PATHOLOGY EXAM 2

morsicatio buccarum

biting trauma on buccal mucosa

morsicatio linguarum

biting trauma on lateral border of tongue

traumatic granuloma with stromal eosinophilia (TUGSE)

deep chronic ulceration with slow resolution

incisional biopsy and removal of trauma

what is the treatment for this?

epulis fissuratum

a benign fibrous hyperplasia caused by irritation, often seen in edentulous (no teeth) patients.

ill fitting denture

what is the most likely cause of this lesion

chemical burn (aspirin)

resulting from placing aspirin next to toothache

phenol burn

chemical burn (hydrogen peroxide burn)

chemical burn (phenol peel)

chemical burn (formocresole necrosis)

thermal burn

caused by contact with hot beverages and food

electrical burns

caused by contact with electricity

contact stomatitis

topical allergic reaction

mouth wash, toothpaste, candy, gum (contact stomatitis)

what coulld be the cause of this lesion

cinnamon

most common flavoring agent that causes contact stomatitis

chemo therapy mucositis

begins few days- weeks after CHEMOTHERAPY

radiation mucositis

occurs after radiation therapy

radiation dermatitis

occurs after radiation therapy

radiation caries

occurs after radiation

candidiasis

occurs after radiation

osteoradionecrosis

occurs 4m to 3yrs after radiotherapy

> 60 Gy

radiation dose that increases risk of osteoradionecrosis

fistula associated with osteoradionecrosis

osteoradionecrosis

ill defined radiolucency occurs after radiation therapy

mandible

most common location of osteoradionecrosis

before treatment begins

best time for dental treatment of radiation patients

MRONJ

current/previous treatment with antiresorptive medication and ho history of radiation therapy

cocaine osetonecrosis

bone necrosis associated with cocaine use, often affecting the nasal cavity

anesthesia necrosis

necrosis/ ischemia from epinephrine

petechiae

minute hemorrhage (1-2 mm)

pupura

a larger area of hemorrhage (max 1 cm) under the skin or mucous membranes

ecchymoisis

any hemorrhage over 2cm, often referred to as a bruise.

hematoma

accumulation of blood within tissues producing a mass

amalgam tattoo

what is the most likely cause of this blue/gray lesion

lead poisoning/ plumbism

what caused the black marginal ridges

silver poisoning/ argyria

diffuse gray discoloration of skin, gray marginal gingiva

mercury poisoning/ acrodynia (pink disease)

a condition characterized by pink or red skin rash, irritability, and pain in the extremities

sequestrum

a piece of necrotic bone that has become separated from healthy bone

antral pseudocyst

dome shaped, faintly radiopaque lesions arising from maxillary sinus

surgery

how would you treat this?

cervicofacial emphysema

rapid onset of facial swelling and pain

ephelis (freckles)

benign focal increase in MELANIN deposition, INCREASES with UV

actinic lentigo

what is this lesion

actinic lentigo

benign brown macule, caused increase in MELANOCYTES, does NOT change with UV

melanocanthoma

benign ACQUIRED dark melanosis of mucosa

trauma (ex: toothbrush)

what is the cause of this lesion

labial melanotic macule

benign focal increase in MELANIN deposits, NO change with UV

oral melanotic macule

a benign, localized area of increased MELANIN in the oral mucosa

melanocytic macule

what is this lesion

acquired melanocytic nevus

develops during childhood, most common on HARD PALATE or GINGIVA

acquired melanocytic nevus

what is this lesion?

acquired melanocytic nevus

benign localized proliferation of nevus cells (no dendritic processes) that develops during childhood or young adulthood

congenital melanocytic nevus

a type of nevus present at birth, characterized by pigmented lesions that may vary in size and can carry a RISK of MELANOMA

melanoma

what is the concern with congenital nevus?

removal for esthetic reasons or definitive diagnosis

what is the treatment for melanocytic nevus

blue nevus

macular/dome shaped blue/black lesion smaller than 1cm

amalgam tattoo

what is the most likely diagnosis

blue nevus

what is the most likely diagnosis

palate

most common site of BLUE NEVUS in ORAL CAVITY

tyndall effect (melanin granules scatter short wavelengths (blue))

why do blue nevus appear blue?

melanoma

malignant neoplasm of MELANOCYTES

melanoma

3rd most common skin cancer

melanoma

most deadly skin cancer

oral

what kind of melanoma has the worst prognosis

melanoma

blue/black CHANGING lesion with asymmetrical broders

melanoma

what is the most likely diagnosis

melanoma

what is the most likely diagnosis

papillary tip melanossi

brown discoloration of fungiform papillae, more common in DARKER SKIN individuals

melasma (cholasma)

ACQUIRED hyperpigmentation of face and neck, gets DARKER with UV

melasma (cholasma)

hyperpigmentation of sun exposed skin

peutz-jehgers syndrome

freckle like brown lesions on lips, buccal mucosa, tongue, and extremities

peutz-jeghers syndrome

autosomal dominant genetic disorder characterized by freckle-like lesions and INTESTINAL POLYPS (risk of cancer)

seborrheic keratosis

acquired, benign proliferation of epidermal BASAL cells

seborrheic keratosis

what kind of lesion are these

hormonal therapy

potential cause of melasma

gigantism

increased growth hormone BEFORE closure of epiphyseal plates

acromegaly

increased growth hormone AFTER closure of epiphyseal plates

gigantism/acromegaly

presents with enlarged mandible, prognathism, MACRODONTIA

dwarfism

caused by decrease in growth hormone

dwarfism

presents with delayed eruption of teeth and MICRODONTIA

jaundice

excess billlirubin in bloodstream

amyloidosis

a disease characterized by the abnormal accumulation of amyloid proteins in organs and tissues, death imminent

primary amyloidosis

presents with thick lips and macroglossia

crohn’s disease

a type of inflammatory bowel disease that causes inflammation in the digestive tract, resulting in abdominal pain, diarrhea, and malnutrition

crohn’s disease

oral lesions can PRECEDE GI lesions

crohns disease

oral lesions with COBBLESTONE appearance

hypophosphatasia

caused by DECREASED alkaline phosphatase enzyme

hypophosphatasia

presents with LACK OF CEMENTUM and PREMATURE LOSS of teeth

hypophosphatemia (vit D resistant rickets)

large pulp horns and multiple none vital teeth without caries or trauma causing

hypophosphatemia

characterized by low serum phosphate and low calcium

iron deficiency anemia

presents with angular cheilitis, atrophic tongue, glossitis, and potentially candidiasis

iron deficiency anemia

what is the most likely cause

plummer-vinson syndrome

a condition associated with iron deficiency anemia, characterized by dysphagia due to ESOPHAGEAL WEBS, kaoilonychia (spoon like nails), atrophic glossitis

hyperthyroidism

presents with excessive perspiration, tongue tremor, bulging eyes, glossopyrosis (burning tongue), goiter and weight loss

hypothyroidism

presents with cold intolerance, thick tongue, weight gain, dry skin, constipation, and hair loss

cretinism (congenital hypothyroidism)

IN CHILDREN large protruding tongue, delayed development/eruption of teeth, intellectual diaability

regulate calcium levels

function of parathyroid hormone

hyperparathyroidism

LOSS of trabecular bone pattern and lamina dura

addison’s disease

insufficient production of corticosteroid (decreased cortisol)