Exam 2-Benign Neoplasms (excluding salivary gland)

Question 1

TERM: Pathologic new growth of tissue in which growth is not controlled by normal regulatory functions and which does not regress after removal of the stimulus which produced it.

Answer 1

Neoplasm

Question 2

Neoplasm: Pathologic new ______ of tissue in which growth is not controlled by normal regulatory functions and which does not ______ after removal of the stimulus which produced it.

Answer 2

Growth…regress

Question 3

Clinically can usually tell if a tumor (neoplasm) is of ________ or mesenchymal origin and whether it is benign or malignant.

Answer 3

epithelial

Question 4

What are the two types of Epithelial neoplasms?

Answer 4

HPV, and KA(Kerato-acanth-oma)

Question 5

What are the three types of neoplasms seen that have HPV origin?

Answer 5

1.Papilloma 2.Verruca Vulgaris (common wart) 3.Condyloma Acuminatum (vernerial warts)

Question 6

ALL EPITHELIAL neoplasms, of EPITHELIAL origin, caused by HPV……are _______ tumors and are treated by removal

Answer 6

benign

Question 7

What type of EPITHELIAL neoplasm has clinical and histological features similar to SKIN CANCER (squamous cell carcinoma), but are considered reactive, not neoplastic.

Answer 7

Kerato-A-Canthoma (KA)

Question 8

Since these often resemble skin cancer, _________’s are usually at sun exposed areas of the head and neck

Answer 8

kerato-a-canthoma’s

Question 9

Kerato-a-canthoma’s are typically in ______ aged patients, and only ___% are on or in the oral cavity.

Answer 9

older…10%

Question 10

hmmmm what is this describing? Rapid growth, often UMBILICATE with ROLLED borders…Natural history: Involution and healing.

Answer 10

kerato-a-canthoma

Question 11

How do you clinically tell if a benign neoplasm is mesenchymal? most look IDENTICAL clinically and present as asymptomatic, slowly growing ________ masses

Answer 11

SUBMUCOSAL

Question 12

What are the 3 types (what tissue types?) of benign neoplasms?

Answer 12

Connective, Muscle, Nervous

Question 13

What are the 3 types of Connective Tissue mesenchymal benign neoplasms?

Answer 13

1.Fibroma 2.Lipoma 3.Verru-ci-form Xanthoma

Question 14

What is the most common benign, mesenchymal, connective tissue neoplasm?

Answer 14

A fibroma

Question 15

What is a benign neoplasm of FAT, may appear yellowish, very common in skin, less so ORALLY?

Answer 15

Lipoma

Question 16

WTF!??! What is a reactive lesion with predilection for the HARD PALATE or GINGIVA?? Most common ORALLY but reported on skin and genitals….

Answer 16

VX….Verru-ciform Xanthoma

Question 17

(verrucous, “verruciform”) is just a fancy way of saying something has a WHAT?

Answer 17

surface irregularity

Question 18

A verrucifom xanthoma will change color from pink to _______

Answer 18

white

Question 19

Who’s histology?? Epithelium displays papillary hyperplasia. Connective tissue papillae contain phagocytic cells which have engulfed lipid (xanthoma cells)

Answer 19

Verrucifom Xanthoma

Question 20

What are the four types of benign neoplasms of the MUSCLE?

Answer 20

1.Leiomyoma (smooth muscle) 2.Rhabdomyoma (skeletal muscle) 3.Granular cell tumor 4. Congenital Epilus of the newborn

Question 21

Where is the most common site of a liomyoma?

Answer 21

the uterus

Question 22

What is the frequency of leiomyoma in the oral cavity? They can be reddish to ______…

Answer 22

rare….purple

Question 23

Where is the most common site of a rhabdomyoma?…Its RARE in the oral cavity, but if it does occur there…WHERE does it show up?

Answer 23

the heart….the tongue

Question 24

Originally thought to arise from muscle (granular cell myoblastoma) now thought to be of nerve origin, possibly sheath….WHAT THE F?

Answer 24

Granular Cell Tumor (benign)

Question 25

A granular cell tumor is most likely from nerve origin, esp the _______

Answer 25

sheath

Question 26

What is the most common site for a granular cell tumor?

Answer 26

tongue

Question 27

Is a granular cell tumor freely movable or fixed?

Answer 27

fixed

Question 28

Histology of a Granular Cell Tumor: Large WHAT SHAPE? cells with granular cytoplasm, about 1/2 cause overlying epithelium to react in a pattern that simulates ________ called pseudoepitheliomatous hyperplasia (PEH)

Answer 28

polygonal... carcinoma

Question 29

What is the name for a congenital tumor of the anterior alveolar ridge?

Answer 29

Congenital Epilus of the Newborn

Question 30

Which arch is more likely to see Congenital Epilus of the Newborn? Which sex?

Answer 30

Maxilla (2:1)....Females (freggin 8:1)

Question 31

Histo of Congenital Epilus of the Newborn-Identical cells to granular cell tumor but cells don't react to WHAT TYPE OF markers for nerve, No PEH (WHAT DOES THIS MEAN AGAIN??!)....May regress if incompletely "excised"

Answer 31

Immunohistochemical...(PEH..pseudo-epithiomatis-hyperplasia)

Question 32

TERM: not neoplasm but aberration of healing following trauma.....Mass of tangled regenerating nerve in scar tissue

Answer 32

Traumatic Neuroma

Question 33

Where are the two most common locations for a Traumatic Neuroma?

Answer 33

1.borders of the tongue 2.lower lip at mental foramen (PAIN ON PALPATION)

Question 34

Is there pain associated with Traumatic Neuroma?

Answer 34

YES, on PALPATION

Question 35

What is a Benign neoplasm occurring in a nerve and composed of Schwann cells, axons and fibrous tissue?

Answer 35

A NeuroFibroma

Question 36

A Neurofibroma Can occur in most tissues and organs of body, including ________, soft tissue and bone, most HAVE WHAT SYMPTOMS?

Answer 36

oral cavity...asymptomatic

Question 37

Neurofibromatosis is also called...

Answer 37

Von Recklinghausens Disease of Skin

Question 38

What is condition of neuroectoderm ranging from simple skin pigmentation to widespread involvement of central and peripheral nervous system. 1/2 inherited as autosound dominant trait, other 1/2 somatic mutations. (Gene for most on chromosome #17)

Answer 38

Neurofibromatosis: Von Recklinghausens Disease of Skin

Question 39

What is a nearfibromatosis of the eye? (Axillary freckling, pigmentary defects of iris)

Answer 39

LISCH Spots

Question 40

___-___% of patients develop malignancy in their neurofibromas.

Answer 40

1-5%

Question 41

Benign encapsulated neural neoplasm arising WITHIN the sheath or neurilemma of a peripheral nerve

Answer 41

Neurilemmoma (Schwannoma)

Question 42

Antoni A Schwannoma = _______ areas of replicated basement membrane material surrounded by Schwann cell nuclei

Answer 42

Acellular

Question 43

Haphazardly arranged spindled Schwann cells in | loose stroma =

Answer 43

Antoni B Nerilemmoma (Schwannoma)

Question 44

Melanotic _________ tumor of infancy: Neural crest tumor occurring almost exclusively in _____ but does occur in extragnathic sites.

Answer 44

neuroectodermal...jaws

Question 45

Melanotic neuroectodermal tumor of infancy: which age range and area are most affected?

Answer 45

1 year old, maxillary

Question 46

What is the immunohistochem marker found in neuroectodermalMelanotic neuroectodermal tumor of infancy???

Answer 46

VMA (VanilyMandelic Acid) found in blood and urine

Question 47

Even with aggressive cutarage, Melanotic neuroectodermal tumor of infancy has a recurrence rate of __-___%

Answer 47

10-20%

Question 48

Multiple Endocrine Neoplasia Type 3 (MEN 3): 95% of patients with mutation of _____ gene, a proto-oncogene on chromosome ___.

Answer 48

RET...10

Question 49

Multiple Endocrine Neoplasia Type 3 (MEN 3): 50% - inherited as WHAT KIND OF GENETIC problem?

Answer 49

autosomal dominant

Question 50

If half of Multiple Endocrine Neoplasia Type 3 (MEN 3)'s are inherited as AD- how do the other half occur? (hint 3 ways)

Answer 50

somatic mutations...a. Mucosal neuromas (predates other tumors) b.Medullary carcinoma of thyroid c. Pheochromocytoma of adrenal medulla

Question 51

Treatment of most benign mesenchymal tumors is _______.

Answer 51

excision