Oral Pathology: Giant Cell Lesions and Hyperparathyroidism

Practice flashcards covering the clinical, radiographic, and histopathologic features of giant cell lesions and hyperparathyroidism based on the lecture transcript.

Giant cell lesions of the jaw

A group of conditions including giant cell granuloma (central and peripheral), giant cell tumor (osteoclastoma), aneurysmal bone cyst, cherubism, and brown tumor of hyperparathyroidism.

Peripheral giant cell granuloma (giant cell epulis)

A common reactive tumor-like growth of the oral cavity caused by local irritation or trauma, occurring exclusively on the gingiva or edentulous alveolar ridge.

"Cupping" resorption

A radiographic feature sometimes seen in the underlying alveolar bone beneath a peripheral giant cell granuloma.

Central giant cell granuloma (CGCG)

A non-neoplastic intraosseous lesion, most common in females under age $30$ and often located in the anterior mandible, which can be categorized as aggressive or nonaggressive.

Aggressive central giant cell lesions

Lesions characterized by pain, rapid growth, cortical perforation, root resorption, and a marked tendency to recur after treatment.

Nonaggressive central giant cell lesions

The most common category of CGCG, exhibiting slow growth, few symptoms, and no cortical perforation or root resorption.

Cherubism

A rare developmental jaw condition generally inherited as an autosomal dominant trait with the gene mapped to chromosome $4p 16$, characterized by bilateral expansion of the posterior jaws.

"Eyes upturned to heaven" appearance

A clinical feature of cherubism caused by the involvement of the infraorbital rim and orbital floor tilting the eyeballs upward.

Eosinophilic cuffing

Eosinophilic deposits surrounding small blood vessels in the lesion stroma; a feature considered specific to cherubism.

Aneurysmal bone cyst (ABC)

An intraosseous accumulation of blood-filled spaces (not lined by endothelium) surrounded by cellular fibrous connective tissue and reactive bone.

"Blow-out" distention

A radiographic description of the ballooning contour of the affected bone often seen in cases of aneurysmal bone cyst.

"Blood-soaked sponge"

The characteristic surgical appearance of an aneurysmal bone cyst when the periosteum and thin bony shell are removed.

Primary hyperparathyroidism

The uncontrolled production of parathyroid hormone (PTH), usually due to a parathyroid adenoma ($80\%$ to $90\%$ of cases) or parathyroid hyperplasia.

Secondary hyperparathyroidism

Continuous production of PTH in response to chronic low serum calcium levels, usually associated with chronic renal disease.

"Stones, bones and abdominal groans"

The classic triad of signs and symptoms associated with hyperparathyroidism, specifically relating to renal calculi and osseous changes.

Brown tumor of hyperparathyroidism

A radiolucent bone lesion that is histopathologically identical to central giant cell granuloma, named for its dark reddish-brown color due to hemorrhage and hemosiderin.

Osteitis fibrosa cystica

The most severe skeletal manifestation of chronic hyperparathyroidism, developing from the central degeneration and fibrosis of longstanding brown tumors.

Renal osteodystrophy

Striking enlargement of the jaws known to occur in patients with secondary hyperparathyroidism caused by end-stage renal disease.