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Dent 355 Rima CT Hyperplasia (Slide # 1+2)
Dent 355 Rima CT Hyperplasia (Slide # 1+2)
Inflammation and repair together Production of granulation tissue Range: richly cellular and vascular Non inflamed, avascular, dense collagen avascular,
Epulides
hyperplastic, hyperplastic, not neoplastic
Mostly from interdental tissue Irritation from dental plaque and calculus Types:
Fibrous epulis (ossifying fibroma, hyperplastic gingivitis)
commonest
Epulides
More common in females More in anterior to molar region Maxilla>mandible Recur if causative factor persists Or if incompletely excised as in PGCG
Fibrous epulis
Clinically: Pedunculated or sessile Firm Similar in color to adjacent gingiva Ulceration ++-
Fibrous epulis
Histopathology: Cellularity variable Mature collagen Inflammatory infiltrate
Fibrous epulis
Chronic hyperplastic gingivitis Or Peripheral ossifying fibroma
Pyogenic granuloma
Pregnancy epulis: pyogenic granuloma in a pregnant female
Gradually increasing in size Regress after delivery Recur if excised in pregnancy and bleed
Pyogenic granuloma
Histopathology: Highly vascular proliferation
Lobular organization (lobular capillary hemangioma) hemangioma) _+ Ulcerated surface Older lesions: more fibrous
Pyogenic granuloma
Treatment and prognosis
Conservative surgical excision down to periosteum Occasionally it may recur Pregnancy tumor: delay treatment, may resolve spontaneously
Local surgical excison to underlying bone Scaling and polishing Recurrence rate 10% 10%
Prognosis
HYPERPARATHYROIDISM
Most common site is the buccal mucosa Labial mucosa tongue and gingiva Chronic minor trauma appears to be the cause Under denture: Leaf fibroma
Irritation fibroma
Histopathology
Multinucleated fibroblasts
Retrocuspid papilla
Same histopathology as giant cell fibroma Developmental lesion, lingual to mandibular canine on the interdental papilla 25-99% 25-99% of young adults and children
Gingival fibromatosis
This is not neoplastic
Aggressive fibromatosis
Fibrosarcoma
Fibrosarcoma
Variable proportions of stroma and mature fat tissue: fibrolipoma, angiolipoma, myxolipoma fibrolipoma, angiolipoma, myxolipoma
Floats in formalin ** traumatic herniation of the buccal pad of fat in infants and young children
lipoma
Lipoma
liposarcoma
Clinically
Dark red-purple redElevation: smooth, lobulated, lobulated, soft or hard Blanching on pressure May increase in size:
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Histopathology:
Other Malformations:
Other vascular anomalies: sublingual varicosities Malignant vascular lesions: Kaposi lesions: sarcoma and angiosarcoma Angiomatous syndromes: syndromes:
Cellular hemangioma
AVM
Kaposi sarcoma
Angiosarcoma
Angiomatous syndromes
StrurgeStrurge-Weber Syndrome
1.
2.
3.
Hemangiomatous lesions of one or more of the branches of the trigeminal nerve Ipsilateral hemangiomas and calcifications in the meninges over cerebral cortex Convulsions affecting the limbs on the opposite side
..Angiomatous syndromes:
Lymphangioma
Lymphangioma
Cystic hygroma
Early in development of lymphatic changes Detected at birth Up to 10 cm in diameter
Neurofibroma
Soliotary or Multiple/ associated with:
Neurofibroma
Neurofibroma
Neurofibroma
Histologically: Considerable variation Schwann cells and fibroblasts Varying amount of collagen and mucoid tissue A few nerve fibers run through the lesion May be circumscribed or diffuse
Neurofibroma
Neurofibroma
Neurofibromatosis I
NF1 NF1 mutation (tumor suppressor gene) Familial, AD or sporadic mutation Multiple neurofibromas of cutanous nerves
Intraoraly: mucosal swellings and bone involvement (mental and ID nerve)
CafCaf-au lait spots Other findings: axillary freckeling Malignant transformationin 5-15% of all 15% cases
Neurofibromatosis
Types I (skin) and II (central nervous system)
Schwannoma (Neurilemmoma)
Encapsulated Nerve fibers dont pass through the lesion
Traumatic neuroma
Non neoplastic disorganized overgrowth of nerve fibers, Schwann cells and scar tissue severed end of nerves Exaggerated regeneration of nerve tissue Clinical features Slowly growing Firm, fixed to surrounding structures Painful to palpation large nerves, such as mental foramen
Clinical features
Slowly growing. Most common in tongue. Firm, fixed to overlying mucosa and deep structures Multiple tumors may occur
PsuedoPsuedo-epitheliomatous hyperplasia
Tunmors of muscles
Leiomyoma, leiomyomatous hamartoma, leiomyosarcoma Rhabdomyoma, rhabdomyosarcoma
Leiomyoma
Rhabdomyoma
Lymphoma
Hodgkins lymphoma NonNon-Hodgkins lymphoma
Hodgkins lymphoma
30% 30% of all lymphomas Young age group Cervical lymph nodes in 75% 75% ReedReed- Sternberg cell is the diagnostic cell: large cell with 2 nuclei or bilobed nucleus (mirror image) Genetic factors and viral infection (EBV) Prognosis: clinical staging and histologic grading Distribution: mainly nodal
Hodgkins lymphoma
Histopathologic types: Lymphocyte predominant Mixed cellularity Nodular sclerosis Lymphocyte depletion
NonNon-Hodgkins lymphoma
B cell: majority T cell/ NK
extra nodal MALT lymphoma better prognosis than lymphoma nodal, remian localized for long periods Salivary gland.Sjogren Syndrome and gland.Sjogren myoepithelial sialadentitis Bone AIDS
Burkits Lymphoma
Endemic and sporadic Endemic: Africa: EBV and Malaria Children 2-14 yrs
Starts in the jaws, maxillary and posterior Rapidly growing, multifocal Starts in the abdomen