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PATH-Neoplasia

Neoplasia

QuestionAnswer
neoplasia new, abnormal growth, uncontrolled cells proliferation (multiplication, irreversible
tumor "swelling", used as a synonym for neoplasm
what behavior do neoplasms exhibit? unlimited growth and unregulated growth
what are causes of neoplasia chemicals viruses (aka oncogenic viruses) radiation (sunlight, xrays, nuclear fission) (can occur spontaneously secondary to a genetic mutation
what are tumor classifications? benign and malignant
benign tumor (neoplasia) localized, encapsulated w/ fibrous CT, invade adjacent tissue, resemble normal ctissue tx. surgical excision, either local excision or enucleation
malignant tumor (cancerous) invades and destroys surrounding tiss., can spread, well differentiated-neoplasic cells resemble normal cells poorly diferentiated- do not undifferentiated/anaplastic-do not resemble tiss. derived from at all
pleomorphic cells of malignant tumors vary in size and shape
hyperchromatic nuclei of cells darkers than those of normal cells, exhibit an increased nuclear-cytoplasmic ratio
mitotic figures normal and abnormalmitotic figures seen in nucleus of neoplastic cells tx. surgery, chemotherapy, radiation therapy (often combo)
classification of tumors(benign) usually well-differentiated usually slow growth mitotic figures are rare usually encapsulated no metastasis
classfication of tumors (malignant) well differentiated to anaplastic slow-to-rapid growth mitotic figures may be numerous invasive and unencapsulated metastasis likely
what is the suffix "-oma" used to indicate a tumor *prefix is determined by tissue or cell of origin
lipoma benign tumor of fat
osteoma benign tumor of bone
carcinoma malignant tumor of epithelium
sarcoma malignant tumor of CT
squamous cell carcinoma or epidermoid carcinoma malignant tumor of squamous epithelium
osteosarcoma malignant tumor of bone
what can epithelial tumors derive from? squamous epithelium salivary gland epithelium odontogenic epithelium
papilloma small, benign tumor of squamous epithelium, exophytic pedunculated or sessile growth
what are the papillary projections of papilloma? *cauliflower most often on soft palate or tongue occurs any age or sex DDX w/ verruca vulgaris and condyloma acuminatum (venereal wart)
how does pailloma appear microscopically? numerous fingerlike or papillary projections w/ central core of fibrous CT surfaced by normal stratified squamous epithelium
tx for papilloma? surgical excision removal of base to prevent reoccurance
what are 3 premalignant lesions? leukoplakia erythoplakia epithelial dysplasia
leukoplakia "white plaque" (clinical term not histologic term) biopsy needed to establish definitive Dx most due to hyperkeratosis or epithelial hyperplasia and hyperkeratosis can't be rubbed off
how does leukoplakia appear microscopically? may show epithelial dysplasia (premalignant condition) or squamous cell carcinoma ~5-25% reveal epithelial dysplasia
tx for leukoplakia dependent on histologic finding
leukoplakia-Snuffer's keratosis aka. tobacco pouch keratosis
most leukoplakia are: asymptomatic result of hyperkeratosis result of hyperkeratosis comboed w/ epithelial hyperplasia tx depends on histo findings area at increased risk for SCC
erythroplakia located on floor or mouth, tongue, soft palate can appear as: smooth red patch, granular red and velvety patch <common than leukoplakia >serious than leukoplakia
what is speckled leukoplakia? subcatogory of erythroplakia lesion shows a mix of red and white areas
how does erythroplakia appear microscopically? 90% of cases demonstartes epithelial dysplasia or squamous cell carcinoma
tx of erythroplakia dependent on histologic Dx
epithelial dysplasia premalignant, disordered growth, precedes squamous cell carcinoma, changes may revert to normal if stimulus is removed
how can epithelial dysplasia appear clinically? erythematous, white, mixed erythematous and white
(T/F)Dysplasia in other tissues is not considered a premalignant process True.
tx of epithelial dysplasia surgical excision
(T/F) epithelial dysplasia is carcinoma in situ True. severe dysplasia involving full thickness of epithelium
squamous cell carcinoma aka. epidermoid carcinoma malignant tumor of squamous epithelium *most primary common primary malignancy of oral cavity can infiltrate adjacent tiss. and form distant metastases (lymph nodes in neck, lungs, <3) can infiltrate and destroy bone
how does squamous carinoma appear clinically? exophytic ulcerative mass
how does SCC microscopically? tumor cells invade CT underlying epithelial basement membrane well-differentiated tumors show keratin -keratin pearls, usually seen in individual cells w/in tumor
where can SCC appear in the oral cavity? *most often on floor of mouth ventrolateral tongue, soft palate, tonsillar pillar, retromolar areas *vermillion border of lips, skin of face locations have better Px than of oral mucosa
what's the interaction of SCC and sun exposure? causes lips to turn from dark pink to mottled grayish pink interface becomes blurred, linear fissures seen at right angles to line of interface
who does SCC affect the most? over 40s mostly men, incidence has increased in women
solar cheilitis subcategory of squamous cell carcinoma condition in which mild to severe epithelial dysplasia occurs
risk factors of squamous cell caricnoma tobacco alcohol consumption
tx and px of squamous cell carinoma surgical excision, radion therapy, chemotherapy (these patients may have xerostomia) TNM can be used to determine px (higher stage, worse px)
TNM Staging- Tumor T1- <2cm in diameter T2- 2-4cm in diameter T3- > 4cm in diameter T4- invades adjacent structures
TNM Staging- Node N0- no palpable nodes N1- ipsilateral palpable nodes N2- contralateral or bilateral nodes N3- fixed palpable nodes
TMN Staging- Metastasis M0- no distant metastasis (so none at all?) M1- clinical metastasis
verrucous carcinoma form of SCC slow growing exophytic tumor w/ pebbly red and white surface *msot cases in men 55+ and involve vestibule and buccal mucosa
how does verrucous carcinoma appear microscopically? tumor w/ numerous papillary epithelial projections papillary projections filled w/ keratin epithelium well differentiated, doesn't contain atypical cells, exhibits broad-based rete pegs, tumor doesn't show invasion through basement membrane
tx of verrucous carcinoma surgical excision
basal cell carcinoma malignant skin tumor assoc. w/ excesive exposure sun arises on skin of face appears as nonhealing ulcer w/ charct. rolled borders white adults w/ no sex predilection
how does basal cell carcinoma appear microscopically? composed of basal cells into underlying CT
tx of basal cell carcinoma surgical excision radiation therapy rarely metastasizes
name 4 salivary tumors pelomorphic adenoma monomorphic adenoma adenoid cystic carcinoma (cylindroma) mucoepidermoid carcinoma
salivary gland tumors may arise in either major or minor salivary glands -minor salivary gland tumors most often located at junction of hard and soft palate
adenomas/adenocarcinomas benign/malignant tumors of salivary glands
pleomorphic adenoma (benign mixed tumor) benign salivary gland tumor 90% of all salivary gland tumors
how does pelomorphic adenoma appear microscopically? encapsulated tumor composed of tiss. that appears to be a mix of both epithelium and CT
what is the most common extraoral location of pleomorphic adenoma? parotid gland
what is the most common intraoral location of pleomorphic adenoma? palate
how does pleomorphic adenoma appear clinically? appears as slowly enlarging, nonulcerated, painless, dome-shaped mass occurs individuals <40 yrs more often in women than men
tx of pleomorphic adenoma surgical excision reoccurence related to success of initial surgical removal
does carcinoma arise in a pleomorphic adenoma? yes, these lesions have been known to undergo malignant transformation
monomorphic adenoma benign, encapsulated salivary gland tumor *occurs < often than pleomorphic tumor uniform pattern of epithelial cells *occurs most commonly adult females upper lip + buccal mucosa
tx of monomorphic adenoma surgical excision
Warthin tumor-monomorphic adenoma aka.papillary cystadenoma lymphomatosum encapsulated tumor w/ epithelial + lymphoid tiss. (painless, soft, fluctuant mass) occurs parotid gland occurs adult malen
tx of warthin tumor-monomorphic adenoma surgical excision
adenoid cystic carcinoma aka. clindroma slow growing malignant tumor of salivary gland organ most common extraoral-parotid most common inftraoral-palate > common women > common 5th and 6th decades
how does adenoid cystic carcinoma appear microscopically? unencapsulated, infiltrates surrounding tiss. small, deeply staining, uniform epithelial cells resembles "swiss cheese"
tx for adenoid cystic carcinoma surgical excision, radiation, reoccurence is common, poor Px is distant metastases
mucoepidermoid carcinoma malignant salivary gland tumor nonencapsulated, infiltrating females made of mucous cells w/ epidermoid cells
how does mucoepidermoid carcinoma appear clinically? slowly enlarging mass, usually adults *most common malignant salivary gland tumor in kids major glands-parotid minor gland-palate
tx of mucoepidermoid carcinoma surgical excision w/ follow-up survival rate low as 50% after 5 yrs
random mucoepidermoid carcinoma shit may occur w/in bone (r/l) in mandibular premolar/molar region, can be salivary tiss. trapped in bone or from tranformed epithelial lining of dentigerous cyst
odontogenic tumors derived from tooth-forming tiss. composed of epithelium, mesenchyme or mixed most benign
epithelial odontogenic tumors ameloblastoma calcifying epithelial odontogenic tumor calcifying odontogenic cyst
mesenchymal odontogenic tumors odontogenic myxoma cementifying fibroma ossifying fibroma and ossifying fibroma benign cementoblastoma
mixed odontogenic tumors amelobastic fibroma ameloblastic fibro-odontoma odontoma
peripheral odontognic tumors peripheral ossifying fibroma other peripheral odontogenic tumors
ameloblastoma benign slow-growing, locally aggressive epithelial odontogenci tumor occurs max. and man. most often mandible in molar/ramus area unencapsulated, infiltrates into surrounding tiss.
how do ameloblastomas appear radiographically? multiocular soap-bubble, or honey-combed r/l occurs anywhere w/in jaw, can occur in assoc. w/ dentigerous cyst causes bone expansion occurs in adults
tx of ameloblastoma surgical removal, reoccurence coomon
calcifying epithelial odontogenic tumor aka. pindborg tumor benign epithelial odontogenic tumor composed of polyhedral epithelial cells, amyloid like material abnormal enamel seen w/ calcifications occurs in adults
how does the calcifying epithelial odontogenic tumor appear radiographically? uniocular or mutliocular r/l occurs >mandible than max., most often bicuspid/molar area
tx for calcifying epithelial odontogenic tumor surgical excision
calcifying odontogenic cyst nonaggressive lined by odontogenic epithelium ghost cell shit > common indivudals under 40
how do calcifying odontogenic cysts appear radiographically? well defined lesion r/l uniocular or multiocular calcifications may be r/o
tx for calcifying odontogenic cysts surgical enuleation usually doesn't reoccur
odontogenic myxoma benign, well circumscribed composed of fibrous tiss. w/ calcifications classified as fibroosseous lesion
ossifying fibromas benign well circumscribed tumor composed fibrous CT, calcifications occurs in adults, 3-4th decades most cases in mandible
how does ossifying fibromas appear microscopically contains fibrous CT and calcifications cemento-ossifying tiss.
how does ossifying fibromas appear radiographically? varies r/l to r/o depending on amount of calcified tiss.
tx of ossifying fibromas surgical excision reoccurence rare
perpherial ossifying fibroma well demarcated sessile or pedunculated lesion orgins-interdental papilla derives from pdl cells > common in women
tx of peripheral ossifying fibroma surgical ecision w/ thorough scaling of adjacent teeth to remove irritants that can induce regrowth 16% recurrence rate
benign cementoblastoma cementum-producing lesion fused to roots of vital teeth
how does benign cementoblastoma appear radiographically well defined r/o mass surrounded w/ radiolucent halo seen mandibular molar or premolar teeth occurs young adults pain frequent symptom
how does benign cementoblastoma appear microscopically? proliferation of cellular cementum fused to root or roots of affected tooth
tx of benign cementoblastoma enulceation of tumor, removal of involved tooth doesn't reoccur
ameloblastic fibroma benign, non encapsulated odontogenic tumor tiss. resembles dental papilla most cases in <20yr old > in males > common in mandibular bicuspid and molar region
how does ameloblastic fibroma appear radiographically? well defined or poorly defined uniocular or multiocular r/l
tx for ameloblastic fibroma surgical excision low recurrence rate
odontoma odontogenic tumor composed of enamel, dentin, cementum, pulp tiss. occurs young adults + yound adults most common clinical manifestations is failure of permanent tooth to erupt 2 types- complex and compound
odontoma- complex mass (odontogenic tiss.) doesn't resemble teeth (posterior mandible) radio.-r/o mass
odontoma- compound collection of numerous of small teeth (usually in anterior maxilla) radio. cluster of miniture teeth
tx of odontoma surgical ecision
osteosarcoma malignant tumor of bone forming tiss. >common primary malignancy of bone in pt under 40 painful, diffuse swelling, destructive may initally present as toothache/mobility
how does osteosarcoma appear radiographically? poorly defined lesion, widening of pdl space
tx of osteosarcoma chemo followed by surgery 20% survival rate of Syra
peripheral ossifying fibroma
how does osteosarcoma appear radiographically? poorly defined lesion, widening of pdl space
tx of osteosarcoma chemo followed by surgery 20% survival rate of Syra
peripheral ossifying fibroma
how does osteosarcoma appear radiographically? poorly defined lesion, widening of pdl space
tx of osteosarcoma chemo followed by surgery 20% survival rate of Syra
peripheral ossifying fibroma well demarcated sessile, or pedunculated lesion, females origins gingival interdental papilla (most likely from pdl cells) composed fibrous CT w/ bone and calcifications
what other fibromas is peripheral ossifying fibroma similar to? cementifying and ossifying fibromas
other peripheral odontogenic tumors rare lesions occur in gingiva, no bone invvolvment -peripheral ameloblastoma -peripheral calcifying epithelial odontogenic tumor tx.surgical excision
Created by: 100000001783325