42

ORAL PATHOLOGY
SECTIONS QUIZZES
CENTER EVEREST
01020112626
1- DENTAL CARIES
Slide number Identification & answers
3 Nursing bottle caries (A type of rampant caries).
A → arrested caries (note eburnated dentine).
4
B → root caries
A → rampant caries
5
B → smooth surface caries
Black → beaded dentinal tubules
6
Yellow → tertiary dentine (irregular secondary dentine).
A → transverse clefts
7
B → liquefaction foci
1 → surface zone
2 → body of the lesion
8 3 → dark zone
4 → translucent zone
5 → sound enamel
Blue → zone of fatty degeneration of Tome`s fibers.
Yellow → zone of sclerosis.
9 Green → zone of demineralization.
Red → zone of bacterial invasion.
Orange → zone of decomposed dentine.
Red → enamel (undermined).
Yellow → fractured (carious) enamel & dentine.
10 Blue → dead tract.
Orange → sclerotic dentinal tubules.
Green → secondary dentine (irregular or tertiary).

2- PULP DISEASES
Slide number Identification & answers
1 → epitheliated pulp polyp.
2 → child (around 12-14 years old).
3 → epithelium & source:
i. Implantation of epithelial cell on its surface (as normally
12 desquamated cells carried by saliva to the surface of the pulp).
ii. Transplantation of epithelial cells from the buccal mucosa rubbed
against the hyperplastic tissue mass.
4 → fibroblasts, endothelial cells and chronic inflammatory cells.
1 → acute closed pulpitis (sharp severe lancinating pain) or chronic closed
pulpitis (mild dull aching pain).
2 → pulp abscess composed of pus space surrounded by acute or chronic
13 inflammatory cells.
Pus is formed of PMLs + dead and living bacteria + digestive tissue +
bacterial toxins.
A → electrical (galvanic) irritation.
14 B → aerodontalgia (Due to N2 mbolism in blood vessels → dilatation →
pressure on nerves inside pulp).
A → bacterial irritation of pulp due to fractured tooth.
15 B → bacterial irritation of pulp due to caries.
1 → pulp stone
2 → blue arrow → true (free) pulp stone another type → false (attached).
16
3 → asymptomatic but may cause neuralgic pain & problematic during
endodontic treatment.
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3- PERIAPICAL LESIONS
Slide number Identification & answers
1 → chronic periapical abscess or periapical granuloma.
18
2 → periapical granuloma (cholesterol clefts surrounded by MNGCs).
A → Black → plasma cell blue → lymphocyte
19 B → blue → MNGCs red → cholesterol clefts
C → black → macrophage
1 → periapical granuloma (with epithelial proliferation).
2 → blue → root
Black → granulation tissue (inflammatory cells + fibroblasts + collagen +
newly formed capillaries).
Red → epithelial proliferation.
Green → fibrous capsule.
3- Sources of epithelium:
20 I. Epithelial rests of Malassez, but may arise from:
II. Respiratory epithelium of maxillary sinus (in maxillary
teeth).
III. Oral epithelium growing through fistulous tract.
IV. Oral epithelium growing apically from periodontal pockets.
4→ fibrous capsule surrounding the lesion (making it localized well
defined).
1 → Acute periapical abscess or chronic periapical abscess.
2 → acute (sharp severe continuous lancinating pain, severe pain with
percussion test) due to severe inflammatory process with accumulation of
pus periapically with no escape so increase pressure and pain.
Chronic (asymptomatic or milder pain than acute) due to mild
inflammatory process and escape of pus from broken opened tooth or
fistula.
21 3 → blue → necrotic pulp.
Black → inflammatory cells.
Red → resorbed bone.
1 → chronic periapical abscess
As it appear as a RL on xray.
22 2 → percussion test & gutta percha test.
3 → asymptomatic or mild pain especially with biting on solid food.
23 Root apex, pus space, chronic inflammatory cells, and resorbed bone.
Fistulous tract opening from chronic periapical abscess.
24
Associated with picture (B) (inflammatory cells not foam cells).

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4- OSTEOMYELITIS
Slide number Identification & answers
Red → osteoblast.
Yellow → osteocyte.
26 Blue → osteoclast (MNGC).
Green → reversal lines.
Acute suppurative osteomyelitis.
27 Red → empty lacuna of osteocyte → sequestrum formation.
1 → Hyperbaric oxygen used in resistant cases of chronic suppurative osteomyelitis.
2 → contraindicated in:
28 i. Viral disease. iii. Optic neuritis.
ii. Lung disease. iv. Residual, recurrent malignancy.
1 → focal sclerosing osteomyelitis (bony scar).
29 2 → localized well defined RO mass below apex (the root outline is visible).
1 → Garre`s osteomyelitis (onion skin appearance).
30 2 → age → 10-15 years old.
1 → dry socket (alveolar osteitis).
2 → severe throbbing pain.
3 → X-ray to detect any tooth fragment in socket.
1- Irrigation with warm saline, local antiseptic (chlorhexidine).
2- Packing of socket with:
31  iodoform gauze containing eugenol.
 Local antibiotic (tetracycline)
 antifibrinolytic (alveogel).
* Packing is repeated every 24 h. for 3 days then every 2 days until GT fill exposed
bone (may take 3-4 weeks).
3- Systemic antibiotic.
A → chronic suppurative osteomyelitis.
32 B → Garre`s osteomyelitis.
C → focal sclerosing osteomyelitis.
Sequestrum (dead bone).
33 Acute suppurative osteomyelitis.
A → 3 (onion skin appearance of Garre`s osteomyelitis).
34
B → 1 (Moth eaten RL of acute suppurative osteomyelitis).

5- REGRESSIVE CHANGES OF TEETH

Slide number Identification & answers
1-B → caries.
36 2-A → Erosion.
3-C → Attrition.
1-C
37 3-B
6-A
A → Erosion.
B → Abrasion.
38 C → Attrition.
D → Abfraction.
Internal resorption.
39 Idiopathic or associated with pulpitis.
From excessive force of orthodontic treatment.
A → Internal resorption.
40 B → External resorption.
I → Internal resorption.
Dental caries (root caries).
41 Gingival recession (gingivitis & periodontitis).
II → Idiopathic or associated with pulpitis.
A → External resorption of root due to periapical lesion.
42 B → Physiologic external resorption of the root due to shedding.
C → External resorption of the root due to pressure from impacted tooth.

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6- CYSTS PART 1
Slide number Identification & answers
44 True cyst → A
1 → Facial asymmetry & failure of eruption of 3 rd molar & pain.
2 → Dentigerous cyst.
3 → resorption of roots of 2 nd molar & neoplastic transformation into
45 ameloblastoma or sq c c or mucoepidermoid carcinoma.
4 → non keratinized stratified squamous epithelium (lining of the cyst derived
from the reduced enamel epithelium of the unerupted tooth).
1-D
2-C
46 3-B
4-A
A → Satellite (daughter) cysts → increase recurrence rate → odontogenic
keratocyst.
47
B → mucous secreting cells in epithelial lining of dentigerous cyst →
neoplastic transformation into mucoepidermoid carcinoma.
A → Gorlin cyst → ghost cells.
B → Radicular cyst → Rushton bodies.
48 C → Dentigerous cyst → non-keratinized stratified squamous epithelium.
D → Lateral periodontal cyst → nodular thickening of non-keratinized
stratified squamous epithelial lining.
A → Gingival cyst of adult.
From epithelial rest of Serre`s within gingiva.
Age (adult)
49 Vital teeth.
B → Eruption cyst.
From reduced enamel epithelium of erupting tooth.
Age (child)
Vital teeth.
Paradental cyst.
50 Inflammation associated with tooth eruption.
Cervical enamel extension.
51 Predispose to periodontal pocket formation then buccal bifurcation cyst
formation.
1 → gingival cyst of adult.
2 → eruption cyst.
3 → lateral periodontal cyst.
52 4 → residual cyst.
5 → radicular cyst.
6 → dentigerous cyst.
7 → odontogenic keratocyst.
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7- CYSTS PART 2
Slide number Identification & answers
1 → respiratory epithelial lining.
54 2 → nasopalatine duct cyst or median palatal cyst.
3 → nasopalatine duct cyst (neurovascular tissue in CT wall of cyst).
1 → yellow → sublingual mass (above geniohyoid muscle).
Red → sebaceous gland.
55
Green → orthokeratinized stratified squamous epithelial lining of cyst.
2 → dermoid cyst.
1 → Aneurysmal bone cyst.
56
2 → MNGCs surrounding areas of hemorrhage.
A → well defined heart shape unilocular RL between upper two central
incisors (most likely nasopalatine duct cyst).
57 B → well-defined RL lesion in mid palate.
(A) correlates with the microscopic picture.
1 → branchial cleft cyst.
2 → red → CT wall of cyst containing lymphoid aggregation with
58 germinal centers.
Yellow → non keratinized stratified squamous epithelial lining of cyst.
Multicystic ameloblastoma.
Odontogenic keratocyst.
Aneurysmal bone cyst.
Odontogenic myxoma.
59 Central giant cell granuloma.
Ameloblastic fibroma.
Central mucoepidermoid carcinoma.
Central hemangioma.
A → sebaceous tissue + hair follicle → dermoid cyst.
60 B → thyroid follicles → thyroglossal duct cyst.
C → neurovascular tissue → nasopalatine duct cyst.
Thyroglossal duct cyst.
61 Lingual thyroid nodule.
1 → thyroglossal duct cyst.
2 → upper arrow → respiratory epithelial lining (ciliated).
62 Lower arrow → thyroid follicles in CT wall of the cyst.
3 → move (protrude) the tongue, as the lesion should be movable with
tongue movement.
1 → left → static bone cyst.
Right → traumatic bone cyst.
2 → static → normal salivary gland tissue from submandibular salivary
63 gland.
Traumatic → may be empty or containing remnants of disintegrated blood
clot.
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8- ODONTOGENIC TUMORS PART 1
Slide number Identification & answers
1- Surface epithelium.
2- Discrete odontogenic epithelial islands in CT.
3- The peripheral cells of islands are ameloblast like cells with reversed
polarity.
65 4- The central cells of islands are loosely arranged stellate reticulum like
cells.
5- Microcystic spaces inside the odontogenic epithelial islands.
6- Fibrous CT septa.
Upper left → hemangioameloblastoma (variant of plexiform).
Upper right → granular variant of multicystic ameloblastoma.
66 Lower left → mural type of unicystic ameloblastoma.
Lower right → desmoplastic variant of follicular multicystic
ameloblastoma.
Unicystic ameloblastoma.
67 Large dentigerous cyst.
Ameloblastic fibroma.
A → dentinoid material in adenomatoid adontogenic tumor.
68 B → Leisgang ring in calcifying epithelial odontogenic tumor
(Pindborg).
Adenomatoid odontogenic tumor.
69 Red → duct like structure.
Green → dentinoid calcification.
A → snowflakes appearance → extra follicular type of adenomatoid
70 odontogenic tumor.
B → driven snow appearance → Pindborg tumor.
The upper left picture.
71 Adenomatoid odontogenic tumor (extra follicular type).
Upper left → granular cells → granular variant of multicystic
ameloblastoma.
Upper right → whorled pattern → adenomatoid odontogenic tumor (the
72 pattern of arrangement of its spindle cells).
Lower left → driven snow appearance → Pindborg tumor.
Lower right → egg shell crackling → suggesting aggressive destructive
lesion as solid ameloblastoma.

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9- ODONTOGENIC TUMORS PART 2
Slide number Identification & answers
Left → compound odontome.
74
Right → complex odontome.
A reaction to a chronic inflammation is (A) focal sclerosing
75 osteomyelitis.
A tumor related to intact tooth is (B) true cementoma.
A → Thin strands of odontogenic epithelium in cellular CT stroma.
The peripheral cells of strand are ameloblast like cells with reversed polarity.
The central cells of strand (if present) are loosely arranged stellate reticulum
76 like cells.
B → Ameloblatic fibroma.
X-ray → compound odontome.
77 1 → compound odontome.
2 → complex odontome.
1 → A → well defined RO mass surrounding apex of decayed lower
first molar with the root outline is visible.
B → well defined RO mass surrounded by RL rim related to root of
78 lower first molar with the root apex is obscured.
2 → A → focal sclerosing osteomyelitis.
B → true cementoma.
3 → the root outline visibility (visible in A, not visible in B).
Multicystic ameloblastoma.
Odontogenic keratocyst.
Aneurysmal bone cyst.
79 Odontogenic myxoma.
Ameloblastic fibroma.
Large dentigerous cyst.
Radiographically → periapical cemental dysplasia 3 stages RL then RL
with RO then RO, the lesions are multiple an anterior mandible.
True cementoma is a single well defined RO mass with RL borders
related to the root with obscured apex.
80
Histologically → periapical cemental dysplasia formed of masses of
acellular cementum like material.
True cementoma is formed of masses of cellular cementum with
reversal lines.

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10- SOFT TISSUE ANOMALIES
Slide number Identification & answers
Upper left → torus mandibularis.
Upper right → torus palatinus.
82
Lower left → geographic tongue.
Lower right → lingual thyroid nodule.
Upper left → class I cleft lip according to Vaue classification.
Upper right → class II cleft lip according to Vaue classification.
83 Lower left → class III cleft lip according to Vaue classification.
Lower right → class IV cleft lip according to Vaue classification.
Upper left → class III cleft palate according to Vaue classification.
Upper right → class IV cleft palate according to Vaue classification.
84 Lower left → bifid uvula (class I cleft palate according to Vaue
classification).
Lower right → class II cleft palate according to Vaue classification.
1→E 2→A
85 3→B 4→C
5→D
86 A→5 B→3
C→4 D→1

11- TEETH ANOMALIES

Slide number Identification & answers
1- Fusion.
2- Gemination.
3- Concrescence.
4- Dens evaginatus.
88
5- Dens invaginatous.
6- Taurodontism.
7- Dilaceration.
Gemination.
89 Fusion.
A → hypodontia (may be anodontia).
Fine scanty hair.
Diagnosis → hereditary ectodermal dyplasia.
90 B → absent clavicle.
Supernumerary impacted teeth.
Diagnosis → cleidocranial dysplasia.
Upper left → talon cusp.
Upper right → mulberry molar (change associated with congenital
91 syphilis).
Lower → tulip tooth (molar shape in dentinogenesis imperfecta type I,
II).
Upper left → Hutchinson`s incisor (change associated with congenital
syphilis).
92 Upper right → fusion or gemination according to x-ray or counting
number of teeth)
Lower left → dentinogenesis imperfecta.
Lower right → fusion.
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12- GIANT CELL LESION
Slide number Identification & answers
Red → hemosiderin.
Green → MNGCs (focally distributed).
Black → hemorrhage (extravsasated RBCs).
94 1- Central giant cell granuloma (non-aggressive type).
2- Brown tumor of hyperparathyroidism.
3- Cherubism.
95 Central giant cell granuloma.
1- Central giant cell granuloma (non-aggressive type).
96 2- Brown tumor of hyperparathyroidism.
3- Cherubism.
Loss of lamina dura around roots.
Patient with hyperparathyroidism.
97 Laboratory investigation:
Increase PTH.
Increase serum Ca level (normal 9-11 mg/dl).
Red → gingival epithelium (stratified squamous epithelium)
Blue → cell free zone (grenz zone).
98
Yellow → MNGCs focally distributed around areas of hemorrhage.
Diagnosis → peripheral giant cell granuloma.

13- HYPERPLASTIC LESIONS

Slide number Identification & answers
Inflammatory papillary hyperplasia of the palate.
100 Epulis fissuratum.
Leaf like denture fibroma.
A → leaf like denture fibroma.
101 B → Inflammatory papillary hyperplasia of the palate.
Generalized gingival hyperplasia.
Drugs are:
102 Cyclosporine (immunosuppressive in transplantation cases).
Phenytoin (antiepileptic drug).
Pyogenic granuloma.
103 Arrow → large vascular spaces with thin walled endothelial cells
engorged with RBCs which sometimes are organized in lobular
aggregates

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14- BONE DYSPLASIA
Slide number Identification & answers
105 Cherubism.
1- Central giant cell granuloma (non-aggressive type).
2- Giant cell tumor (non-aggressive type).
106 3- Brown tumor of hyperparathyroidism.
4- Cherubism.
107 Ossifying fibroma (well defined in x-ray).
108 Fibrous dysplasia of bone (ill-defined in x-ray).
1- Liontiasis ossea (clinical appearance of face) of → Paget`s disease of
bone.
2- Chinese letter appearance (histologically the shape of abnormal bone
trabeculae) of → fibrous dysplasia of bone.
109
3- Orange peel appearance (shape of final stage of x-ray) of → fibrous
dysplasia of bone.
4- Mosaic appearance (histologically the shape of dense abnormal bone)
of → Paget`s disease of bone.
5- Café au lait pigmentation → pigmentation associated with Jaffe`s type
& Albright syndrome (severe types of fibrous dysplasia of bone).
6- Cherub face → cherubism.
110 7- Cotton wool appearance → x-ray finding of Paget`s disease of bone.
8- Hockey stick deformity → long bone deformity in polyostotic type of
fibrous dysplasia of bone.

15- PREMALIGNANT LESIONS

Slide number Identification & answers
1 → A → oral ulcers.
B → whitish soft palate (pallor of mucosa).
2 → burning sensation.
112 Xerostomia.
Trizmus.
Atrophy of tongue coating.
1 → oral submucous fibrosis.
2 → A → atrophic epithelium showing signs of dysplasia.
113 B → hypovascular dense collagenous CT.
3 → areca nut & betel leaf chewers.
1 → speckled leukoplakia (erythroleukoplakia.
2 → atrophy of epithelium.
114 3 → increase keratin thickness + increase epithelial thickness
(acanthosis).
4 → malignant transformation into squamous cell carcinoma.
1 → white arrow → individual cell keratinization.
Black arrow → abnormal mitosis.
115 2 → basilar hyperplasia + loss of polarity + irregular cell stratification.
3 → severe epithelial dysplasia.
Black arrow → prominent neocleoli.
Red circle → basilar hyperplasia.
116 Green arrow → abnormal mitosis.
Blue arrow → ↑ nuclear/cytoplasmic ratio.

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16- BENIGN & MALIGNANT NON ODONTOGENIC EPITHELIAL TUMORS
Slide number Identification & answers
1 → Finger like projection (exophytic papillferous growth) on dorsum
tongue.
2 → outward proliferation of epithelium (acanthosis) with central core of
supporting CT.
118 3 → squamous cell papilloma.
4 → cause bleeding, as it contains supporting CT core.
5 → human papilloma virus 6 & 11.
6 → Cowden`s syndrome.
1 → Large ulcer at lateral tongue with raised rolled everted margin.
119 2 → squamous cell carcinoma or TB ulcer or deep fungal ulcer or
syphilitic ulcer.
Surface epithelium showing signs of dysplasia.
Invasion of underlying CT by epithelium showing signs of malignance.
120 The invading epithelium in the form of epithelial pearls & cell nests.
Diagnosis → well differentiated squamous cell carcinoma.
A → poorly differentiated sq.c.c. → anaplastic undifferentiated
cellsshowing ↑↑↑ signs of malignancy with no function & loss of
adhesion so no cell nests.
B → moderately differentiated sq.c.c. → cell nests with moderate signs
121 of malignancy.
C → well differentiated sq.c.c. → invading epithelium with minimal
signs of malignancy with keratin formation in the form of epithelial
pearl.
1 → keratoacanthoma.
2 → human papilloma virus 9-11-13, sun exposure, chemical
122 carcinogens, trauma and genetic factors.
3 → stationary phase.
4 → resolution phase.
1 → keratoacanthoma.
2 → cauliflower → clinical shape of squamous cell papilloma.
3→ cobble stone appearance → Heck`s disease (focal epithelial
123 hyperplasia).
4 → moth eaten appearance → x-ray appearance of central squamous
cell carcinoma (and late stage of acute suppurative osteomyelitis).
5 → crater like appearance → histological appearance of
keratoacanthoma.

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17- VARIANTS OF SQUAMOUS CELL CARCINOMA & BCC
Slide number Identification & answers
I → large polypoid, pink mass with whitish areas in upper left area of the
125 jaw.
II → spindle cell carcinoma.
1 → spindle shape cells showing signs of malignancy.
126 2 → inconspicuous squamous component (on lower left area).
127 ------------------------
1 → nasopharyngeal carcinoma.
2 → Epstein Barr virus.
3 → pharyngeal pain, epistaxis, otalgia, signs of otitis media and unilateral
128 hear loss due to obstruction of Eustachian tube.
4 → malignant epithelial (squamous) cells showing syncytial pattern &
lymphocytes (normal).
1 → Pigmented basal cell carcinoma or nodular melanoma.
129 2 → pigmented basal cell carcinoma (islands of basaloid cells +
pigmentation).
Verrucous carcinoma
130 Note keratin plug + church spire configuration + wide, bulbous rete
processes.
1 → toluidine blue.
131 2 → indicate presence of epithelial dysplasia.
Upper left → palisading of peripheral cells of basaloid islands → basal cell
carcinoma.
Upper right → church spire configuration → the long pointed surface
papillary projection → verrucous carcinoma.
132 Lower left → streaming pattern → arrangement of malignant spindle shape
epithelial cells → spindle cell carcinoma.
Lower right → spindle shape → the shape of malignant spindle shape cells in
spindle cell carcinoma.
Mickey mouse → basal cell carcinoma (rodent ulcer).
Onion → bulbous rete processes in verrucous carcinoma.
133 The evil witch → nasopharyngeal carcinoma (occult, hidden carcinoma).
Snuff → snuff dibbing habit → verrucous carcinoma.
1 → maxillary sinus.
2 → palatal mass or ulceration + pain & mobility of upper teeth near the
134 affected sinus.
3 → stage 4 TNM grading system (as T is 4 → tumor includes more than 2
anatomical structures).
1→T2
NX
135 MX
2 → Stage 2 TNM grading system (!!!).
3 → Spindle cell carcinoma.

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18- SALIVARY GLANDS DISEASES
Slide number Identification & answers
1 → squamous cell carcinoma or mucoepidermoid carcinoma or
necrotizing sialometaplasia.
2 → A → necrotizing sialometaplasia.
137 B → squamous metaplasia of ductal epithelium.
3 → ischemia of minor salivary gland from trauma causing cutting
of blood supply to the gland.
4 → no surgical intervention (self-limiting).
Diagnosis → necrotizing sialometaplasia.
138 1 → absence of signs of dysplasia in epithelium.
2 → no loss in the architectural pattern of the minor salivary gland.
1 → xerostomia (the opposite is sialorrhea or ptyalism).
2 → medication as antihypertensive drugs, mouth breather, heavy
smoking, salivary gland aplasia, Sjogren`s syndrome.
3 → red arrow → epimyoepithelial islands.
139 → lymphocytes.
→ diagnosis → Sjogren`s syndrome.
4 → rheumatoid arthritis, lupus eryhtematosis.
5 → xerophthalmia causing keratoconjunctivitis sicca.
1 → A (mucous retention cyst → true cyst).
140 2 → B (ranula) & C (mucocele) → both are pseudocysts.
1 → D.
2 → B.
141 3 → C.
4 → E.
5 → A.
1 → sialolithiasis.
142 2 → sialolith (salivary stone).
3 → arrow head → squamous metaplasia of ductal epithelium.

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19- SALIVARY GLANDS TUMORS
Slide number Identification & answers
A → cribriform pattern of adenoid cystic carcinoma → numerous
cystic spaces in islands of basaloid cells showing signs of
malignancy.
144 B → Warthin`s tumor → tumor with cystic spaces lined by
double layer epithelial cells and connective tissue with large
aggregation of lymphoid tissue with germinal center.
The benign tumor is B → Warthin`s tumor.
1 → low grade mucoepidermoid carcinoma.
145 2 → red → intermediate cells.
→ yellow → mucous secreting cells.
1 → adenoid cystic carcinoma.
2 → A → tubular pattern.
146 → B → solid pattern.
→ C → cribriform pattern.
1 → adenoid cystic carcinoma with perineural growth (solid
147 pattern).
2 → tubular or solid or cribriform patterns.
1 → pleomorphic adenoma
→ periapical lesion as periapical abscess.
→ globulomaxillary cyst.
148 2 → yellow → duct like structure.
→ red → chondroid material.
3 → final diagnosis is pleomorphic adenoma.
149 Answered.
150 Answered.
151 Answered.
152 Answered.

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20- BENIGN NON ODONTOGENIC CT TUMORS
Slide number Identification & answers
154 Fibroma.
1 → hyperplastic surface epithelium with elongated rete processes
showing pseudocarcinomatous appearance (pseudoepitheliomatous
155 hyperplasia).
2 → granular cell tumor or epulis fissuratum or papillary hyperplasia of
the palate (denture papillomatosis).
1 → S100 – congenital epulis of newborn.
156
2 → ostoid osteoma – aspirin.
Lingual thyroid nodule.
157 Thyroglossal tract cyst.
Choristoma (bone tumor of the tongue).
Gardner syndrome.
158 Supernumerary teeth + multiple epidermoid cysts.
1 → schwanomma.
B → Verocay body.
159 C → Antoni A.
D → Antoni B (diffuse Schwan cells in myxoid strmoa).
A. Storiform pattern of benign fibrous histiocytoma.
B. Cigar shape cells of leiomyoma.
160 C. Spider web appearance of rhabdomyoma.
D. Port wine color → Sturge-Weber syndrome.
A. Capillary hemangioma.
B. Lipoma (signet ring appearance).
161 C. Cavernous lymphangioma.
D. Benign fibrous histiocytoma.
E. Chondroma.
A. Giant cell fibroma.
162 B. Peripheral fibroma.
C. Ossifying fibroma.
A. Endosteal osteoma.
163 B. Periosteal osteoma.
1 → granular cells (polygonal cells with eccentric nuclei and abundant
164 granular esinophillic cytoplasm).
2 → granular cell tumor.

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21- MALIGNANT NON ODONTOGENIC CT TUMORS
Slide number Identification & answers
1 → sheets of lymphocytes with darkly stained nucleus and histiocytes with
pale cytoplasm giving it starry sky appearance.
166 Cells show numerous mitotic figures.
2 → Burkkit`s lymphoma.
1 → laboratory → positive HIV test.
H/P → ↑ proliferation of spindle cells.
167 ↑ extravasated RBCs around slit like vascular spaces.
↑ signs of malignancy.
2 → Kaposi sarcoma.
1 → sunray or sun burst appearance.
168 2 → osteoblastic osteosarcoma.
A → Reed-Sternberg cell → large cell with paired nuclei (mirror image)
giving owl eye appearance.
169 B → Hodgkin`s lymphoma.
C → low grade fever, night sweat, weight loss.
1 → fibrosarcoma, malignant fibrous histiocytoma.
2 → fibrosarcoma.
3 → storiform pleomorphic, giant cell type, myxoid type, angiomatoid type.
170 4 → malignant fibrous histiocytoma, liposarcoma.
5 → fat (lipid) cells.
6 → myxoid type of liposarcoma.
7 → Kaposi sarcoma, HIV patients.
171 8 → Burkitt`s lymphoma.
9 → osteosarcoma & chondrosarcoma.
10 → Hodgkin`s lymphoma, owl eye appearance.
Fibrous dysplasia of bone.
Ossifying fibroma (central).
172 Osteoblastoma.
Ostoid osteoma.
Osteosarcoma.
A. Chicken footprint appearance → myxoid type of liposarcoma.
B. Signet ring appearance → liposarcoma or lipoma.
173 C. Starry sky appearance → Burkitt`s lymphoma.
D. Owl eye appearance → Hodgkin`s lymphoma.
E → Sunray appearance → osteosarcoma & chondrosarcoma.
F → Storiform → storiform pleomorphic malignant fibrous histiocytoma.
174 G → Herring bone pattern → fibrosarcoma.
H → Fish flesh appearance → fibrosarcoma.

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22- PIGMENTED LESIONS
Slide number Identification & answers
1 → blue nevi or intramucosal nevi.
2 → blue nevi.
3 → no.
4 → increase number of nevi.
176 Rapid growth.
Ulceration.
Change (deepening) in color.
Regional lymph node enlargement.
1 → B. 2 → C.
177 3 → D. 4 → A.
5 → F.
1 → Asymmetry.
Border → uneven.
Color → change in color.
178 Diameter → become large.
Evolving → history of change.
2 → a → radial growth pattern.
B → vertical growth pattern.

23- WHITE LESIONS

Slide number Identification & answers
1 → hyperkeratosis.
Acanthosis.
180 Degeneration of basal cell layer.
Subepithelial lymphocytic band.
2 → lichen planus (reticular or plaque form).
Blue → squamous metaplasia in ductal epithelium → nicotinic stomatitis.
181 Green → perinuclear cytoplasmic condensation → white spongy nevus.
A. White raised plaque on dorsum of tongue that cannot be removed by
scratching.
182 B. Violet flat topped papules, may be pruritic on flexor surface of the arm.
C. Acanthosis + subepithelial lymphocytic band.
D. Plaque form of lichen planus.
183 A. Nicotinic stomatitis.
B. Atrophic form of oral lichen planus.
C. Plaque form of oral lichen planus.
D. White lesion associated with smokeless tobacco.
E. White spongy nevus.
184 1 → Frictional hyperkeratosis (linea alba buccalis).
2 → The middle picture.

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