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Pathology II > Soft tissue differential diagnosis > Flashcards

Soft tissue differential diagnosis Flashcards

(36 cards)

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1
Q
A

pseuomembraneous candidiasis

-multiple white plaques
-wipes off leaving erythematous area
-commonly found in immunocompromised patients

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2
Q
A

Hyperplastic candidiasis

-does NOT wipe off
-leukoplakia appearance

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3
Q
A

atrophic candidiasis

-aka erythematous candidiasis
-clinically appears erythematous
-can be seen with central papillary atrophy or median rhomboid glossitis or denture stomatitis (due to poor hygiene)
-will cause a red outline on the mucosa

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4
Q
A

-bump on gums
-location: lingual gingiva
-has not displaced teeth
-no radiographic calcifications
-sessile, nodule, ulceration, erythema
-firm
-middle-aged female

BUMP ON GUMS DIFFERENTIAL DIAGNOSIS

  1. Pyogenic granuloma
  2. Peripheral ossifying fibroma
  3. Peripheral giant cell granuloma
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5
Q

What is the histology of a peripheral giant cell granuloma?

A

Chocolate chip cookies (multinucleated giant cells)

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6
Q

The histology of a pyogenic granuloma would have:

A

granulation tissue (NOT granulomatous tissue)

granulation tissue= endothelial cells, fibroblasts, myofibroblasts

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7
Q

Describe a peripheral ossifying fibroma:

A
  • reactive lesion NOT a neoplasm
  • teens + young adults
  • EXCLUSIVELY on gingiva
  • fibrous hyperplasia with OSSEOUS metaplasia (may appear radiopaque)
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8
Q
A

Peripheral ossifying fibroma

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9
Q
A

Peripheral ossifying fibroma

-may appear radiopaque due to fibrous hyperplasia with osseous metaplasia

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10
Q

Describe a peripheral giant cell granuloma:

A
  • reactive lesion NOT a neoplasm
  • older adults
  • exclusively on gingiva & edentulous alveolar ridge
  • bluish/purple due to containing hemosideran
  • may recur
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11
Q
A

Peripheral giant cell granuloma

-bluish/purple due to containing hemosideran

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12
Q
A
  • location: buccal mucosa & vestibule
  • white plaque
  • wipes off
  • not d/t trauma
  • no tobacco use
  • frequent use of aspirin due to bombed out molar

This is a chemical burn
- intraorally chemical burns look white & oral mucosa sloughs off

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13
Q
A
  • location: hard palate
  • nodule with some redness
  • soft tissue firm
  • female patient
  • not painful
  • slow growing

Differential diagnosis:
- polymorphous low grade adenocarcinoma (PLGA)
- pleomorphic adenoma
- mucoepidermoid carcinoma

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14
Q

On the hard palate there is a ton of minor salivary gland tissue, so if you have a bump/swelling/etc. there is a ____ chance that it is malignant

Another thing to consider when you have an enlargement of the hard palate is a ____

A

50/50

lymphoma

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15
Q

Most common salivary gland tumor:

A

pleomorphic adenoma (AKA benign mixed tumor)

  • middle aged females
  • painless
  • slow growing
  • mix of myoepithelial & ductal elementd
  • ENCAPSULATED
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16
Q

Differential diagnosis for bump on gum:

Study These Flashcards
A
  1. pyogenic granuloma (can occur on tongue)
  2. peripheral ossifying granuloma (exclusive to gingiva)
  3. peripheral giant cell granuloma (exclusive to gingiva)
17
Q

How would you describe this type of inflammation?

What are some differential diagnosis that present with this type of inflammation?

Study These Flashcards
A

Granulomatous inflammation
-pattern of chronic inflammation
-aggregates of epithelioid macrophages
- multinucleated giant cells
- mononuclear leukocytes
- principal lymphocytes
- occasionally plasma cells (peripherally)
- fibrosis variable

Differential diagnosis
1. Crohn’s disease
2. Deep fungal infections (example: coccidiomycosis)
3. Tuberculosis (caseous necrosis)

18
Q

How would you describe this histological slide?

What disease is seen with this type of presentation?

Study These Flashcards
A

Granulation tissue

  1. pyogenic granuloma
19
Q

List the differential diagnosis to the following presentation:

Study These Flashcards
A
  1. chemical burn (aspirin)
  2. toothpaste allergy (SLS)
  3. cheek biting (trauma)
  4. pseudomembranous candidiasis
20
Q

Where is the most common intraoral- extranodal area for lymphomas?

21
Q

You see a bump on the hard palate & upon palpating you note that it is squishy & bogging. What is a good diagnosis?

22
Q

Most common salivary gland tumor:

What is its comprised of histologically?

Study These Flashcards
A

Pleomorphic adenoma
(MC location palate)

Myopeithelial & ductal cells

23
Q

Describe how this appears histologically:

What is a likely diagnosis?

Study These Flashcards
A

Monomorphic adenoma
(MC location upper lip)

Histology
- uniform pattern
- single layered cords of columnar or cuboidal epithelium

24
Q

A malignant salivary gland tumor (the low grade version of this mimics a mucocele):

Study These Flashcards
A

mucoepidermoid carcinoma

  • most common MALIGNANT salivary gland tumor
  • middle-aged females
  • clinically mistaken for mucocele

Histology
- mucus producing cells
- epidermoid (squamous) cells
- may be cystic and/or solid

25
You note this Swiss cheese histological appearance, automatically consider:
Adenoid cystic carcinoma - best recognized salivary gland tumor - malignant salivary gland tumor - middle aged females - painful - slow growing Histology - peri neural & peri vascular invasion - myoepithelial & ductal cells - cribriform pattern
26
Histology - deceptive uniform appearance - different growth patterns - perineurial & perivascular invasion - Indian filing
Polymorphous Low-grade Adenocarcinoma (PLGA) - common malignant minor salivary gland neoplasm - middle-aged females - favors palate
27
If you see a salivary gland tumor in a kid (rare) it is most likely:
mucoepidermoid carcinoma - most common malignant salivary gland neoplasm - middle-aged females - clinically mistaken for a mucocele
28
You can see perineural & perivascular invasion in any tumor, but in the oral cavity its most commonly seen in:
1. adenoid cystic carcinoma 2. PLGA
29
Describe this lesion & give a differential diagnosis:
- sessile, ulcerated nodule located on dorsal of tongue - Differential diagnosis: 1. pyogenic granuloma 2. peripheral giant cell granuloma
30
Describe this lesion & give a differential diagnosis:
- submucosal amass, yellow, located on dorsal of tongue - Differential diagnosis: 1. fordyce granules 2. mucoele 3. squamous cell carcinoma (extremely rare to see on dorsal of tongue- MC on ventral or lateral border) - Histology: - overlying stratified squamous epithelium - proliferation of pseudomembranous hyperplasia - large pinkish cells that have granular cytoplasm - S100 stain = diffusely positive - this is NOT a mucocele because no salivary glands on dorsal of tongue - NOT fordyce granules because they are small & multiple (although they are yellow) - malignancy of muscle - sarcoma bc the tongue is a muscle - benign growth of skeletal muscle - arabdomyoma - benign growth of connective tissue - fibroma - nerve tissue benign tumor - neuroma, schwanoma, neurofibroma Actual diagnosis: granular cell tumor - most common on dorsal of tongue & a yellow-ish submucosal mass
31
Nodular blue-ish bump on tongue rather than yellow, location = dorsal of tongue:
lymphangioma
32
If a white lesion is bilateral, it will never be a ____ but ca be ___ or ____
leukoplakia; lichen planus or oral hairy leukoplakia
33
If a white lesion is unilateral, it can be:
1. leukoplakia 2. hyperplastic candidiasis 3. squamous cell carcinoma 4. epithelial dysplasia 5. carcinoma in-situ
34
If you notice an erythroplakia, the diagnosis options may be:
1. squamous cell carcinoma 2. epithelial dysplasia 3. carcinoma in situ
35
Case 1: -ulcerated nodule located on dorsal of tongue -been present for around 7 months - painful - only lesion present Differential diagnosis 1. erythrematous multiforme 2. pyogenic granuloma 3. peripheral giant cell granuloma (ruled out bc these are not found on tongue) Histology shows granulation tissue- what is this?
Pyogenic granuloma
36

Pathology II (17 decks)

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