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Oral Pathology II > Final Exam - Lesions > Flashcards

Final Exam - Lesions Flashcards

1
Q
  1. 14 y/o boy presents with unsightly appearance of his gums. Generalized overgrowth of his gingival tissues. Growth is firm to palpation.

Differential diagnosis?

A
  • Gingival hyperplasia
    • Medications (dilantin, Ca+ channel blockers, cyclosporine, phenytoin)
  • Leukemia
  • Benign neoplasm
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2
Q
  1. 79 y/o whit female had remaining teeth removed for dentures. At follow-up she presents with 2cm yellowish-red mass growing from an extraction socket on left posterior mandible. Currently being treated for gastric carcinoma.

Differential diagnosis?

A
  • Epulis granulomatosum AKA pyogenic granuloma
  • Gianct cell granuloma
  • Metastatic tumor
  • Osteomyelitis
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3
Q
  1. ***ON FINAL*** 19 y/o African American male woke up with a raised lump of his lower labial mucosa. Lesion seemed to change size, going up and down. Lesion was 2cm, soft and compressible.

Differential diagnosis?

A
  • Mucocele
  • Salivary gland cyst (wouldn’t appear in a day)
  • Hemangioma (more common in 1st 10 years of life)
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4
Q
  1. ***ON FINAL*** 19 y/o African American male woke up with a raised lump of his lower labial mucosa. Lesion seemed to change size, going up and down. Lesion was 2cm, soft and compressible.

To prevent recurrence, what must you keep in mind when removing the lesion?

A
  • Excision - be sure to remove the adjacent salivary glands because you cannot tell which one has the broken duct
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5
Q
  1. 68 y/o female requested to have a bump removed on her cheek. 1-12cm firm nodule in right buccal mucosa. Lesion was sessile, and mucosa overlying lesion was normal color.

Differential diagnosis?

A
  • Fibroma
  • Neurofibroma
  • Mucocele (not right if it’s been there a long time)
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6
Q
  1. 68 y/o female requested to have a bump removed on her cheek. 1-12cm firm nodule in right buccal mucosa. Lesion was sessile, and mucosa overlying lesion was normal color.

What’s the difference between a tumor and a neoplasm?

A
  • Neoplasm = abnormal growth of cells that can be benign or malignant.
  • Cells that form a lump or mass that the eye can see is referred to as a tumor.
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7
Q
  1. 57 y/o white male found a 2cm raised, reddish lesion of the lateral border of his tongue. He stated the lesion has been present for some time.

Differential diagnosis?

A
  • Oral malignant melanoma
  • Hemangioma (usually seen in kids, but adults rarely)
  • Squamous cell carcinoma (best location)
  • Kaposi’s Sarcoma
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8
Q
  1. 57 y/o white male found a 2cm raised, reddish lesion of the lateral border of his tongue. He stated the lesion has been present for some time.

What lesion and condition must be considered when patients present with intra-oral vacular lesions?

A
  • Kaposi’s sarcoma - which can infer that the patient has HIV/immunocompromised
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9
Q
  1. 57 y/o white male found a 2cm raised, reddish lesion of the lateral border of his tongue. He stated the lesion has been present for some time.

Do you consider this to be a neoplasm or a hamartoma?

A
  • Hamartoma - tend to be benign tissue that grow in abnormal configuration.
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10
Q
  1. ***ON FINAL*** 14 y/o white female presents with localized overgrowth of her gingiva. A 4 x 5cm mass, with surface ulceration on anterior right maxilla. Lesion was painless and has been present for a couple weeks.

What are the 4 localized gingival over-growth lesions this could be?

A
  1. Pyogenic granuloma
  2. Irritation Fibroma
  3. Peripheral giant cell granuloma
  4. Peripheral ondontogenic (ossifying) granuloma
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11
Q
  1. ***ON FINAL*** 14 y/o white female presents with localized overgrowth of her gingiva. A 4 x 5cm mass, with surface ulceration on anterior right maxilla. Lesion was painless and has been present for a couple weeks.

What is the nature of all these lesions?

A

They are reactive rather than neoplastic (either benign or malignant - and usually the result of hyperplasia)

These also recur very often and have a stimulus such as plaque or physical irritation that can bring them back.

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12
Q
  1. One patient returns for recall after 2 years. Removing the dentures you notice her hard palate is erythematous and has multiple small pebbly elevations (bumpy, hyperplastic, asymptomatic).

Provisional diagnosis?

A
  • Inflammatory papillary hyperplasia
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13
Q
  1. One patient returns for recall after 2 years. Removing the dentures you notice her hard palate is erythematous and has multiple small pebbly elevations (bumpy, hyperplastic, asymptomatic).

What is the etiology of this condition and how should you treat it?

A
  • Flat and red - candidiasis
  • Bumpy and red - papillary hyperplasia
  • Ill-fitting denture, reline or re-make denture
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14
Q
  1. 58 y/o white female came for new dentures. Along the facial borders on the lower denture there are large folds of firm tissue.

Differential diagnosis?

A
  • Epulis fissuratum
  • Fibroma
  • Pyogenic granuloma
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15
Q
  1. 26 y/o white female has a white, exophytic papillary lesion on the right dorsal surface of her tongue. Lesion was pedunculated and patient said it has been there for years.

Differential diagnosis?

A
  • Squamous papilloma - subset of HPV
  • Condyloma acuminatum - genital warts
  • Verruca vulgaris - common warts
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16
Q
  1. 26 y/o white female has a white, exophytic papillary lesion on the right dorsal surface of her tongue. Lesion was pedunculated and patient said it has been there for years.

Define Neoplasm, Pedunculated, Sessile, Exophytic.

A
  • Neoplasm - abnormal mass of tissue that results when cells divide more than they should or not die when they should.
  • Pedunculated - lesion attached with a narrow, stalk-like base
  • Sessile - fixed, not movable
  • Exophytic - grows outward beyond surface epithelium from which it originates
17
Q
  1. A 67 y/o female developed a crusted lesion on left lower lip. Lesion has continued to expand over the course of a year, now at 12cm ulcerated nodule. Firm and fixed to surrounding tissue.

Differential diagnosis?

A
  • Squamous cell carcinoma
  • Basal cell carcinoma
  • Deep fungal infection
18
Q
  1. A 67 y/o female developed a crusted lesion on left lower lip. Lesion has continued to expand over the course of a year, now at 12cm ulcerated nodule. Firm and fixed to surrounding tissue.

What is the etiologic factor linked to this lesion?

A
  • Carcinoma orginates in cells of the stratum spinosum and clinically appears as a scaly plaque, erythematous, with invasion of underlying tissues.
  • Ulcer is the precursor for this lesion
19
Q
  1. ***ON FINAL*** A 63 y/o alcoholic male presents with a 5 cm mass of the left lateral border of his tongue. Predominantly exophytic, it is fixed to the deeper musculature of the tongue. Surface is ulcerated and necrotic.

Differential diagnosis?

A
  • Oral squamous cell carcinoma
  • Verrucous carcinoma
  • Sarcoma
20
Q

What is the one factor that distinguishes benign neoplasms from malignant?

A

The ability to metastasize

21
Q
  1. A 56 y/o white female presents with a whitish, exophytic, papillary growth of the attached gingiva around a lower premolar. Lesion had been present for about a year, but not painful. History of snuff usage (48 years).

Differential diagnosis?

A
  • Verrucous carcinoma (snuff dippers cancer)
  • Proliferative verrucous leukoplakia
  • Squamous papilloma
22
Q
  1. A 53 y/o african american male presents with a slightly raised 1cm mass in substance of the right lateral border of his tongue. Lesion is firm and somewhat fixed to surrounding structures. Surface mucosa is normal color, but has lost papillae.

Differential diagnosis?

A
  • Granular cell tumor
  • Squamous cell carcinoma
  • Lymphoma
23
Q
  1. A 9 y/o male present with 10cm mass of right maxillary mucobuccal fold. Lesion has grown rapidly over past 4 weeks.

Differential diagnosis?

A
  • Rhabdomyosarcoma (poor prognosis)
  • Squamous cell carcinoma
  • Metastatic malignancy
24
Q

Differentiate between carcinoma and sarcoma.

A
  • Carcinoma - cancers that develop from epithelial cells (usually ectoderm or endodermal origin)
  • Sarcoma - cancers arising from mesenchymal origin (bone, cartilage, fate, muscle, vasculature, or hemopoietic tissues - and more common in children)
25
Q

Name the following malignancies of:

  1. Fibrous connective tissue
  2. Bone
  3. Glandular tissue
  4. Adipose tissue
  5. White blood cells
A
  1. Fibrosarcoma
  2. Osteosarcoma
  3. Adenocarcinoma
  4. Liposarcoma
  5. Leukemia
26
Q
  1. A 27 y/o african american had a painless, freely movable, 2-3cm nodule on his upper lip. It was slowly growing and has been there for 8 months.

Differential diagnosis?

A
  • Neurilemoma (Schwannoma)
  • Neurofibroma
  • Pleomorphic adenoma
27
Q
  1. A 15 y/o white female noticed a bump in the roof of her mouth for about a month. 2-3cm submucosal mass in posterior-lateral hard palate on the right. Overlying mucosa was intact.

Differential diagnosis?

A
  • Benign pleomorphic adenoma
  • Neurofibroma in early stages
  • Osteolipoma or sialolipoma of the palate
28
Q

What are the 4 basic tissues of the body?

A
  1. Epithelial tissue
  2. Connective tissue
  3. Muscle tissue
  4. Nervous tissue
29
Q
  1. A 56 y/o female developed a rapidly growing mass of her right posterior-lateral hard palate. Lesion was 4 cm in diameter, ulcerated and painful.

Differential diagnosis?

A
  • Adenocystic carcinoma
  • Benign salivary gland tumor
  • Adenocarcinoma
30
Q
  1. A 56 y/o female developed a rapidly growing mass of her right posterior-lateral hard palate. Lesion was 4 cm in diameter, ulcerated and painful.

What is the prognosis of this disease in terms of 5 year survival?

A
  • Very good for 5 year survival, poor for 20 years - due to RECURRENCE!

Oral Pathology II (5 decks)

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