Difference between revisions of "Oral pathology"
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*Overlying (squamous) mucosa benign (flat). | *Overlying (squamous) mucosa benign (flat). | ||
**+/-Hyperkeratosis +/-focal ulceration.<ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | **+/-Hyperkeratosis +/-focal ulceration.<ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | ||
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<pre> | |||
TONGUE LESION, BIOPSY: | |||
- FIBROMA. | |||
</pre> | |||
=Pigmented lesions of the oral cavity= | =Pigmented lesions of the oral cavity= | ||
Revision as of 16:00, 19 December 2012
Oral pathology is a domain of dentistry. In the context of anatomical pathology, it can be lumped with head and neck pathology. Oral lesions redirects here.
Odontogenic tumours and cysts
Main article: Odontogenic tumours and cysts
Oral infections
Oral candidiasis
General
- Due to candida - a fungus.
- May be associated with immunodeficiency, e.g. AIDS, organ transplant/immunosuppression.
Forms:[1]
- Pseudomembranous (thrush).
- Erythematous.
- Hyperplastic.
Microscopic
- See candidiasis.
Hairy leukoplakia
General
Features:[1]
Gross
- White confluent patches (icing sugar) - usu. tongue.
DDx:
- See leukoplakia.
Images:
Microscopic
Features:[4]
- Hyperkeratosis (thicker stratum corneum).[5]
- Acanthosis (thicker stratum spinosum).[6]
- "Balloon cells" in upper stratum spinosum - perinuclear clearing.
Oral neoplasms
Peripheral fibroma
- AKA focal fibrous hyperplasia, AKA peripheral ossifying fibroma, AKA fibroid epulis (old term), AKA fibroepithelial polyp.[7]
- AKA oral fibroma.[8][9]
General
- Most common oral cavity tumour.[9]
- Female predominance (female:male = 2:1), usually 30-50 years old.[9]
- Multiple oral fibromas may be seen in Cowden disease.[10][11]
- Histologically similar to fibrous papule.[12]
Microscopic
Features:[12]
- Fibrous stroma - key feature.
- "Very pink" at low power.
- +/-Collagen bundles, may be prominent.
- Prominent (dilated) vessels.
- Overlying (squamous) mucosa benign (flat).
- +/-Hyperkeratosis +/-focal ulceration.[9]
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TONGUE LESION, BIOPSY: - FIBROMA.
Pigmented lesions of the oral cavity
A brief DDx of pigmented lesions:[13]
- Diffuse & bilateral:
- Peutz-Jeghers syndrome.
- Addison's disease.
- Drug-induced.
- Smoker's melanosis.
- Focal:
- Vascular lesions.
- Amalgam tattoo.
- Melanocytic lesions.
- Melanotic macule.
- Blue nevus.
- Malignant melanoma.
Smoker's melanosis
General
- Benign.
- Seen in ~20% of smokers.[13]
- Presence of find (smoking) dose-dependent, i.e. longer heavier smokers are more likely to have it.
Gross
- Typically labial gingvia or buccal mucosa.[13]
Microscopic
Features:
- Basal melanosis.
- +/-Melanin incontinence.
Image:
Intramucosal melanocytic nevus
- Abbreviated IMN.
- AKA intramucosal melanocytic nevus.
General
- Most common oral nevus.[14]
- Second most common is the blue nevus.
- Essentially an intradermal melanocytic nevus.
Microscopic
Features:
- Symmetrical lesion.
- "Matures" with depth
- Less cellular with depth
- Less nuclear atypia with depth.
- Smaller cells with depth.
- Smaller nests with depth.
- Rare mitoses (superficial).
- No deep mitoses.
- No destruction of surrounding structures.
- No nucleoli.
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PALATE LESION, PUNCH BIOPSY: - INTRAMUCOSAL MELANOCYTIC NEVUS.
See also
References
- ↑ 1.0 1.1 Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 777. ISBN 0-7216-0187-1.
- ↑ Kanitakis, J.; Zambruno, G.; Marchand, C.; Perret-Liaudet, P.; Hermier, C.; Thivolet, J. (1990). "[Oral hairy leukoplakia in AIDS. Histologic and ultrastructural study of 8 cases].". Ann Dermatol Venereol 117 (5): 345-53. PMID 2169222.
- ↑ Itin, PH.; Lautenschlager, S. (1997). "Viral lesions of the mouth in HIV-infected patients.". Dermatology 194 (1): 1-7. PMID 9031782.
- ↑ URL: http://www.pathologyoutlines.com/oralcavity.html#hairyleukoplakia.
- ↑ URL: http://www.emedicine.com/asp/dictionary.asp?keyword=hyperkeratosis.
- ↑ URL: http://www.emedicine.com/asp/dictionary.asp?keyword=acanthosis.
- ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 775. ISBN 978-0781779425.
- ↑ URL: http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3. Accessed on: 20 August 2012.
- ↑ 9.0 9.1 9.2 9.3 Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 240. ISBN 978-0443069604.
- ↑ Segura Saint-Gerons, R.; Ceballos Salobreña, A.; Toro Rojas, M.; Gándara Rey, JM. (Aug 2006). "Oral manifestations of Cowden's disease. Presentation of a clinical case.". Med Oral Patol Oral Cir Bucal 11 (5): E421-4. PMID 16878060.
- ↑ Oliveira, MA.; Medina, JB.; Xavier, FC.; Magalhães, M.; Ortega, KL. (2010). "Cowden syndrome.". Dermatol Online J 16 (1): 7. PMID 20137749.
- ↑ 12.0 12.1 Fernandez-Flores, A. (Jul 2010). "Solitary oral fibromas of the tongue show similar morphologic features to fibrous papule of the face: a study of 31 cases.". Am J Dermatopathol 32 (5): 442-7. doi:10.1097/DAD.0b013e3181c47142. PMID 20421776.
- ↑ 13.0 13.1 13.2 Kauzman, A.; Pavone, M.; Blanas, N.; Bradley, G. (Nov 2004). "Pigmented lesions of the oral cavity: review, differential diagnosis, and case presentations.". J Can Dent Assoc 70 (10): 682-3. PMID 15530266.
- ↑ URL: http://emedicine.medscape.com/article/1079272-overview. Accessed on: 10 December 2012.