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OPT Epithelial
| Term | Definition |
|---|---|
| oral squamous papilloma | benign HPV 6&11 induced proliferation of stratified squamous epithelium |
| recurrent respiratory papillomatosis (RRP) | papillomas in respiratory tract; juvenile and adult onset |
| juvenile-onset RRP | passed to fetus from mother with genital warts; laryngeal papillomas |
| adult-onset RRP | laryngeal papillomas that cause hoarseness |
| verruca vulgaris | common wart; benign proliferation of squamous epithelium induced by HPV-2 that is contagious |
| condyloma accuminatum (venereal wart) | HPV-induced proliferation of squamous epithelium transmitted sexually |
| multifocal epithelial hyperplasia (Heck disease) | proliferation from HPV 13&32; papules on lips and tongue |
| sinonasal papilloma | benign proliferations of sinonasal mucosa, not always induced by HPV |
| molluscum contagiosum | epithelial proliferation induced by this member of the DNA poxvirus; pink umbilicated papules on head and genitals |
| verruciform xanthoma | squamous proliferation mainly in mouth of unknown cause; fine papillary surface with white/yellow/red color |
| seborrheic keratosis | on sun-exposed skin but not in mouth; benign tan-brown macules that have 'stuck-on' appearance |
| sign of Leser-Trelat | sudden appearance of many seborrheic keratoses |
| sebaceous hyperplasia | localized proliferation of sebaceous glands in nose, cheeks and forehead; resembles basal cell carcinoma |
| Muir-Torre syndrome | autosomal dominant disorder of sebaceous hyperplasia, malignancies and keratoacanthomas |
| ephelis (freckle) | hyperpigmented macule, more often in fair-skinned, blue-eyed people |
| actinic lentigo (solar lentigo) | well-demarcated pigmented brown macule on sun-exposed skin in old people |
| lentigo simplex | benign cutaneous melanocytic hyperplasia not caused by sun-exposure; LEOPARD syndrome |
| melasma | 'mask of pregnancy'; hyperpigmentation of face and neck, can also be due to oral contraceptives |
| oral melanotic macule (focal melanosis) | increase of melanin in basal layer of oral mucosa; usually solitary and benign but resembles melanoma |
| acquired melanocytic nevus (mole) | proliferation of neural crest nevus cells that migrate to epidermis; associated with BRAF mutation |
| junctional nevus | increased nevus cells along basal layer, forming 'theques'; flat and demarcated |
| compound nevus | nevus cells in junctional area and superficial CT; slightly elevated |
| intradermal nevus | all nevus cells in CT; raised with papillomatous surface |
| intramucosal nevus | intradermal nevus in the mouth; most common melanocytic spot in mouth |
| congenital malanocytic nevus | present at birth and more malignant than acquired forms |
| halo nevus | zone of depgimentation surrounding nevus due to immunologic attack |
| spitz nevus | nevus that mimics melanoma seen in children |
| blue nevus | 'Tyndall effect' gives nevus a blue color since deep in CT; common type in oral cavity |
| leukoplakia | white patch or plaque that cannot be rubbed off and isn't anything else; no histopathologic change -premalignant, especially in smokers and become SCC on lateral tongue, floor and lower lip in particular -biopsy and microscopic evaluation is mandatory |
| verruciform leukoplakia | leukoplakia with surface irregularities with projections |
| erythroplakia | leukoplakia with areas of redness |
| speckled leukoplakia/erythroleukoplakia | leukoplakia with combined color change |
| proliferative verrucous leukoplakia (PVL) | high risk, multiple plaques that progress to verrucous to SCCA |
| epithelial dysplasia | alteration of squamous epithelium that can progress to SCCA without invasion of CT |
| erythroplakia | red patch or plaque not diagnosed as anything else; almost all have epithelial dysplasia, carcinoma in situ, or invasive SCCA so should be biopsied ASAP |
| smokeless tobacco keratosis | thickened and white mucosa where tobacco is placed; should be biopsied if remains 6 weeks after cessation |
| oral submucous fibrosis | chronic, progressive scarring at high risk for SCCA, from chewing betel quid |
| nicotine stomatitis | seen on palate in pipe and cigar smokers, due to heat rather than chemicals |
| actinic keratosis (solar keratosis) | from UV exposure, precancerous scaly plaque with sandpaper surface |
| actinic cheilosis | lesion on lower lip vermillion in males; scaly with possible ulcerations |
| keratoacanthoma | self-limiting, mimics SCCA in sun-exposed areas; dome-shaped nodule with keratin plug |
| squamous cell carcinoma | malignancy of stratified squamous epithelium, 90% of oral malignancies |
| HIV-positive oropharyngeal carcinoma | SSCA that is on the rise, related to HPV transmission via oral sex |
| tobacco smoke | has over 70 carcinogens and produces free radicals to increase risk of SCCA |
| smokeless tobacco | increases risk for SCCA but depends on type; dry snuff is worse than wet snuff |
| alcohol | not initiating factor for SCCA but potentiates other effects |
| Plummer-Vinson syndrome | severe iron-deficiency anemia with increased risk for SCCA on pharynx |
| oncogenic viruses | high risk HPV can increase risk of SCCA especially HPV-16 |
| immunosuppression | diminished immune system can affect development of SCCA |
| ocogenes and tumor suppressor genes | can be acted on by viruses, radiation and carcinogens to allow cancer to develop |
| SCCA of lip vermillion | 90% on the lower lip; crusted, ulcerated mass that grows slowly |
| tongue | most common site of intraoral SCCA, usually on lateral and ventral surfaces |
| SCCA of floor of mouth | arises from preexisting leukoplakia/erythroplakia; most likely to metastasize |
| gingival and alveolar SCCA | irregular lesion that spreads laterally along the gingiva |
| SCCA of buccal mucosa | worse prognosis with tendency to metastasize |
| oropharyngeal SCCA | in posterior region of oral cavity, usually larger and higher chance to metastasize |
| metastatic spread | largely spread through lymphatics to cervical lymph nodes |
| TNM (tumor-node-metastasis) | staging of cancer based on size of primary tumor, metastasis to regional nodes and distant metastases |
| treatment of oral SCCA | guided by clinical stage, location; includes excision, chemo, radiation or combination |
| tumor stage | best prognostic indicator for lip and intraoral carcinomas |
| HPV-status | best prognostic indicator for oropharyngeal carcinomas |
| verrucous carcinoma | low-grade SCCA usually at site of cewing tobacco; large, white thick plaque |
| spindle cell carcinoma | rare variant of SCCA with invasive portion of tumor formed by spindle-shaped epithelial cells that mimic sarcomas; fast-growing and metastasizes early |
| adenosquamous carcinoma | rare, high grade variant of SCCA with combination of surface SCCA and underlying adenocarcinoma; sometimes produces mucin, almost universal cervical lymph node metastasis at time of discovery |
| basaloid squamous carcinoma | high-grade SCCA variant with high association with alcohol and smoking; usually late stage at diagnosis |
| carcinoma of maxillary sinus | uncommon and usually SCCA; chronic sinusitis at first then fast progressing to pain and paresthesia |
| sinonasal undifferentiated carcinoma (SNUC) | high-grade malignancy of nasal cavity; rapid growth and tumor necrosis |
| nasopharyngeal carcinoma | cancer of lymphoid-rich nasopharynx, endemic in China; associated with smoking, EBV, enlarged cervical nodes |
| basal cell carcinoma | most common skin cancer in the US; locally invasive slow-spreading tumor from UV exposure |
| nodular | most common BCCA, with telangiectatic blood vessels |
| pigmented | BCCA that mimics melanoma |
| sclerosing | BCCA that looks like a scar; perform Mohs surgery on this type |
| superficial | BCCA that looks like psoriasis |
| nevoid | BCCA that looks like nevus and there are usually multiple; part of nevoid basal cell carcinoma syndrome |
| Merkel cell carcinoma (neuroendocrine carcinoma of skin) | rare aggressive malignancy from UV exposure and weak immune status; tumor cells contain granules that look like these in Merkel touch receptors |
| melanoma | extremely fatal malignant melanocytic tumor; can occur wherever melanocytes are present |
| radial growth phase | lateral spread of melanoma along basal cell layer |
| vertical growth phase | melanoma tumor cells that invade the underlying connective tissue |
| ABC's of melanoma | Asymmetry, Border irregularity, Color variegation, Diameter larger than pencil eraser, Evolving size, shape, color etc. |
| superficial spreading melanoma | 70% of cutaneous melanomas; in interscapular area in men and back of legs in women |
| lentigo maligna melanoma | melanoma that develops in pre-existing pigmentation on face of elderly; has long radial growth phase |
| nodular melanoma | melanoma when vertical invasion begins immediately and sometimes shows no pigment |
| acral lentiginous melanoma | melanoma most common in blacks and oral cavity |
| oral melanomas | rare but usually on palate and maxillary gingiva/mucosa |
| depth of invasion | important prognostic indicator for melanoma |
| Clark system | classifies melanomas on 5 levels of tissue |
| Breslow system | classifies melanoma by actual measurement of tumor thickness |
| treatment of cutaneous melanoma | surgical excision with wide margins |
| sentinal node biopsy | surgery used to see if first node on drainage path contains tumor to decide if more surgery should be done |
| mucosal melanomas of head and neck | all aggressive and stage III melanomas; usually have distant metastases |
Created by:
aharnold
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