

Question 48

Intraoral site for lymphangioma

Answer 48

Ant 2/3rd of the tongue resulting in macroglossia Presents as soft fluctuant nodules or vesicles with pebbly surface ranging in colour from pink to blue

Question 49

Types of lymphangioma

Answer 49

Macrocytic : cyst like spaces 2cm or more in diameter - CYSTIC HYGROMA - In the neck involving vital structures Microcytic: vascular channels of less than 2cm in diameter MIXED: combi of macro and micro

Question 50

Which type of lymphangioma is common in oral cavity

Answer 50

MICROCYSTIC

Question 51

Benign reactive proliferation of the superficial fascia - fibroblasts in young adults presents as rapidly growing firm mass pain and tenderness

Answer 51

Nodular fascitis

Question 52

Common intraoral site for nodular fascitis

Answer 52

Buccal mucosa

Question 53

Group of locally aggressive fibrous proliferation that show infiltrative destructive and recurrent growth but no tendency to metastasize

Answer 53

Fibromatosis

Question 54

Common intraoral site for fibromatosis

Answer 54

Paramandibular soft tissues Of children and young adults