Pathology KC #6

What is the term to describe a malignant tumor in bone?

-Osteosarcoma

-Osteoma

-Lipoma

-Carcinoma

-Osteosarcoma

What is the treatment for a benign cementoblastoma?

-No treatment needed

-Surgical excision and drainage

-Enucleation of tumor and tooth extraction

-Surgery and radiation therapy follow-up

Enucleation of tumor and tooth extraction

Osteosarcoma occurs more often in the _____ and more often in _____.

maxilla; males

maxilla; females

mandible; males

mandible; females

mandible;males

The adenomatoid odontogenic tumor features ductlike structures that

A. resemble those found in major salivary glands.

B. resemble those found in minor salivary glands.

C. are actually ameloblast-like cells that resemble ducts because of their circular arrangement.

D. are actually odontoblast-like cells that resemble ducts because of their circular arrangement.

C. are actually ameloblast-like cells that resemble ducts because of their circular arrangement.

Which choice is not regarded as an initiating factor in the development of oral cancer?

-Cigar, pipe, and cigarette smoking

-Snuff dipping and tobacco chewing

-Consumption of alcohol

-Chronic irritation

Chronic irritation

Clinical signs and symptoms of a pleomorphic adenoma include the following except one. Which is the exception?

-Nonulcerated lesion

-Painless

-Quickly enlarging

-Dome-shaped mass

Quickly enlarging

A common location of the oral neurofibroma is the

-tongue.

-palate.

-gingiva.

-buccal mucosa.

tongue

Squamous cell carcinoma of the oral epithelium usually metastasizes first to which site?

-Spleen

-Lungs

-Liver

-Lymph nodes

Lymph nodes

Intraoral minor salivary gland tumors are most commonly located

-on the labial and buccal mucosa.

-at the junction of the hard and soft palate.

-on the retromolar area.

-on the floor of the mouth.

at the junction of the hard and soft palate.

_____ means new growth.

-Metastasis

-Neoplasia

-Hypertrophy

-Hyperplasia

Neoplasia

According to the TNM staging system for oral squamous carcinoma, T2, N1, M0 would mean tumor _____ cm in diameter, _____ palpable nodes, and _____ metastasis.

-less than 2; ipsilateral; no distant

-2 to 4; ipsilateral; no distant

-2 to 4; contralateral; no distant

-2 to 4; contralateral; distant

2 to 4; ipsilateral; no distant

Multiple myeloma is a systemic, malignant proliferation of

red blood cells.

plasma cells.

eosinophils.

basophils.

plasma cells

The majority of adenomatoid odontogenic tumors occur in _____ years of age.

females over 40

males over 40

females under 20

males under 20

females under 20

**70% occur in this age group in impacted teeth

**maxilla more than mandible

Most cases of verrucous carcinoma occur in the _____ years old.

-posterior lateral border of the tongue of women over 40

-floor of the mouth of women over 70

-vestibule and buccal mucosa of men over 55

-bone of the mandible of men over 20

vestibule and buccal mucosa of men over 55

Which intraoral lesion appears as a smooth red patch or a granular red and velvety patch?

-Sarcoma

-Papilloma

-Erythroplakia

-Leukoplakia

Erythroplakia

Patients who have undergone radiation therapy for malignant tumors of the head and neck often experience severe xerostomia as a result of radiation damage to _____ tissue.

-oral mucosa

-striated muscle

-salivary gland

-tooth

salivary gland

Squamous cell carcinomas on the vermilion border of the lips and skin of the face are

A. associated with lack of exposure to the sun and vitamin D deficiency.

B. more common in individuals with dark skin.

C. associated with a poorer prognosis than that for squamous cell carcinoma of the oral mucosa.

D. associated with color changes of the vermilion border from dark pink and uniform to mottled grayish pink.

D. associated with color changes of the vermilion border from dark pink and uniform to mottled grayish pink.

An ameloblastoma may appear as a _____ on radiographic images.

-unilocular radiolucency

-multilocular opacity

-multilocular, soap-bubble radiolucency

-unilocular or multilocular radiopacity

multilocular, soap-bubble radiolucency

Bence Jones proteins are associated with

-osteosarcoma.

-leukemia.

-lymphoma.

-multiple myeloma.

multiple myeloma

Sarcomas are _____ common than carcinomas.

-10 times more

-3 times more

-3 times less

-10 times less

10 times less

Which statement about malignant melanoma is true?

A. It has a benign counterpart known as the benign melanoma.

B. Most malignant melanomas arise on the skin as a result of prolonged exposure to chemicals such as benzene.

C. Primary malignant melanoma of the oral cavity is rare.

D. The most common intraoral location is the tongue.

C. Primary malignant melanoma of the oral cavity is rare.

**most arise on the skin as a result of prolonged sun exposure (all melanomas are malignant)

When a mucoepidermoid carcinoma arises within bone, it will usually be found in the _____ region.

-maxillary anterior

-maxillary posterior

-mandibular anterior

-mandibular posterior

mandibular posterior

***FLIP

D. ameloblastoma.

The name of the benign tumor that is slow growing but locally aggressive and derived in association with an impacted tooth and dentigerous cyst is termed

A. calcifying odontogenic cyst.

B. odontogenic myxoma.

C. compound odontoma.

D. ameloblastoma.

The granular cell tumor

A. most often occurs on the tongue followed by the buccal mucosa.

B. appears as a painful, ulcerated nodule.

C. occurs most commonly in children.

D. occurs most often in men.

A. most often occurs on the tongue followed by the buccal mucosa.

Because the origin of these tumors is glandular epithelium, benign tumors of salivary gland origin are termed

-adenomas

-nevi

-chondromas

-lipomas

adenomas

Anaplastic means the tumor:

A) is composed of cells that vary in size and shape.

B) has cells with darker nuclei than those of normal cells.

C) has cells that exhibit an increased nuclear-to-cytoplasmic ratio.

D) does not resemble the tissue from which it was derived.

D) does not resemble the tissue from which it was derived.

The papilloma will appear whiter clinically because of additional amounts of what substance?

A) Keratin

B) Exudate

C) Granulation tissue

D) Macrophages

A) Keratin

Approximately _____% of patients with chondrosarcoma involving the jaws survive 5 years after the diagnosis.

A) 10

B) 30

C) 50

D) 70

B) 30

Which tumor occurs most frequently in the anterior part of the jaws?

A) Ameloblastoma

B) Calcifying epithelial odontogenic tumor

C) Adenomatoid odontogenic tumor

D) Odontogenic myxoma

C) Adenomatoid odontogenic tumor

Severe epithelial dysplasia involving the full thickness of the epithelium is termed

A) anaplasia.

B) squamous cell carcinoma.

C) carcinoma in situ.

D) metastasis.

C) carcinoma in situ.

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

Cells closely resemble their cells of origin.

Benign

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

Mitosis is uncontrolled with rapid division.

Malignant

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

Growth expands by invasion and replaces normal tissue.

Malignant

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

The majority of these neoplasms are encapsulated.

Benign

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

Recurrence of the tumor is not common.

Benign

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

In naming the neoplasm, the word sarcoma or carcinoma is used.

Malignant

For each neoplasm description below, choose whether the neoplasm is benign or malignant:

Cells are poorly differentiated.

Malignant

The Warthin tumor:

A) is a unique type of pleomorphic adenoma.

B) presents as a painless, soft mass, usually in the sublingual gland.

C) often develops bilaterally in adult women.

D) contains sheets of lymphocytes that surround the cystic structures.

D) contains sheets of lymphocytes that surround the cystic structures.

Which tumor is an unencapsulated, infiltrating tumor composed of a combination of mucous cells interspersed with squamous-like epithelial cells?

A) Adenoid cystic carcinoma

B) Mucoepidermoid carcinoma

C) Monomorphic adenoma

D) Pleomorphic adenoma

B) Mucoepidermoid carcinoma

Which statement about hemangiomas is true?

A) The gingiva is the most common intraoral location.

B) They are more common in boys than in girls.

C) They appear as variably sized, deep red or blue lesions that do not blanch when pressure is applied.

D) They may occur in adults as a response to trauma and represent an abnormal proliferation of blood vessels during the healing process.

D) They may occur in adults as a response to trauma and represent an abnormal proliferation of blood vessels during the healing process.

Which statement is true of the odontogenic myxoma?

A) It occurs most often in people over 50.

B) It exhibits a unilocular radiolucency with well-defined margins.

C) The tumor may become quite large and cause displacement of teeth.

D) Most cases arise in the posterior maxilla.

C) The tumor may become quite large and cause displacement of teeth.

Adenoid cystic carcinoma is commonly seen in which demographic group?

A) Men

B) Women of childbearing age

C) Fifth and sixth decades of life

D) Children

C) Fifth and sixth decades of life

Epithelial dysplasia is a microscopy-based diagnosis; it indicates disordered growth and is considered a premalignant condition.

A) Both statements are true.

B) Both statements are false.

C) The first statement is true; the second is false.

D) The first statement is false; the second is true.

A) Both statements are true.

Where is the most frequent intraoral site for metastatic tumors of the jaws?

A) Nares

B) Maxilla

C) Mandible

D) Zygoma

C) Mandible

Kaposi sarcoma is

A) caused by a human herpesvirus.

B) seen only in association with HIV infection.

C) most often seen intraorally on the tongue.

D) a malignant striated muscle tumor.

A) caused by a human herpesvirus.

"Keratin pearls" are a characteristic feature of

A) squamous cell carcinoma.

B) Basal cell carcinoma.

C) pleomorphic adenoma.

D) monomorphic adenoma.

A) squamous cell carcinoma.

Which is a common characteristic of benign neoplasms?

A) Inability to spread to distant sites

B) Nonencapsulated

C) Undifferentiated and pleomorphic

D) No resemblance to surrounding cells

A) Inability to spread to distant sites

Acute leukemia is characterized by a proliferation of _____ cells.

A) immature white blood

B) mature white blood

C) immature plasma

D) mature plasma

A) immature white blood

An intraoral mucosal lesion that shows a mixture of red and white areas is termed:

A) erythroplakia.

B) speckled erythroplakia.

C) speckled leukoplakia.

D) leukoplakia.

C) speckled leukoplakia.

Squamous cell carcinoma of the oral epithelium usually metastasizes first to the lymph nodes of the neck. Common distant sites include:

A) kidneys and spleen.

B) lungs and liver.

C) breast and lungs.

D) liver and spleen.

B) lungs and liver.

For each vocabulary word below, select the corresponding definition from the list provided.

a. central

b. odontogenic

c. in situ

d. hyperchromatic

e. pleomorphic

f. aberrant

g. enucleation

a. Central: occurring within bone

b. Odontogenic: tooth forming

c. In situ: confined to the site of origin without an invasion of neighboring tissues

d. Hyperchromatic: microscopic staining that is more intense than normal

e. Pleomorphic: occurring in various forms

f. Aberrant: deviating from the usual or natural type

g. Enucleation: complete surgical removal without cutting into the lesion

The central cemento ossifying fibroma is most likely derived from which cells?

-Ameloblasts

-Odontoblasts

-Osteoblasts

-Cells of the periodontal ligament

-Cells of the periodontal ligament

A _____ both invades and destroys surrounding tissue and has the ability to spread throughout the body.

-benign tumor

-malignant tumor

-hypertrophy

-hyperplasia

malignant tumor

Squamous cell carcinoma may appear anywhere in the oral cavity; where is the most common site?

-Floor of the mouth

-Gingiva

-Retromolar pad

-Midline of the hard palate

Floor of the mouth

The most common intraoral location for the pleomorphic adenoma is the

-parotid gland.

-submandibular gland.

-palate.

-floor of the mouth.

-palate.

A basal cell carcinoma will _____ metastasize.

never

rarely

often

always

rarely

The most common location for an intraoral lymphoma is the

-floor of the mouth.

-posterior lateral border of the

tongue.

-tonsillar area.

-vestibule.

-tonsillar area.

Which statement about epithelial dysplasia is true?

-It is considered a malignant condition.

-Unlike squamous cell carcinoma, cellular changes in epithelial dysplasia may revert to normal if the stimulus, such as tobacco smoking, is removed.

-It presents clinically as an erythematous lesion and not a white lesion (leukoplakia).

-Lesions often arise on the hard and soft palate.

-Unlike squamous cell carcinoma, cellular changes in epithelial dysplasia may revert to normal if the stimulus, such as tobacco smoking, is removed.

Idiopathic leukoplakia

-is a malignant lesion of the oral mucosa.

-can be rubbed off with gauze squares.

-is caused by direct irritation, as in tobacco pouch keratosis.

-does not have a specific known cause.

-does not have a specific known cause.

The multiple myeloma is a benign proliferation of plasma cells that produce large amounts of immunoglobulin. Patients usually experience bone pain and swelling.

-Both statements are true.

-Both statements are false.

-The first statement is true; the second is false.

-The first statement is false; the second is true.

-The first statement is false; the second is true.

**it is malignant

Where do most cases of papilloma occur?

-Hard palate

-Buccal mucosa

-Soft palate or tongue

-Retromolar area

Soft palate or tongue

Which is the most common salivary gland neoplasm?

-Adenoid cystic carcinoma

-Mucoepidermoid carcinoma

-Pleomorphic adenoma

-Monomorphic adenoma

Pleomorphic adenoma

As a general rule, a patient should be referred to an oral and maxillofacial surgeon or dermatologist to have a biopsy performed on any non healing ulcer of the skin or lips that has been present for more than

24 hours.

2 weeks.

3 months.

1 year.

2 weeks

Approximately _____% of leukoplakias examined microscopically demonstrate epithelial dysplasia.

1 to 2

5 to 25

50 to 60

90

5 to 25

Which is the most common malignant salivary gland tumor found in children?

-Adenoid cystic carcinoma

-Mucoepidermoid carcinoma

-Monomorphic adenoma

-Pleomorphic adenoma

Mucoepidermoid carcinoma

How does an adenomatoid odontogenic tumor differ from a dentigerous cyst on radiographic images?

-It will not be associated with an impacted tooth.

-It extends beyond the cementoenamel junction and can involve 50% to 60% of the root.

-It will not form calcifications within the tumor, as does a dentigerous cyst.

-It will not form a well-circumscribed radiolucency.

-It extends beyond the cementoenamel junction and can involve 50% to 60% of the root.

All terms are associated with malignancy except one. Which is the exception?

-Invasive

-Encapsulated

-Cancer

-Metastasis

Encapsulated

All carcinomas are malignant tumors that originate from squamous epithelium except one. Which is the exception?

-Adenoid cystic

-Basal cell

-Verrucous

-Squamous cell

Adenoid cystic

All are common warning signs of malignant neoplasms except one. Which is the exception?

-Leukoplakia

-Bleeding

-Erythroplakia

-Pigmentation

Bleeding

The adenoid cystic carcinoma is

-a benign tumor of salivary gland origin.

-well encapsulated and does not infiltrate surrounding tissue.

-most commonly seen intraorally on the palate.

-painless.

most commonly seen intraorally on the palate.

A central mucoepidermoid carcinoma is derived from either salivary gland tissue trapped within bone or

-a periapical abscess surrounding the apex of a nonvital tooth.

-the transformed epithelial lining of a dentigerous cyst.

-a lateral periodontal cyst.

-an incisive canal cyst.

-the transformed epithelial lining of a dentigerous cyst.

The _____ is a unique type of monomorphic adenoma.

-verrucous carcinoma

-mucoepidermoid carcinoma

-cylindroma

-papillary cystadenoma lymphomatosum

-papillary cystadenoma lymphomatosum

A(n) _____ is composed of islands and sheets of polyhedral epithelial cells with deposits of amyloid-like material that is thought to represent a form of abnormal enamel protein.

-adenomatoid odontogenic tumor

-calcifying epithelial odontogenic tumor

-ameloblastoma

-mucoepidermoid carcinoma

-calcifying epithelial odontogenic tumor

Basal cell carcinoma is a _____ tumor that _____ in the oral cavity.

-benign; occurs

-malignant; occurs

-benign; does not occur

-malignant; does not occur

-malignant; does not occur

A _____ is a benign proliferation of capillaries.

-hematoma

-hemangioma

-hamartoma

-lymphangioma

hemangioma

Which choice represents a characteristic of malignant tumors?

-Encapsulated

-Ability to spread to distant sites

-Benign

-Cells resemble normal cells

-Ability to spread to distant sites

A benign tumor of bone is called a(n):

A) osteoma

B) osteogenic sarcoma

C) chondroma

D) carcinoma.

A) osteoma

Verrucous carcinoma:

A) has a better prognosis than other forms of squamous cell carcinomas.

B) appears clinically as a quick-growing exophytic tumor with a pebbly white surface.

C) is characterized by poorly differentiated epithelium with atypical cells.

D) shows invasion of tumor cells through the basement membrane.

A) has a better prognosis than other forms of squamous cell carcinomas.

The ameloblastoma:

A) occurs exclusively in the mandible.

B) is a benign, encapsulated tumor.

C) is commonly known as a Pindborg tumor.

D) may cause expansion of bone.

D) may cause expansion of bone.

Ghost cells are characteristic of which lesion?

A) Calcifying odontogenic cyst

B) Adenomatoid odontogenic tumor

B) Calcifying epithelial odontogenic tumor

D) Ameloblastoma

A) Calcifying odontogenic cyst

A compound odontoma:

A) consists of a mass of enamel, dentin, cementum, and pulp that does not resemble a normal tooth.

B) usually occurs in the posterior mandible.

C) appears on radiographs as a cluster of miniature teeth surrounded by a radiolucent halo.

D) appears as a radiolucent mass surrounded by a thin radiopaque halo.

C) appears on radiographs as a cluster of miniature teeth surrounded by a radiolucent halo.

Which is the false statement about basal cell carcinoma?

A) It often occurs in white adults with fair complexions.

B) It appears as a non healing ulcer with rolled borders.

C) It is usually seen on the skin of the face.

D) It occurs intraorally.

D) It occurs intraorally.