Practice question answers oral cavity pathology

Practice question answers, oral cavity pathology
Updated: 03/07/2019
© Jun Wang, MD, PhD
1. B. Polypoid growth with fibrous core and smooth non-neoplastic squamous covering is most compatible with irritation fibroma, a reactive process. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. Pyogenic granuloma is indeed a capillary hemangioma with lobulated growth. Squamous cell carcinoma has irregular growth, invasion and cytological atypia. Squamous papilloma has finger like projects with fibrovascular core and benign squamous covering.

2. A. A small shallow oral erosion/ulcer without other presentations is most likely aphthous ulcer. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. Hairy leukoplakia is a white patch/plaque with a smooth or “hairy” surface. Herpes has clusters of small painful vesicles. Squamous cell carcinoma has mass, with or without ulceration.

3. D. Herpes has clusters of small painful vesicles, and typical cytological changes can be noted per Tzanck smear. Aphthous ulcer is small shallow oral erosion/ulcer without other presentations. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. Hairy leukoplakia is a white patch/plaque with a smooth or “hairy” surface. Squamous cell carcinoma has mass, with or without ulceration.

4. A. White patches that can be scraped and has erythematous base is likely candidiasis. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. Hairy leukoplakia is a white patch/plaque with a smooth or “hairy” surface. Herpes has clusters of small painful vesicles. Squamous cell carcinoma has mass, with or without ulceration.

5. C. Pyogenic granuloma is indeed a capillary hemangioma with lobulated growth. Angiosarcoma has complex vascular growth and cytological atypia. Irritation fibroma has polypoid growth with fibrous core and smooth non-neoplastic squamous covering. Squamous cell carcinoma has mass, with or without ulceration. Squamous papilloma has finger like projects with fibrovascular core and benign squamous covering.

6. C. Hairy leukoplakia is a white patch/plaque with a smooth or “hairy” surface, and microscopically it has “balloon cells”. White patch of candidiasis is scrapable. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. Squamous cell carcinoma has mass, with or without ulceration. Squamous papilloma has finger like projects with fibrovascular core and benign squamous covering.

7. B. Hairy leukoplakia is associated with EB virus, commonly in a patient with HIV infection, but HIV is probably not directly associated with it. Cigarette smoking and human papilloma virus are risk factors for leukoplakia/erythroplakia and squamous cell carcinoma. Human herpes virus causes herpes.

8. D. Non-scrapable white patch with warty appearance is likely leukoplakia. White patch of candidiasis is scrapable. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. Squamous cell carcinoma has mass, with or without ulceration.

9. C. Since leukoplakia/erythroplakia likely to have dysplasia/squamous cell carcinoma, a biopsy is recommended.

10. B. Erythroplakia is usually a reddish patch/plaque that commonly harbors dysplasia. White patch of candidiasis is scrapable. Hairy leukoplakia is a white patch/plaque with a smooth or “hairy” surface, and microscopically it has “balloon cells”. Lichen planus usually presents with pruritic, polygonal purple papules with flat top, and microscopically it has lichenoid inflammation. Squamous cell carcinoma has mass, with or without ulceration.

11. C. Since leukoplakia/erythroplakia likely to have dysplasia/squamous cell carcinoma, a biopsy is recommended.

12. E. Squamous cell carcinoma usually presents with mass with or without ulceration, and microscopically it has irregular growth, invasion and cytological atypia. Invasion is not seen in other 4 conditions.



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