Oral Cancer with Histopathology Flashcards
What does the term ‘potentially malignant disorder’ mean?
- Altered tissue or generalised state which cancers are more likely to form
- Encompasses the terms ‘potentially malignant LESION and CONDITION’
In the UK, what is the clinically appearance of tissues which carcinomas are most likely to arise?
NORMAL MUCOSA
In higher incidence areas (e.g. India), what is the clinically appearance of tissues which carcinomas are most likely to arise?
POTENTIALLY MALIGNANT LESIONS
leukoplakia, erythroplakia etc.
What are the predictors of malignancy in leukoplakia?
- Idiopathic
- Older men
- FOM and tongue high risk
- Non-homogenous appearance (irregular)
HISTOLOGICALLY
- Dysplasia
- Atrophy
- Candidal infection (indicator as fungal infections thrive in abnormal epithelial cells_
Which has a higher risk of malignancy, erythroplakia or leukoplakia?
ERYTHROPLAKIA
What are the histological predictors of malignancy in erythroplakia?
- Epithelial dysplasia
- Architectural changes
- Abnormal maturations
- Cytological abnormalities
- Cellular atypia (individual cells)
What is the difference between ‘grading’ and ‘staging’
Grading = HISTOLOGICALLY
Staging = CLINICALLY
What are the WHO’s (2005) classification of histological grading?
- Hyperplasia
- Dysplasia (mild, mod, severe)
- Carcinoma-in-situ
What is basal hyperplasia?
- Increase in NUMBER of cells in basal layer of epithelium
- Regular stratification but basal compartment larger
- NO cellular atypia
What is MILD dysplasia?
- Changes seen in LOWER 1/3 of epithelium
- MILD atypia =
- -> Pleomorphism (change in size and shape of nuclei and/or cell)
- -> Hyperchromatism (darker stain, more DNA)
- -> Basal cell hyperplasia
Most cases regress after irritating stimulus removed (e.g. smoking cessation)
What is MODERATE dysplasia?
- Change seen in LOWER 2/3 of epithelium
- MODERATE atypia = pleomorphism, loss of polarity, hyperchromatism
What is SEVERE dysplasia?
- Changes in UPPER 1/3 of epithelium (into granular layer)
- SEVERE atypia =
- -> Mitotic figures
- -> Cells develop autonomy (inappropriate keratin)
- -> Loss of polarity
- -> Pleomorphism
- -> Hyperchromatism
List some potentially malignant SYSTEMIC conditions
- Lichen planus (erosive variants)
- Oral submucosal fibrosis (betel nut chewing)
- Iron deficiency (atrophy of all epithelium, susceptible to carcinogens)
- Tertiary syphilis (high risk in oral cav)
List some oral epithelial tumours
- Squamous cell papilloma (benign, oral, HPV, wart)
- Squamous cell carcinoma (malignant, older age, risk factors; smoking, betel nut, alcohol, diet, viruses, immundef)
- Lower lip cancer (non-healing ulcer/ swelling, UV exposure, slow growth, local invasion, rare node metastasis)
What are some genetics involved in the development of cancers?
- Onogenes (GF)
- P53 (apotosis regulator)
- Tumour supressor genes
- miRNA
