Os Flashcards Preview

PathCB > Os > Flashcards

Flashcards in Os Deck (19):
1

benign hyperkeratosis

thickening of epi with prod of orthokeratinw/o dysplasia

mechanical, chemical, or idopathic

differential: premalignant dysplasia, carcinoma in situ, verrucus carcinoma, invasive carcinoma, lichen planus, cnadida

mthicker keratinocyte layer

tx: remove irritant no response within 2 weeks biopsy and 6 months recall

 

2

pyogenic granuloma

proliferative inflammatory respinse to loca infection irritant or foreign body

predilection to small female during pregnancy " pregnancy tumor"

sof fleshy easily bleeding mass,in papillae but also lips tongue buccal mucosa

defferential: peripheral giant cell, peripheral ossifying fibromas, squamous cell carcinoma

tx: rule out pregnancy excise with 2mm margins , remove foreign body or infenction

A image thumb
3

Cat-Scratch disease

necrotizing lymphadenitis by Bartonella henselae

children young associated with kittens and cats younger than 1 yr

lymph nodes firm painless lobulates adhered together, location in scratch not in drainage field, node can go liquifactive necrosis( mild pain and may drain pus)

differential: squmous cell carcinoma lymphadenitis, tuberculous lymphadenitis, hodkin, non hodkin, mononucleosis 

tx: obtain serum cat scratch antigenfor Bartonella -> + treat with Erythromycin or doxycycline to prevent liquifactive necrosis, if necrosis incision and drainage or complet removal

 

A image thumb
4

Apthous Stomatitis

aka canker ulcer, last 5-14 days

leukoclastic vasculitis where antibodies to either Strep Sanguisor mucous membrane epi elicit intense local neutrophil response

Minor: discrete yellow fibrin based, may report predromalstage of pruritis, pain

Major: larger may last several months

differential: recurrent herpes vesicles, ulcers of Behcet syndrome

surface infiltrated with neutand deeper with lynphocytesand macrophages

tx: Minor: topical silver nitrat, pheno, cautery or chlorohexidine

respond well to tetracycline family and prednisone therapy

 

A image thumb
5

Radicular Cyst

etiology

clinical

ddx

tx

aka apical periodontitis

etiology: bacterial toxins leach out of apex -> rest of Malasex stimulated proliferate and form lumen 

clinical : acute pain percusion, chronic asympt, radilucency 

ddx : osteoporotic bone marrow defects, early odontogenic tumors

tx : RCT , extraction

A image thumb
6

cells responsible for periodontal cysts

rest of malassez

A image thumb
7

all cyst defined as?

pathological cavity lined by epithelium

8

Dentigerous Cyst

etiology

clinical

ddx

tx

etiology : pathological cavity lined by REDUCED ENAMEL epi after corwn formation and desintegration of Stellate reticulum. teens and Young adults

clinical ; expansion of the jaw, clinical missing tooth, radiolucency associated with unerupted tooth, mand canal displaced toward inferior border, max tooth maybe discplaced to sinus

ddx:  ameloblastoma, adenomatoid odontogenic cyst, odontogenic keratocysts

tx: aspiration, exploration and incisional biopsy -> enucleation and curettage 

A image thumb
9

Lateral Periodontal Cyst

etiology

clinical

ddx

tx

etiology:  cyst from rest of malassez, female adults predilection on premolars

clinical:  buccolingual expansion, divergent roots tipping crowns tooth mobility. 

ddx: Odontogenic keratocyst, 

tx: removal via enucleation and curettage or peripheral resection 0.5 cm margins for recurrents

A image thumb
10

Residual Cyst

etiology

clinical

ddx

tx

etiology:  cyst after tooth removal or attempted cyst removal

clinical:  asympt and maybe expansion with intact mucosa, histo cholesterol clefts aka Rushton bodies

ddx:  odontogenic tumors, 

tx: exploration removal  enucleation and curettage

A image thumb
11

Rushton bodies

cholesterol clefts along cllections of hyeline

A image thumb
12

Proliferative verrucous Leukoplakia PVL

etiology

clinical

ddx

tx

etiology:  from benign leukoplakia of only hyperkeratosis though verrocous hyperplasia carcinoma invasive SCC and final extremely aggresive 

clinical 

ddx candidasis, lcihen planus,squamous cell carcinoma

tx,  incisional biopsy, excise and skin graft, chemoprevention slows down oral nystatin, 

A image thumb
13

 

Verrucous Carcinoma

etiology

clinical

ddx

tx

etiology:  noninvasive nonmetastasizing  proliferation of malignant epi cells smokeless tabacco use

clinical: re/white velvet texture, asymptomatic

ddx: benign hyperkeratosis,  squamous papillomas, invasive squamous cell carcinoma

tx incisional biopsy,  excision 1 1.5 cm margin controlled by frozen sections

14

Odontogenic Keratocyst

etiology

clinical

ddx

tx

etiology: from odontogenic epithelium from dental lamina rest ( rest of Serres), Hertwing epi rooth sheath ( rest of Malassez, or reduced enamel epi , mandibular molars

clinical: painless expansion in either jaw, multi or uniocular premolar areas, displaced roots, sinus floor and or mandibular canal

ddx: if multiocular consider ameloblastoma, odontogenic myxoma, central giant cell tumor or cental hemangioma, if uniocular and unerupted tooth consider dentigerous cyst

tx aspiration followed by incisional biopsy, enucleation

A image thumb
15

Ameloblastoma

 

etiology

clinical

ddx

tx

etiology: rom odontogenic epithelium from dental lamina rest ( rest of Serres), Hertwing epi rooth sheath ( rest of Malassez) or epi of dentigerous cyst, increase in black african15-35 yo, mandibular third molar

clinical: painless expansion withour paraesthetia , multioccular thinned cortex

ddx OKC, odontogenic myxoma, central giant cell tumor

tx: aspiration, resection 1 cm marginsbone graft, enucleation and curetage, implant dentistry

A image thumb
16

Leukoplakia

etiology

clinical

ddx

tx

etiology: white patch oral mucosa, acanthosis/hyperkerathosis, candida or fibrin, 

clinical: white patch on buccal mucosa, lateral border of the tongue or floor of mouth

ddx. lichen planus, premalig dysplasias, carcinoma in situ, verucous carcinoma

tx: 3 entities

1: fibrin: thin strands of eosinophilic stainng ovr wound

2: Candida: vertically positioned hyphae with prominent periodic acid Schiff or silver stain

3 Acanthosis/hyperkera: premalignant: atypia with intact basement membrane. Carcinoma in situ: sever dysplasia with nuclear pleomorphism and abnormal mitotic figures from basal layer to surface. Verrucous carcinoma: significant exophytic proliferation and blunted endophytic proliferation but intact basement membrane beneath with dense inflammatory response. Invasive Carcinoma: atypical epi cells forming bundles thorugh membrane and underlying tissues

 

A image thumb
17

Peripheral Ossifying Fibroma

etiology: 

clinical

ddx

tx

etiology: benign reactive proliferation of fibroblast from PDL that retained ability to produce bone, common in young and women

clinical: pedunculated firm mass from interdental papillae, some might show widened PDL, 

ddx: pyogenic granuloma, peripheral giant cell proliferation, squamous cell carcinoma, 

tx: excise with 2 mm margins and base

A image thumb
18

acute necrotizing ulcerative gingivitis

etiology: 

clinical

ddx

tx

etiology: rapid painful bacteria infection by Fusobacterium and Spirochetes

clinical: pain, foul odor, gingiva red puffy, friable, gingival papillae loss replace by pseudomembrane -> necrosis. radiographic bone loss

ddx:  acute herpetic gingivostom, pemphigus, erosive lichen planus, lichenoid drug eruption

tx : debride and 5 day course antibiotic

A image thumb
19

odontogenic fibroma 

etiology: 

clinical

ddx

tx

etiology:  benign tumor from mesenchymal from dental papilla

clinical: teen and young, painless mass in either jaw, possible tooth mobility and displacement, radiograph: well deliniated expansible uniocilar radiolucensy, thinned cortex, mircoscopic moderate number fibroblast abundate collagen prod

ddx: OKC, Ameloblastic fibromas, early ossyfying fibroma

tx: exploration removal of lesion via enucleation and curretage, peripheral ressection 0.5 margins