Oral Pathology - Lesions

Erythroplakia

Red lesion requiring biopsy; commonly associated with severe dysplasia or invasive squamous cell carcinoma.

Papilloma

Benign squamous epithelial tumor with a cauliflower-like appearance on soft palate or tongue.

Fissured tongue

Genetic condition of dorsal tongue with grooves that collect food debris and cause irritation.

Basal cell carcinoma

Malignant skin tumor associated with sun exposure that presents as a nonhealing ulcer.

Recurrent aphthous stomatitis

Painful canker sores occurring on unattached mucosa like the tongue, vestibule, or buccal mucosa.

Chronic hyperplastic candidiasis

White patches on tongue that do not rub off and may demonstrate epithelial dysplasia.

Erythematous candidiasis

Red candidal infection associated with a burning sensation and acute atrophic changes.

Verrucous carcinoma

Slow-growing exophytic carcinoma with pebbly red-and-white surface from smokeless tobacco use.

Amalgam tattoo

Mucosal pigmentation resulting from implantation of dental restorative material.

Primary herpetic stomatitis

HSV-1 infection with fever, lymphadenopathy, painful oral ulcers, and erythematous gingivitis.

Angular cheilitis

Erythema and fissuring occurring at the corners of the mouth.

Traumatic ulcer

Painful ulcer with yellow fibrin membrane and red halo; biopsy if nonhealing.

Melanotic macule

Flat, well-circumscribed brown lesion of the oral mucosa.

Herpes labialis

Recurrent HSV on vermilion border with tingling, clustered vesicles, and crusting.

Migratory glossitis (Geographic tongue)

Red depapillated areas with white/yellow borders that change location over time.

Recurrent herpetic stomatitis

HSV recurrence on mucoperiosteum with clustered vesicles that rupture and heal in 7-10 days.

Pemphigus vulgaris

Autoimmune vesiculobullous disorder producing fragile, shallow blisters that rupture easily.

Pseudomembranous candidiasis (Thrush)

White plaques of yeast and debris that are easily wiped away.

Erosive lichen planus

Painful erosions, bullae, and desquamative gingivitis from epithelium separating from connective tissue.

Squamous cell carcinoma

Most common oral malignancy; invades basement membrane and metastasizes to lymph nodes.

Dentifrice stomatitis

Desquamation of superficial epithelium caused by toothpaste or cinnamon flavoring reaction.

Pemphigoid

Autoimmune disease causing deep vesicles that rupture rapidly, affecting palate and gingiva.

Adenoid cystic carcinoma

Malignant minor salivary gland tumor associated with pain and facial nerve paralysis.

Metastatic disease

Malignancy in bone presenting as nonhealing extraction sites or moth-eaten radiolucencies.

Actinic cheilitis

Premalignant condition of lower lip from chronic UV exposure with loss of vermilion border.

Periapical granuloma

Chronically inflamed granulation tissue at the apex of a nonvital tooth.

Periapical (radicular) cyst

True cyst developing from epithelial proliferation within a periapical granuloma.

Residual cyst

Cyst remaining after tooth extraction when periapical lesion is left behind.

Dentigerous cyst

Developmental cyst formed around the crown of an unerupted tooth (e.g., mandibular 3rd molar).

Lateral periodontal cyst

Developmental cyst on the lateral root aspect, common in mandibular canine-premolar region.

Odontogenic keratocyst

Developmental cyst lined by parakeratinized epithelium, common in posterior mandible.

Nasopalatine duct cyst

Developmental cyst from nasopalatine duct remnants; appears heart-shaped radiographically.

Stafne defect

Lingual bone depression filled with normal salivary gland tissue; pseudocyst.

Traumatic bone cyst

Pathologic cavity in bone lacking epithelial lining; scallops around tooth roots.

Central giant cell lesion

Multilocular lesion with giant cells; crosses mandibular midline and causes root resorption.

Ameloblastoma

Benign, locally aggressive odontogenic tumor with soap-bubble/honeycomb appearance.

Osteomyelitis

Inflammatory bone disease presenting as acute/chronic infection (e.g., focal/diffuse sclerosing).

Condensing osteitis

Increased bone density near tooth apex reacting to low-grade infection; common in molars.

Focal cemento-osseous dysplasia

Asymptomatic single-site fibro-osseous lesion in posterior mandible of a vital tooth.

Periapical cemento-osseous dysplasia

Asymptomatic lesion in mandibular anterior region associated with vital teeth.

Fibrous dysplasia

Bone replaced by fibrous tissue and immature bone; ground-glass radiographic appearance.

Cemento-osseous dysplasia

Most common benign fibro-osseous lesion, occurring in focal, periapical, and florid forms.

Minor aphthae

Single painful oval ulcer with red halo and yellow membrane; heals in 10-14 days without scars.

Major aphthae

Large painful aphthous ulcer persisting 6-8 weeks and healing with scar formation.

Herpetiform aphthae

Form of aphthous stomatitis characterized by clusters of multiple small ulcers.

Peripheral giant cell granuloma

Reactive lesion containing giant cells that causes cupping resorption of underlying bone.

Leukoedema

Variant of normal gray-white mucosa that disappears when stretched.

Leukoplakia

White lesion with well-defined margins that cannot be wiped off; requires biopsy if persistent.

Epulis fissuratum

Denture flange-induced hyperplasia producing folds of tissue in alveolar mucosa.

Hemangioma

Benign capillary proliferation forming a red/blue lesion that blanches under pressure.

Lipoma

Benign fat lesion presenting as a yellow mass on buccal mucosa or vestibule.

Peripheral ossifying fibroma

Reactive gingival growth arising from interdental papilla, often ulcerated.

Smokeless tobacco keratosis

White/gray velvety, rippled lesion in labial vestibule; reversible after habit cessation.

Fordyce's granules

Ectopic sebaceous glands appearing as tiny yellow papules on oral mucosa.

Pleomorphic adenoma

Slow-growing, painless, firm benign salivary gland tumor commonly found on palate.

Inflammatory papillary hyperplasia

Denture-induced palatal hyperplasia with cobblestone red papillary projections.

Ranula

Large mucocele-like lesion occurring unilaterally on the floor of the mouth.

Mucoepidermoid carcinoma

Most common malignant salivary gland tumor; presents as painless rubbery swelling.

Reticular lichen planus

White lesion composed of Wickham striae occurring bilaterally on buccal mucosa.

Mucus retention cyst

Epithelium-lined cystic lesion caused by obstruction of a salivary gland duct.

Sinus tract (Periapical abscess)

Lesion associated with a nonvital tooth representing a drainage tract from an abscess.

Linea alba

White line along the occlusal plane caused by friction or pressure.

Fibroma

Persistent exophytic scar-like mass along the line of occlusion.

Pyogenic granuloma

Vascular reactive connective tissue lesion that bleeds easily; red or purple.

Frictional hyperkeratosis

Keratin thickening from chronic rubbing that resolves when trauma stops.

Warthin's tumor

Benign salivary gland tumor almost exclusively in the parotid gland of smokers.

Mucocele

Blue dome-shaped fluid-filled lesion from severed salivary duct; history of rupture/recurrence.

Nicotine stomatitis

Diffuse gray-white palatal change with red punctate papules caused by smoking.

Granular cell tumor

Benign tumor of large granular cells occurring on dorsal tongue as a painless nodule.