Oral pathology
Oral pathology is a domain of dentistry. In the context of anatomical pathology, it can be lumped with head and neck pathology.
Odontogenic tumours and cysts
Main article: Odontogenic tumours and cysts
Oral neoplasms
Peripheral fibroma
- AKA focal fibrous hyperplasia, AKA peripheral ossifying fibroma, AKA fibroid epulis (old term), AKA fibroepithelial polyp.[1]
- AKA oral fibroma.[2][3]
General
- Most common oral cavity tumour.[3]
- Female predominance (female:male = 2:1), usually 30-50 years old.[3]
- Multiple oral fibromas may be seen in Cowden disease.[4][5]
- Histologically similar to fibrous papule.[6]
Microscopic
Features:[6]
- 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.[3]
Pigmented lesions of the oral cavity
A brief DDx of pigmented lesions:[7]
- 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.[7]
- Presence of find (smoking) dose-dependent, i.e. longer heavier smokers are more likely to have it.
Gross
- Typically labial gingvia or buccal mucosa.[7]
Microscopic
Features:
- Basal melanosis.
- +/-Melanin incontinence.
Image:
See also
References
- ↑ 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.
- ↑ 3.0 3.1 3.2 3.3 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.
- ↑ 6.0 6.1 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.
- ↑ 7.0 7.1 7.2 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.