Pathology 2 - Potentially malignant lesions Flashcards
(44 cards)
Define a potentially malignant lesion.
Altered tissue in which cancer is more likely to form
Define a potentially malignant condition.
Generalised state with increased cancer risk
Give examples of potentially malignant conditions.
- lichen planus
- oral submucous fibrosis
- iron deficiency
- tertiary syphilis
Why is an iron deficiency a potentially malignant condition?
Iron deficiency thins the mucosa which makes it easier to carcinogens to penetrate
Which lesions have a higher transformation rate?
- leukoplakia
- chronic hyperplastic candidiasis
- proliferative verrucous leukoplakia
- erythroplakia
What is chronic hyperplastic candidiasis also known as?
Candidal leukoplakia
Where is chronic hyperplastic candidiasis typically found?
Commissures of smokers
How is chronic hyperplastic candidiasis managed?
- systemic antifungal (fluconazole)
- biopsy
- smoking cessation
- observation
From where do most oral carcinomas arise in the UK?
Clinically normal mucosa
What is the transformation risk of leukoplakia?
50-100x risk than clinically normal mucosa
What factors increase the risk of transformation of leukoplakia?
- age
- female
- FOM or tongue are high risk sites
- non-homogeneous appearance
What does altered or missing p53 indicate as a molecular marker?
- p53 is a tumour suppressor gene
- changes indicate progression of a lesion
What impact does a positive result for HPV in a tumour have?
Tumours that are positive for HPV have a better prognosis than those that are negative
Define dysplasia.
Disordered maturation in a tissue
Define atypia.
Changes within cells
What can be observed in histopathology slides to aid diagnosis?
- architectural changes
- cytological abnormalities
What are the grading of epithelial dysplasia?
- hyperplasia
- mild
- moderate
- severe
- carcinoma-in-situ
Can you grade epithelial dysplasia clinically?
No - a microscopic diagnosis
Describe basal hyperplasia.
- increased basal cell numbers
- regular stratification but basal compartment is larger
- no cellular atypia (!)
Describe mild dysplasia.
- changes to architecture in lower third
- mild cellular atypia (not all cells show changes)
Define pleomorphism.
Variety of shapes and sizes of cells or cellular components
Define hyperchromatism.
Cells stain darker due to increase in DNA
Describe moderate dysplasia.
- changes to architecture extending into middle third
- moderate atypia
Describe severe dysplasia.
- architectural changes extend into more than 2/3 of epithelium
- most cells are affected by atypia
- numerous mitoses, loss of polarity and mitotic figures
