premalignant oral lesions

Question 1

What is a premalignant lesion?

Answer 1

A morphologically altered oral lesion with higher risk of transforming into oral cancer.

Question 2

What are the three possible cellular reactions to a carcinogen?

Answer 2

Hyperplasia, Atrophy, Irreversible cell damage.

Question 3

What genetic changes lead to neoplastic transformation?

Answer 3

Oncogene activation, mutations/deletions in suppressor genes and DNA repair genes.

Question 4

How are premalignant lesions identified?

Answer 4

Through clinical, morphological, and molecular means.

Question 5

What is leukoplakia?

Answer 5

A white patch on oral mucosa that cannot be diagnosed as another disease; a diagnosis of exclusion.

Question 6

Is leukoplakia a histopathologic diagnosis?

Answer 6

No, it’s a clinical term.

Question 7

What percent of oral carcinoma arises near leukoplakia?

Answer 7

More than one-third.

Question 8

How much more likely are leukoplakia patients to develop oral cancer?

Answer 8

Fivefold higher risk.

Question 9

What is the malignant transformation rate of speckled leukoplakia?

Answer 9

0.47

Question 10

Name three local etiological factors of leukoplakia.

Answer 10

Tobacco, alcohol, chronic irritation.

Question 11

Name two systemic etiological factors of leukoplakia.

Answer 11

Endocrine dysfunction, infections like HSV and HPV.

Question 12

List three clinical types of leukoplakia.

Answer 12

Homogeneous, Speckled (erythroleukoplakia), Verrucous.

Question 13

Which leukoplakia type has the highest malignant potential?

Answer 13

Speckled leukoplakia.

Question 14

What is the significance of a biopsy in leukoplakia?

Answer 14

It confirms the presence of dysplasia, carcinoma in situ, or carcinoma.

Question 15

Define epithelial dysplasia.

Answer 15

Disordered growth of epithelium with cytological and architectural atypia.

Question 16

Is dysplasia reversible?

Answer 16

Yes, if the causative stimulus is removed.

Question 17

What are the three grades of dysplasia?

Answer 17

Mild, Moderate, Severe.

Question 18

How deep does mild dysplasia extend?

Answer 18

Lower third of the epithelium.

Question 19

How deep does severe dysplasia extend?

Answer 19

More than two-thirds of the epithelium.

Question 20

What is carcinoma in situ?

Answer 20

Full-thickness dysplasia without invasion past basement membrane.

Question 21

What organism is associated with candidal leukoplakia?

Answer 21

Candida albicans.

Question 22

What is another name for candidal leukoplakia?

Answer 22

Chronic hyperplastic candidiasis.

Question 23

What are common sites for candidal leukoplakia?

Answer 23

Dorsum of the tongue and commissural buccal mucosa.

Question 24

What is seen histologically in candidal leukoplakia?

Answer 24

Hyperparakeratosis, candida hyphae, chronic inflammation, dysplasia.

Question 25

What is erythroplakia?

Answer 25

A red velvety lesion that cannot be classified as any other disease.

Question 26

How likely is erythroplakia to show dysplasia or carcinoma?

Answer 26

0.9

Question 27

What causes the red appearance of erythroplakia?

Answer 27

Increased subepithelial vessels, epithelial thinning, lack of keratin.

Question 28

What are the three types of erythroplakia?

Answer 28

Homogeneous, erythroleukoplakia, speckled.

Question 29

What is the diagnostic approach to persistent red oral lesions?

Answer 29

Biopsy after 2 weeks if not resolved.

Question 30

What syndromes cause oral epithelial atrophy?

Answer 30

Plummer-Vinson syndrome and submucous fibrosis.

Question 31

What are oral signs of Plummer-Vinson syndrome?

Answer 31

Burning tongue, angular cheilitis, atrophy of lingual papillae.

Question 32

What substance in betel nut causes submucous fibrosis?

Answer 32

Alkaloids that stimulate fibroblast proliferation.

Question 33

What is a hallmark clinical sign of submucous fibrosis?

Answer 33

Trismus and whitish-yellow mucosa.

Question 34

What causes actinic cheilitis?

Answer 34

Chronic exposure to UV light.

Question 35

Which lip is more commonly affected by actinic cheilitis?

Answer 35

Lower lip.

Question 36

What is seen histologically in actinic cheilitis?

Answer 36

Atrophic epithelium, epithelial dysplasia, collagen degeneration.

Question 37

Who is most at risk for actinic cheilitis?

Answer 37

Fair-skinned males with high sun exposure (e.g., farmers, sailors).