6leathers.txt

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Grant32
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191297
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6leathers.txt
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2013-01-03 19:32:08
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Description:
Oral Pathology Lecture 6
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  1. 6 questions for lesion history
    • 1. How long has it been present?
    • 2. Has it changed in size? (rate important)
    • 3. has it changed in character? (lump-->ulcer)
    • 4. Any symptoms? (inflammation, tingling)
    • 5. Any constitutional problems? (fever, sore throat)
    • 6. Historic reason for lesion
  2. Components of lesion clinical exam
    • 1. Anatomic location
    • 2. Size and shape
    • 3. Single or multiple
    • 4. Surface 
    • 5. Color
    • 6. Boundaries
    • 7. Consistency upon palpation
    • 8. Any pulsation?
    • 9. Lymph node exam
  3. Biopsy indications
    • 1. Present for more than 2 weeks and no etiologic basis
    • 2. No response to local treatment after 10-14 days 
    • 3. Persistent hyperkeratotic changes in the surface tissue
  4. Suspicious indications of malignacncy
    • 1. Erythroplasia
    • 2. Ulceration
    • 3. Duration/ Growth rate
    • 4. Bleeding
    • 5. Induration/fixation
  5. Types of biopsies
    • 1. Oral cytology
    • 2. Aspiration biopsy
    • 3. Incisional biopsy
    • 4. Excisional biopsy
  6. Characteristics of biopsy
    • 1. Take a narrow deep wedge to show full pathologic process
    • 2. Capture the margin of the tissue (transition from normal)
  7. Vesicular-ulcerated erythematous surface lesions
    • 1. Herpes-Simplex
    • 2. Varicella Zoster
    • 3. Candidosis
    • 4. Benign mucous membrane pemphigoid
    • 5. Bullous pemphigoid
    • 6. Pemphigus
    • 7. Lupus Erythematosus
    • 8. Apthous Ulcers
    • 9. Erosive Lichen Planus
    • 10. Erythema Multiforme
  8. Soft tissue enlargements
    • 1. Hemangioma
    • 2. Lymphangioma
    • 3. Fibroma
    • 4. Lipoma
    • 5. Neuro-fibroma
  9. When can we use full excisional biopsy?
    • When the lesion is smaller than 1 cm
    • Cut through mucosa down to the muscle
    • Wedge elliptical shape includes both lesion and normal tissue
  10. Which types of lesions blanch?
    Vesicular lesoins
  11. The most common salivary gland disease
    Pleomorphic adenoma
  12. The most common malignant salivary gland disease
    Mucoepidermod carcinoma in the hard palate
  13. Adenoid cystic carcinoma
    • Invades neural tissue
    • Poor prognosis
  14. The most common minor salivary gland disease
    Polymorphous low grade adenocarcinoma
  15. Intra Osseous Lesions
    • 1. Ameloblastoma (most common odontogenic tumor)
    • 2. Keratocyst
    • 3. Central Giant Cell Granuloma
    • 4. Anuerysmal bone cyst
    • 5. Myxoma
  16. Intra-osseous cyst lesions
    • 1. Lateral periodontal cyst
    • 2. Radicular cyst and periapical granuloma
    • 3. Hyperplastic Dental Follicle
    • 4. Follicular Cysts (dentigerous and primordial)
    • 5. Odontogenic Keratocyst
  17. Types of fluid to place biopsy specimen
    Formalin or formaldehyde
  18. What should we conduct first before biopsying?
    A lymph node exam (avoid metastasis assumption)
  19. Does a bone biopsy take longer than a soft tissue biopsy?
    yes, they have to decalcify first
  20. What are the different types of biopsies?
    • 1. Cytology (cell scraping, many false negatives)
    • 2. Aspiration (often with bony lesions, insert needle)
    • 3. Incisional (only a portion of tissue, extensive/malignant lesions)
    • 4. Excisional (<1cm, benign lesions)

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