Oral Pathology
Posted by John Doe at Dental Assistant on February 18, 2012.
Categories: Dental Secrets
Share
Print
Email-
+8
Vote
8 votes
DIFFERENTIAL DIAGNOSES AND GENERAL CONSIDERATIONS
Intrabony Lesions
13 5. What are pseudocysts of the jaw bones? Give examples.
These conditions appear cystlike on radiograph but are not true cysts. Examples include:
- Traumatic (simple) bone cyst: empty at surgery
- Aneurysmal bone cyst: giant cells and blood-filled spaces
- Static bone cyst (Stalne bone cavity): salivary gland depression
- Hematopoietic marrow defect: hematopoietic marrow
136. What is the differential diagnosis for a multiloculated radiolucency?
- Dentigerous cyst
- Odontogenic keratocyst
- Ameloblastoma
- Vascular malformations, such as hemangiomas
- Odontogenic myxoma
- Intraosseous salivary gland tumors
- Lesions that contain giant cells, such as aneurysmal bone cyst, central giant cell granuloma. and cherubism
Soft Tissue Lesions
137. What is th e differential diagnosis for an upper lip nodule?
Salivary gland lesion: sialolith, benign salivary gland tumor (especially pleomorphic adenoma and canalicular adenoma), malignant salivary gland tumor.
Vascular lesion: hemangioma, lymphangioma, other vascular anomaly.
Neural lesion: neurofibroma, schwannoma, neuroma.
Skin appendage tumors.
138. What may cause diffuse swelling of the lips?
- Vascular malformations, such as lymphangiomas and hemangiomas
- Angioneurotic edema
- Hypersensitivit y reactions
- Cheilitis glandularis
- Cheilitis granulomatosa (e.g., Melkersson-Rosenthal syndrome)
- Crohn's disease
139. What is the differential diagnosis for a solitary gingival nodule?
The most common diagnoses are fibroma or fibrous hyperplasia, pyogenic granuloma (especially in a pregnant patient), peripheral giant cell granuloma, and peripheral ossifying fibroma (essentially a fibrous hyperplasia with metaplastic bone formation) . Other less common conditions include benign and malignant tumors, especially of odontogenic origin, and (in elderly patients) metastatic tumors.
140. What may cause generalized overgrowth of gingival tissues?
Common causes include plaque accumulation; drugs such as phenytoin, cyclosporine A, sodium valproate , diltiazem, and nifedipine (the last two are calcium channel blockers); fibromatosis gingivae; and leukemic inf iltrate.
14 1. A labial salivary gland biopsy is useful for dia gnosis of certain systemic conditions.What are they?
- Sjogren's syndrome
- Autoimmune sialadenitis associated with connective-tissue disease
- Graft-vs.-host disease
- Amyloidosis
- Sarcoidosis
142. What may ca use chronic xerostomia?
Common causes include many anticholinergic drugs, autoimmune sialadenitis (such as Sjogren's syndrome a nd graft-vs.-host disease), aging (although many experts believe this to be drug-related), radiation to the gland, primary neurologic dysfunction, and nutritional deficiencies (e.g., vitamin A, vitamin B, and iron).
143. Name possible causes of bilateral parotid swelling.
Mumps Malnutrition Sjögren's syndrome Alcoholism Radiation-induced acute parotitis Bulimia Diabetes mellitus Warthin 's tumor
144. What may cause depapillation of the tongue?
Vitamin B deficiency Median r homboid glossitis (focally) Iron deficiency Syphilis Folate deficiency Plummer-Vinson syndrome Benign migratory glossitis (focally)
145. What may cause diffuse enlargement of the tongue?
Co ngenital macrog lossia Cretinism Lymphangioma Acromegaly He mangioma Trisomy 21 Neurofibr omatosis Amyloidosis Hyperpituitarisni Hypothyroidism
146. What is the differential diagnosis of midline swellings of the floor of the mouth?
Ranula (mucocele) Derrriojd cyst Epidermoid cyst Benign lymphoepithelial cyst
147. What may cause diffuse white plaques in the oral cavity?
- Lichen planus (especially plaquetype)
- Pachyonychia congenita
- Cannon's white sponge nevus
- Dyskeratosis congenita
- Leuk edema
- Extensive leu koplakia (especially proliferative verrucous leukoplakia)
- Hereditary benign intraepithelial dyskeratosis
- Candidiasis
148. Name the conditions that may give rise to papillary lesions of the ora l cavity.
Possible underlying conditions include papilloma, verruca vulgaris, condyloma, papillary hyperplasia of the palatal mucosa (denture injury), Heck's disease, oral florid papillomatosis, venucous carcinoma, papillary squamous cell carcinoma, pyostomatitis vegetans (associated with inflammatory bowel disease), and verrucif orm xanthoma.
149. What lesions may occur in the oral cavity of neonates?
Lesions in the oral cavity of neonates include neuroectodermal tumor of infancy, congenital epulis of the newborn, gingival cyst of the newborn, palatal cys t of the newborn (Bohn's nodules and Epstein's pearls), lymphangiomas of the alveolar ridge, and natal teeth.
150. What may cause "burning mouth" syndrome?
This sensation usually results from mucosa that is atrophic or inflamed, which, in turn, may be caused by candidiasis (especially atrophic candidiasis of the tongue or of the palate caused by d entures), xerostomia, allergies (especially to den ture materials), and specific inflammatory mucosal lesions, such as lichen planus and migratory glossitis. Sometimes a psychological component may be inv olved.
151. What may cause oral paresthesia?
Ora l paresthesia may be caused by manipulation or inflammation of a nerve or tissues around a nerve, direct damage to a nerve or tissues around a nerve, tum or impinging on or invading a nerve, pnmary neural tumor, and central nervous system tumor.
152. Why do lesions appear white in the oral cavity?
Lesions appear white because the epithelium has been changed, usually thickened, causing the underlying blood vessels to be deeper, as in hyperke ratosis, epithelial hyperplasia (acanthos is), and swelling of the epithelial cel ls (Cannon's nevus, leukedema). Lesions may appear white if exudate or necrosis is present in the epithelium (candidiasis, ulcers) or if there are fewer ves sels in the connective tissue (scar). Finally, a change in the intrinsic nature of the epit helial cell, such as epithelial dysplasia, m ay cause the mucosa to appear wh ite (leukoplakia).
153. Why do lesions appear red in the oral cavity?
Les ions appear red because the epithelium is thinned and the underlying vessels are now closer to the surface, as in epithelial atrophy, desquamative con ditions, healing ulcers, and loss of the keratin layer. Redness also may be caused by an increase in the number or dilatation of blood vessels in the connective tissue, as in inflammation. Finally, a change in th e intrinsic nature of the epithelial cell, such as epithelial dysplasia, may cause the mucosa to look red (erythro plakia).
154. Distinguish macules, papules, and plaque.
A macule is a localized lesion that is not raised and is better seen than felt. It is often used to describe localized pigmented lesions, such as amalgam tattoos and melanotic macules. Both papules and plaque are raised lesions; the papule is <5 mm, and the plaque is larger.
155. What is the difference between a bulla and vesicle?
The bulla is usually > 5 mm in size; the vesicle is <5 mm.
156. Differentiate between a hamartoma and a choristoma.
A hamartoma is a tumorlike growth consisting of an overgrowth of tissues that histologically appear mature and are native to the area (e.g., hemangioma, odontoma). A choristoma is a tumorlike growth consisting of an overgrowth of tissues that histologically appear mature but are not native to the area (e.g., cartilaginous choristoma or bony choristoma of the tongue). A hamartoma of the skin and mucosa is sometimes called a nevus (e.g., vascular, epidermal, or melanocytic nevus).
157. What are oncocytes?
Oncocytes are eosinophilic, swollen cells found in many salivary gland tumors, such as oncocytomas and Warthin's tumor, and in oncocytic metaplasia of salivary ducts. They are swollen because they contain many mitochondria.
158. What are Russell bodies?
Russell bodies are round, eosinophilic bodies found in reactive lesions and represent globules of immunoglobulin within plasma cells.
Other articles
Both comments and pings are currently closed.
