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Oral Path 2 Finals > Connective Tissue Lesions (fibrous) > Flashcards

Connective Tissue Lesions (fibrous) Flashcards

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1
Q

Reactive conditions are derived from ___ cells and are represented by fibrous hyperplasia or exuberant proliferations of granulation tissue

A

Mesenchymal

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2
Q

Reactive conditions are derived from ___ cells and are represented by fibrous hyperplasia or exuberant proliferations of granulation tissue

A

Mesenchymal

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3
Q

____ hyperplasias comprise a group of fibrous connective tissue lesion that commonly occur in the oral mucosa secondary to injury

A

Reactive

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4
Q

A reactive hyperplastic mass that occurs on the gingiva and is believed to be derived from connective tissue of the submucosa or PDL

A

Peripheral fibroma

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5
Q

Any age

Males > females

Gingiva anterior to to permanent molars is most often affected

A

Peripheral fibroma

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6
Q

Presents clinically as a stalk (pedunculated) or a broad-based (sessile) mass that is similar in color to surrounding connective tissue

A

Peripheral fibroma

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7
Q

Hyperplastic scar

Highly collagenous and relatively avascular. Contains mild to moderate chronic inflammatory cell infiltrate

A

Peripheral fibroma

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8
Q

Gingival counterpart of peripheral fibroma

A

Traumatic fibroma (oral mucosa)

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9
Q

A subtype of peripheral fibroma that is a gingival mass in which islands of women (immature)bone and osteoid are seen.

A

Peripheral ossifying fibroma

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10
Q

A subtype of peripheral fibroma that is a gingival mass composed of well-vascularized, non encapsulated fibrous connective tissue.

Strands of odontogenic epithelium are often abundant

Amorphous hard tissue resembling tertiary dentin

A

Peripheral odontogenic fibroma

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11
Q

A subtype of peripheral fibroma that is a fibrous hyperplasia in which many of the mesenchymal cells are relatively larger than normal fibroblasts and assumes a stellate shape

A

Giant cell fibroma

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12
Q

DD of peripheral fibroma

A

Peirpheral giant cell granuloma
Pyogenic granuloma

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13
Q

Treatment of peripheral fibroma

A

Local excision, which should include the PDL

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14
Q

Reactive lesion usually caused by chronic trauma to oral mucous membrane

Overexuberant fibrous connective tissue repair results in a clinically evident submucosal mass

These are misnomers because there lesions are not benign tumor of fibroblasts

A

Focal fibrous hyperplasia

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15
Q

No gender and racial predilection

Very common reactive hyperplasia - typically found in buccal mucosa, lateral border of the tongue, and lower lip.

Painless, broad-based swelling that is pale in color, due to lack of vascular channels

A

Focal fibrous hyperplasia

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16
Q

These lesion have limited growth potential and do not exceed by 1-2 cm in diameter

A

Focal fibrous hyperplasia

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17
Q

If multiple focal fibrous hyperplasia, what are the syndrome that is commonly associated with?

A

Cowden’s syndrome or multiple hamartoma syndrome

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18
Q

Organ system associated with focal fibrous hyperplasia

A

Skin
Breast
Mucosa
Throid
Colon

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19
Q

Frequently encountered abnormalities in focal fibrous hyperplasia

A

Numerous fibromas and papillomas:
Cutaneous papules
Keratosses
Trichilemmomas
Benign and malignant neoplasms of the breast and thyroid
Colonic polyps

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20
Q

Underlying genetic problem appears to be related to germline mutation of the tumor suppressor gene in focal fibrous hyperplasia

A

PTEN found on chromosome 10q23

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21
Q

Histopath of focal fibrous hyperplasia

A

Collagen overproduction

Hyperkeratotic epithelium

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22
Q

DD of focal fibrous hyperplasia

A

IF TONGUE
Neurofibroma
Schwannoma
Granular cell tumor

LOWER LIP AND BUCCAL MUCOSA
Lipoma
Mucocele
Salivary gland tumor

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23
Q

Treatment of focal fibrous hypeplasia

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A

Simple surgical excision

24
Q

Benign proliferation of spindle cells of disrupted but probable Fibroblastic origin

Was first described as a tumor of the pleura

Buccal mucosa

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A

Solitary fibrous tumor

25
Rare case of these lesion cause hyperglycemia due to tumor production of insulin like growth factors
Solitary fibrous tumor
26
Pattern less proliferation of spindle cells
Solitary fibrous tumor
27
IHC of solitary fibrous tumor
STAT-6 - 100% CD34 - 90-95% CD99. - 70% Bcl-2. - 20-25% Factor XIIIa- positive cells may be found
28
Treatment for solitary fibrous tumor
Surgical excision
29
Oral Fibroblastic proliferations Very common oral lesions Uncommon to rare tumor Rare oral tumor
VCOL - fibrous hyperplasia UTRT - solitary fibrous tumor, myofibroma, benign fibrous histiocytoma ROT - Nodular fasciitis, fibromatosis, fibrosarcoma, malignant fibrous histiocytoma
30
Gene associated with solitary fibrous tumor
NAB2-STAT6 gene
31
What are the reactive hyperplasias? (PPT NI DOC)
Pyogenic granuloma Peripheral giant cell granuloma Peripheral fibroma Focal fibrous hyperplasia
32
Location: gingiva Color: red lesions Histopath: high vasularity, fibroblastic
Pyogenic granuloma Periapical giant cell granuloma
33
Color: same with gingival/surrounding tisues Histopath: avascular, fibroblastic
Peripheral fibroma Focal fibrous hyperplasia
34
Hyperplastic granulation tissue predominantly on the gingiva
Pyogenic granuloma
35
Exuberant connective tissue proliferation to a known stimulus or injury
Pyogenic granuloma
36
Appears as red mass because it is composed of hyperplastic granulation tissue in which capillaries are very prominent
Pyogenic granuloma
37
2nd decade of life Commonly seen on the attached gingiva Tongue, lower lip, buccal mucosa are most common
Pyogenic granuloma
38
Histopath of pyogenic granuloma
Lobular mass of hyperplastic granulation tissue Vascularization Neutrophils, ulceration ay be present
39
DD of pyogrnic granuloma
Peirpheral GCG Peripheral dontogenic fibroma Peripheral ossifying fiboma Kasposi sarcoma Metastatic cancer
40
Treatment of pyogenic granuloma
Surgical excision Removal of local etiologic factor
41
Reactive localized proliferation of mononuclear cels and osteoclasts (multinucleated giant cells) in a vascular stroma located in the soft tissue soft gingiva or alveolar ridge mucosa
Peripheral giant cell granuloma
42
Scattered fibrblasts are the basic element Non0functional osteoclast like multinucleated giant cells
Peripheral giant cell granuloma
43
Essential diagnostic criteria of peripheral giant cell granuloma
Located on gingiva/alveolar ridge cellular mononuclear stroma clustered osteoclasts Hermorrhage No origin from underlying intraosseous giant cell granuloma
44
DD of peripheral giant cell granuloma
Pyogenic granuloma Bone resorption in PGCG than PG
45
Treatment for PGCG
Surgical excision m underlying bone may be reduced to minimize recurrence Removal of local etiologic factors
46
IHC for nerve sheath tumor
S-100 Neurofilament
47
IHC for myofibroma
Muscle actin
48
IHC for leiomyoma/saarcoma
Muscle actin Desmin
49
Rhabdomyoma/sarcoma
Muscle actin Desmin
50
IHC for fibrous histiocytoma and malignant counterpart
All negative
51
IHC for solitary fibrous tumor
CD34 CD99
52
IHC for kaposi sarcoma
CD31 Tumor is also positive for HHV-8
53
Most common soft tissue sarcoma
Fibrosarcoma
54
Considered now as rare malignant spindle cell tumor represented a range of spindle cell malignancies
Fibrosarcoma
55
Soft tissue and bone malignancy of the head and neck Proloferstion of malignant mesencymal cells Secondary ulceration Young adults are commonly affected
Fibrosarcoma
56
exhibits malignant-appearing fibroblasts, typically in a herringbone or interlacing fascicular pattern Collagen may be sparse, and mitotic figures frequent. Atypical spindle cells
Fibrosarcoma
57
5 year survival rate: 30-50%
Fibrosarcoma

Oral Path 2 Finals (9 decks)

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