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Soft Tissue Enlargement Lab (Slide For Lab # 1)
Soft Tissue Enlargement Lab (Slide For Lab # 1)
Leaf Fibroma
Psuedoepitheiomatous hyperplasia
This 13 year-old yearfemale is referred for evaluation of an asymptomatic, 1 x 1.5 asymptomatic, mm mass in the right buccal mucosa in the premolar area at the level of the occlusal plane. The patient plane. wears full orthodontic appliances. She appliances. believes that the lesion was present before she started the orthodontic treatment one year ago.
Differential Diagnosis
List
1 2 3 4 5
Hyperplastic epithelium
Granular cells
Diagnosis??
Microscopic features
Pseudoepitheliomatou s hyperplasia of overlying stratified squamous epithelium Large cells with granular, eosinophilic cytoplasm
Granules: lysosomes
PEH
Clinical Differential Diagnosis of Localized Soft Tissue Enlargements with a normal mucosa: mucosa: Benign mesenchymal tumors (irritation fibroma, schwannoma, neurofibroma, lipoma) Benign salivary gland tumors Low grade salivary adenocarcinomas
Irritation fibroma
Histopathology
Patient:19-year-old male Patient:19-yearChief Complaint: Referred by Internal Medicine to evaluate for possible odontogenic cause of right submandibular swelling.
Hodgkins lymphoma
lymphocytes
Clinical Findings: A diffuse, compressible, nonnontender, purple surface lesion is present on the left soft palate.
Differential Diagnosis of Intravascular Blood Lesions Lesions Surface Lesions: Hemangioma Varix Kaposis sarcoma
Kaposi Sarcoma
Cellular hemangioma
Endothelial cells
AVM
Thick walled
Sublingual varicosities
Nose bleeding
A diffuse,
compressible, nontender enlargement is present in the anterior dorsum of the tongue. No thrill or bruit evident.
Lymphangioma
Lymphatic fluid
Cystic Hygroma
Large fluctuant swelling 10 cm in diameter May extend to base of the tongue and floor of the mouth
Hemangioma
Epulides
Types:
Fibrous epulis, chronic hyperplastic gingivitis pyogenic granuloma Peripheral giant cell granuloma Peripheral ossifying fibroma Peripheral odontogenic fibroma
Pyogenic granuloma
Vascular spaces
Clinical findings
Area is firm but movable, somewhat pedunculated and located about 5mm from Stensons duct. It is of unknown duration and nonpainful to palpation.
Schwannoma
Capsule
Schwannoma
Schwannoma
Microscopic
features:
Rows of cells with palisading nuclei S-100 stain is positive (neural origin) No neurites (nerve fibers) passing through
Neurofibroma
Neurofibroma
Neurofibroma
Neurofibromatosis
CafCaf-au lait spots Other findings: axillary freckeling Malignant transformation In 5-15% of cases 5-
Traumatic neuroma
Nerve bundels
Lipoma
liposarcoma
NonNon-Hodgkin's lymphoma
Aggressive fibromatosis
Fibrosarcoma