Pathology of the Oral Cavity & Salivary Glands

Question 1

This disorder is inflammation of the salivary glands that causes swelling, xerostomia (dry mouth), and trismus (inability to open mouth).

Answer 1

Sialidentitis - usually due to salivary stones or post-operation dehydration

Question 2

How does mucoepidermoid carcinoma differ from benign salivary gland tumors?

Answer 2

More rapid-growing, may or may not include pain, may or may not involve the facial nerve

Question 3

Viral causes of oropharynx squamous cell carcinoma have surpassed tobacco and alcohol. What viruses are most associated with oropharynx squamous cell carcinoma?

Answer 3

HPV 16 & 18

Question 4

Hairy leukoplakia is due to immunosuppression or viral infection. What viruses are associated with the oral pathology?

Answer 4

HIV, EBV

Question 5

What is the malignant variant of leukoplakia?

Answer 5

Squamous cell carcinoma

Question 6

True/False. Larger glands are more associated with malignant tumors.

Answer 6

False. Malignancy is more associated with small glands (sublingual). Larger glands (parotid) are more likely to have benign tumors.

Question 7

Pain associated with sialolithiasis (improves/worsens) with eating.

Answer 7

Worsens - thinking about food or eating stimulates saliva production, which causes pain due to stones

Question 8

Why are surgical interventions for parotid tumors rare?

Answer 8

The facial nerve runs through the gland

Question 9

How does a canker sore differ from a cold sore?

Answer 9

Canker sores are oral ulcers often due to stress. Cold sores are due to primary or reactivation of an HSV-1 infection.

Question 10

What is the most common salivary location of pleomorphic adenoma?

Answer 10

Parotid gland

Question 11

This benign oral pathology has a red, velvety appearance and is highly associated with alcohol, tobacco, and carcinogens.

Answer 11

Erythroplakia

Question 12

What marker can be used to measure HPV-mediated squamous cell carcinoma in the head and neck?

Answer 12

p16 - tumor suppressor that inactivates CDK4 to prevent phosphorylation of Rb. Production of p16 is increased due to stimulation of the cell cycle by E7

Question 13

This benign oral pathology is caused by an autoimmune disorder that destroys the basal cell layer and gives a “sawtooth” pattern or “Lacy White lines” to the mucosa.

Answer 13

Lichen Planus

Question 14

What pathogen is the most common cause of oral candidiasis?

Answer 14

Candida albicans

Question 15

An individual with recurrent aphthous ulcers is given this diagnosis.

Answer 15

Sutton’s Disease - 5+ episodes per year

Question 16

True/False. Pharyngitis generally has a bilateral onset.

Answer 16

True - if only one side if effected, other diagnoses should be considered

Question 17

What is the treatment for oral candidiasis?

Answer 17

Nystatin

Question 18

Disruption of cell cycle regulatory steps contributes to malignancy. What molecules are implicated in this process?

Answer 18

Cyclin-CDK4 (phosphorylates Rb) & p53

Question 19

At what stage do cancerous cells invade the basement membrane?

Answer 19

Invasive carcinoma

Question 20

What HPV proteins are implicated in tumor pathogenesis? What are their functions?

Answer 20

E6 - degrades p53
E7 - binds to and inhibits Rb so E2F continues to stimulate the cell cycle

Question 21

What is the most common benign tumor of the salivary glands?

Answer 21

Pleomorphic adenoma

Question 22

This cystic tumor has essentially no risk of malignant transformation and is the second most common parotid gland tumor.

Answer 22

Warthin’s tumor

Question 23

How does Warthin’s tumor differ from pleomorphic adenoma?

Answer 23

Warthin’s tumor is cystic, may appear bilaterally, and is associated with smoking

Question 24

What is the most common benign tumor of the oral cavity and oropharynx?

Answer 24

Squamous Papilloma

Question 25

What is the clinical presentation of pleomorphic adenoma?

Answer 25

Slow-growing, unilateral, firm, painless salivary gland

Question 26

Leukoplakia is a white patch or plaque in the oral cavity that cannot be scratched off. What is the treatment?

Answer 26

Leukoplakia is always due to some other underlying etiology (irritation, smoking, infection). The underlying cause must be treated and lesion removed.

Question 27

What risk factors are most associated with squamous cell carcinoma of the oral cavity?

Answer 27

Tobacco, alcohol

Question 28

This benign oral pathology is due to abnormal misfolded fibrillar proteins and is diagnosed with apple-green birefringence on Congo Red stain.

Answer 28

Amyloidosis

Question 29

What is an aphthous ulcer?

Answer 29

Canker sore - ulcer of the non-keratinized oral mucosa often due to stress

Question 30

What is the most common malignant salivary gland tumor?

Answer 30

Mucoepidermoid carcinoma

Question 31

What is Behcet Syndrome?

Answer 31

Recurrent aphthous ulcers, genital ulcers, and uveitis (ocular inflammation).

Question 32

With what virus is squamous papilloma most associated?

Answer 32

HPV 6 & 11

Question 33

How can oral candidiasis be differentiated from hairy leukoplakia?

Answer 33

Oral candidiasis can easily be scrapped off, but hairy leukoplakia cannot.