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2013-01-13 16:36:53
simplified opath4 charts OSD4

OSD4 simplified charts
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  1. Squamous Papilloma
    "Pedunculated, fingerlike projections of SSE, Koilocytes, HPV6 and 11"
  2. Verruca Vulgaris
    "HPV 2, 4, 6, 40; Papillary projections covered in hyperkeratotic SSE, elongated rete ridges, koilocytes"
  3. Condyloma Acuminatum
    "HPV, STD, Acanthotic SSE�blunted projection, Prickle cells with raisin nuclei and koilocytes"
  4. Multifocal Epithelial Hyperplasia
    "Proliferation of squamous epithelium, HPV 13 and 32, HLA-DR4 allele"
  5. Molluscum Contagiosum
    "Virus-induced, epithelial hyperplasia, multiple papules"
  6. Leukoplakia
    "Hyperkeratosis w/ or w/o acanthosis, parakeratin or orthokeratin, oral precancer, chronic inflammatory cells, dysplastic epithelial cells"
  7. Erythroplakia
    "Macule or plaque, severe epithelial dysplasia, carcinoma in situ, superficially invasive SCC, no keratin production, very thin epithelium"
  8. Smokeless Tobacco
    "Gingival recession, acanthosis, hyperkeratosis, chevron formation, dysplasia"
  9. Oral Submucous Fibrosis
    "Betal quid, trismus, dense-hypovascular CT, hyperkeratosis, basilar hyperplasia, fibrosis in lamina propria"
  10. Nicotinic Stomatitis
    "Due to heat, small red papules in white lesion, hyperkeratosis, acanthosis"
  11. Actinic Keratosis
    "Sun exposure, scaly plaques, excessive parakeratin, hyperchromatism and pleomorphism of epidermal cells"
  12. Actinic Chelitis
    "Lower lip vermillion atrophy, sun-exposure, keratin production, solar elastosis of underlying CT, inflammatory infiltrate"
  13. Keratoacanthoma
    "Central plug of keratin, well-differentiated SCC"
  14. Squamous Cell Carcinoma
    "HPV 16, 18, 31, 32, dysplastic surface epithelium, invasive islands, cords of malignant squamous epi cells: lamina dura�BM�subepithelial CT; angiogenesis, fibrosis, keratin pearls"
  15. Spindle Cell Carcinoma
    "Dysplastic surface squamous epithelium, invasive spindle cell element"
  16. Basal Cell Carcinoma
    "Skin cancer, sun-exposure, ulceration, hyperchromatic epithelial cells, palisading of peripheral cells, demarcated islands and strands, solar elastosis"
  17. Sebaceous Hyperplasia
    "Localized proliferation of sebaceous glands, small central depression, sebum expression upon compression of the lesion, Muir-Torre Syndrome"
  18. Verrucous Carcinoma
    • "Low-grade variant of SCC, chronic smokeless tobacco use, large exophytic papillary mass, wide, elongated rete ridges, parakeratin plugs"
    • (Snuff Dipper�s Cancer)
  19. Nasopharyngeal Carcinoma
    "Arises from lining epithelium of the lymphoid tissue-rich nasopharnx, EBV, Tobacco use, Waldeyer�s Ring"
  20. Sebhorrheic Keratosis
    "Benign, raised, proliferation of epidermal basal cells, NOT oral, acanthosis, hyperkeratosis, pseudocysts (keratin-filled invaginations), upward proliferation"
  21. Ephelis (Freckle)
    "Hyperpigmented macule of the skin, SSE with abundant melanin deposition in basal layer, no elongation of rete ridges, NEVER elevated, sun-exposure effect"
  22. Actinic Lentigo
    • "Due to sun-exposure, but doesn�t change color intensity, well-demarcated, but irregular borders, increased melanin"
    • "(Liver Spots, Age Spots)"
  23. Lentigo Simplex
    "Benign cutaneous melanocytic hyperplasia, no color change with sun, basal keratinocytes, melanin incontinence"
  24. Peutz-Jegher�s Syndrome
    "Freckle-like lesions of hands, perioral skin and oral mucosa most affected, intestinal polyposis, Circumoral lentigines, GI adenocarcinoma"
  25. Addison�s Disease
    "Adrenal cortical insufficiency, diffuse hypermelanosis, �bronzing of the skin�"
  26. Melasma
    • "Bilateral hyperpigmentation of sun-exposed skin of face and neck, associated with pregnancy, increased melanin deposition, wood lamp for melanin visualization"
    • (Mask of Pregnancy)
  27. Oral Melanotic Macule
    "No sun-exposure, flat, brown mucosal discoloration, lower lip macule, increase in melanin, melanin incontinence"
  28. Oral Melanoacanthoma
    "African Americans, dramatic enlargement within months, darkly pigmented"
  29. Caf�-au-lait Spot
    "Flat, brown macules, >1.5cm in diameter, 6+=neurofibromatosis, seen in Albright Syndrome"
  30. Acquired Melanocytic Nevi
    "Localized proliferation of NCC derived cells, hard palate, slightly elevated, junctional, compound, intramucosal/intradermal nevi"
  31. Congenital Melanocytic Nevus
    "Hypertrichosis, compound or intradermal nevi, infiltration of cells between collagen bundles, �Giant Hairy Nevus�"
  32. Halo Nevus
    "Melanocytic nevus with a pale HYPOpigmented border, autoimmune attack on melanocytes"
  33. Blue Nevus
    "Tyndall effect causes blue color, melanin particles deep in spindle-shaped melanocytes, compound nevus"
  34. Melanoma
    "Malignant neoplasm of melanocytic origin, sun-exposure (acute), BRAF gene, ABCDE clinical diagnosis, BANS (worst prognosis)"
  35. Superficial Spreading Melanoma
    "Most common, nodular, deeply pigmented exophytic lesion, spread of atypical melanocytes ALONG basilar portion of epidermis, Pagetoid pattern, lateral spread"
  36. Lentigo Maligna Melanoma
    "From Lentigo meligna or Hitchinson�s Freckle, Sun-exposure, fair-skin, melanoma in situ in a radial growth phase"
  37. Acral Lentiginous Melanoma
    "African Americans, Oral melanoma, atypical melanocytes IN the basal portion of epithelium, invasion into the superficial lamina dura, dendritic processes"
  38. Vitiligo
    "Autoimmune, onset after stress, sun-exposure, injury, NO melanocytes present in involved skin"
  39. Pityriasis (Tinea) Versicolor
    "HYPO or HYPERpigmented, fungal related, more obvious when patient is tan, �spaghetti and meatballs� seen with KOH stain"
  40. Fibroma
    "Exophytic, nodular mass, dense, fibrous CT covered by SSE, NOT encapsulated, pedunculated, response to local irritation or trauma, fibrous maturation of a preexisting pyogenic granuloma "
  41. Giant Cell Fibroma
    "Retrocuspid papilla, vascular, fibrous CT, multi-nucleated, stellate fibroblasts within superficial CT, Rete ridges narrow and elongated"
  42. Peripheral Ossifying Fibroma
    "Exclusively on gingiva, interdental papillae, formation of mineralized product (central bone formation), pyogenic granuloma (ddx)"
  43. Pyogenic Granuloma
    "Response to local irritation or trauma, pedunculated, highly vascular, endothelium-lined channels engorged with RBCs, lobular aggregates of vessels"
  44. Peripheral Giant Cell Granuloma
    "Response to local irritation or trauma, exclusively on gingiva, nodular proliferation of multi-nucleated giant cells within the gingiva, highly vascularized, RBCs"
  45. Traumatic Neuroma
    • "Haphazard proliferation of mature, myelinated and unmyelinated nerve bundles, reactive proliferation after local trauma to a nerve, regeneration pathology"
    • Amputation Neuroma
  46. Neurilemoma
    • "Schwann cell origin, Antoni A/B, palasaded arrangement around the central, acellular eosinophilic areas (Verocay Bodies)�Reduplicated BM and cytoplasmic processes, S100 protein +"
    • Schwannoma
  47. Granular Cell Tumor
    "Benign, derived from Schwann or neuroendocrine cells, tongue, large polygonal cells, NOT encapsulated (but benign), S100+, acanthosis, PEH"
  48. Neurofibroma
    "Peripheral nerve neoplasm, solitary or part of neurofibromatosis, skin, interlacing bundles of spindle-shaped cells, wavy nuclei, mast cells"
  49. Neurofibromatosis
    "NF1 gene, Von Recklinghausen�s Disease, Plexiform variant (bag of worms), Caf�-au-lait (6+), Axillary Freckling (Crowe�s Sign), Lisch Nodules, optic glioma, neurofibromas, enlargement of fungiform papillae, mandibular foramen, and increased bone density"
  50. Paraganglioma
    "Paraganglia (tissues from NCCs), carotid body tumor"
  51. Multiple Endocrine Neoplasia
    MEN 2B
    "Marfanoid body build, Pheochromocytomas (increased catecholamines), leads to medullary thyroid carcinoma, increased VMA and Epi:NorEpi"
  52. Melanotic Neuroectodermal
    • "NCC origin, Maxilla, pigmented neoplasm, high urinary levels of VMA, benign, despite rapid growth and potential to destroy bone"
    • Tumor of Infancy
  53. Inflammatory Papillary Hyperplasia (Denture Papillomatosis)
    "Ill-fitting dentures, hard palate, mouth breathers, high palatal vault, hyperplastic SSE, PEH, sclerosing sialadenitis if salivary glands present, loose and edematous to densely collagenized CT, chronic inflammatory cell infiltrate"
  54. Epulis Fissuratum
    "Ill-Fitting Dentures, Fibroepithelial polyp/leaf-like fibroma, hard palate, pedunculated, hyperkeratotic overlying epithelium, irregular hyperplasic rete ridges"
  55. Congenital Epulis
    "Soft tissue tumor, alveolar ridges of newborns, polypoid mass"
  56. Hemangioma
    "Benign tumors of infancy, endothelial proliferation, circumscribed cellular mass of vascular endothelial cells, strawberry hemangioma (bright red, superficial), deeper hemangiomas are bluish due to Tyndall Effect"
  57. Vascular Malformations
    "NO endothelial proliferation, Port Wine Stains (face, along CNV), excessive numbers of dilated blood vessels in the middle and deep dermis"
  58. Sturge-Weber Angiomatosis
    "Hamartomatous vascular proliferation involving tissues of brain and face, port wine stain or nevus flammeus, leptomenigial angiomas, gyriform �tramline� calcifications in the brain, glaucoma, vascular dilation of oral lesions, vascular hyperplasia of gums"
  59. Lymphangioma
    "Hamartomatous tumors of lymphathic vessels, dilated lymphatic vessels beneath the atrophic surface epithelium and in the deeper CT (Cavernous Lymphangioma), Cystic Hygroma, pebbly and vesicle apper."
  60. Leiomyoma
    "Benign tumor of smooth muscle, Masson Trichome stain shows SM bundles with normal collagen"
  61. Rhabdomyoma
    "Benign neoplasm of skeletal muscle, rounded and polygonal cells with focal vacuolization (spider web appearance) granular eosinophilic cytoplasm, PTAH=focal cross striations"
  62. Lipoma
    "Benign tumor of mature fat cells, yellow-nodular masses, sessile or pedunculated, thin fibrous capsule"
  63. Osseus and Cartilagionous Choristomas
    "Microscopically NORMAL tissue in an ABNORMAL location, bone and/or cartilage in the TONGUE, mass of dense lamellar bone beneath surface epithelium"
  64. Fibrosarcoma
    "Malignant tumor of fibroblasts, spindle-shaped cells with mild pleomorphism"
  65. Liposarcoma
    "Malignant tumor of fatty cell origin, well-differentiated/atypical lipomatous tumor (most common)"
  66. Leiomyosarcoma
    "Malignant tumor of smooth muscle origin, uterine wall and GI tract, RARE in oral cavity"
  67. Rhabdomyosarcoma
    "Malignant tumor of skeletal muscle origin, infiltrative mass that grows rapidly, head and neck common"
  68. Malignant Peripheral Nerve Sheath Tumor
    50% of NF1 gene + people get this (Neurofibromatosis)
  69. Kaposi�s Sarcoma
    "Vascular neoplasm caused by HHV8 and KSHV, propensity in HIV+, lesion arises in endothelial cells"
  70. Metastasis to Oral Soft Tissues
    "Uncommon, Batson�s Plexus allows metastasis, gingiva and tongue most common, lung>kidney>melanoma>prostate>breast cancer for metastasis to oral cavity"
  71. Mucocele
    "Rupture of salivary gland duct due to local trauma, NEVER on upper lip, mucin-filled cyst-like (not a true cyst) cavity, granulation and foamy histiocytes present"
  72. Ranula
    "Mucocele on the floor of the mouth, spilled mucin from sublingual gland"
  73. Salivary Duct Cyst
    "True cyst, �Mucous Retention Cyst�, lined by thin cuboidal epithelium, excretory gland duct lined by columnar epithelium, major and minor salivary glands"
  74. Sialolithiasis
    "Calcified structures that develop within the salivary duct system, submandibular gland, radiopaque masses, concentric laminations around amorphous debris, squamous metaplasa of duct, �milk� stone out of duct with massage"
  75. Sialadenitis
    "Inflammation of salivary gland, due to bacteria, sialolithiasis, congential strictures; purulent exudates, chronic inflammatory infiltrate with associated acinar atrophy and ductal dilation and fibrosis"
  76. Sialadenosis
    "Non-inflammatory, salivary gland enlargement, parotid gland most common, hypertrophy of acinar cells, excessive accumulation of secretory granules "
  77. Sialorrhea
    "Excessive salivation, Water Brash, Drooling"
  78. Xerostomia
    "Subjective dry mouth, usually due to medications in older people, saliva is ropey, thick or foamy, prone to dental caries and candidiasis"
  79. Sjogren Syndrome
    "Chronic systemic autoimmune involving salivary and lacrimal gland dysfunction, Sicca Syndrome, Elevated IgG, RF, Anti-SS-A/B, lymphocytic infiltration of salivary glands, destruction of acinar cells, presence of focal chronic inflammatory aggregates"
  80. Benign Lymphoepithelial Lesion
    "Mikulicz disease, autoimmune disease, bilateral salivary and lacrimal enlargmenet, lymphocytic infiltration of the parotid gland with associated epimyoepithelial island"
  81. Necrotizing Sialometaplasia
    "Local inflammatory destruction of salivary glands, palatal salivary glands most common, necrotic mucous acini and adjacent ductal squamous metaplasia, ulceration in later stages, will heal on its own"
  82. Pleomorphic Adenoma
    "Mixture of ductal and myoepithelial elements, parotid gland most common, well-circumscribed, encapsulated, benign tumor with variable microscopic pattern and mesenchyme-like background, fat or osteoid can be present"
  83. Oncocytosis
    "Transformation of ductal and acinar cells to oncocytes, proliferation and accumulation of oncocytes in salivary glands, polyhedral, granular eosinophilic cytoplasm (result of proliferation of mitochondria)"
  84. Oncocytoma
    "Monomorphic Adenoma, composed of large epithelial cells (oncocytes), well-circumscribed, benign, abundant granular, eosinophilic cytoplasm (mitochondria)"
  85. Warthin�s Tumor
    • "Benign, monomorphic adenoma, parotid gland tumor, associated with smoking, bilateral (but not at same time), 2 layers: inner luminal layer with tall columnar cells, palasading, centrally placed nuclei, second layer of cuboidal or polygonal cells with more vesicular nuclei, papillary infoldings that protrude into cystic spaces "
    • (Papillary Cystadenoma Lymphomatosum)
  86. Canalicular Adenoma
    "Monomorphic Adenoma, minor salivary glands, upper lip, uniform columnar cells forming canal-like ductal structures with deeply basophilic nuclei"
  87. Basal Cell Adenoma
    "Monomorphic Adenoma, Benign, parotid gland, encapsulated or well-circumscribed, cords of basaloid cells arranged in a trabecular pattern"
  88. Mucoepidermoid Carcinoma
    "Malignant, parotid gland, mixture of mucus-producing cells and squamous (epithelial cells), intermediate cells (progenitor cells), solid islands of squamous and intermediate cells, pleomorphism and mitotic activity (High-Grade Tumor)"
  89. Intraosseous Mucoepidermoid Carcinoma
    "Malignant, salivary gland tumor within the jaw (intrabony), associated with impacted teeth or dentigerous cysts, prominent cyst formation, minimal cellular atypia, high proportion of mucous cells (Low-Grade Tumor)"
  90. Acinic Cell Adenocarcinoma
    "Malignant, serous acinar differentiation"
  91. Malignant Mixed Tumors
    "Malignant counterpart to benign mixed tumor or pleomorphic adenoma, �carcinoma ex pleomorphic adenoma� (Epithelial cells�malignant), areas of malignant degeneration of epithelial cells, cellular pleomorphism and abnormal mitotic activity"
  92. Adenoid Cystic Carcinoma
    "Malignant, submandibular gland, mixture of myoepithelial cells and ductal cells; Three histo patterns: Cribriform, tubular, solid; perineural invasion (not pathognomonic)�pain due to cells around nerve bundle, bad prognosis over time"
  93. Polymorphous Low-Grad Adenocarcinoma
    "Malignant, Minor salivary glands, Cribriform pattern mimics adenoid cystic carcinoma, perineural invasion common, good prognosis"