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'''Oral pathology''' is a domain of dentistry. In the context of [[anatomical pathology]], it can be lumped with [[head and neck pathology]]. '''''Oral lesions''''' | '''Oral pathology''' is a domain of dentistry. In the context of [[anatomical pathology]], it can be lumped with [[head and neck pathology]]. '''''Oral lesions''''' and '''''oral cavity''''' redirect here. | ||
=Normal= | |||
==Normal oral mucosa== | |||
:''Buccal mucosa'' redirect here. | |||
===Microscopic=== | |||
*Non-keratinized squamous mucosa. | |||
*No pigmentation. | |||
*No inflammation. | |||
=Reactive= | |||
==Benign leukoplakia== | |||
{{Main|Leukoplakia}} | |||
===General=== | |||
*Very common finding. | |||
*Biopsied as it may be malignant. | |||
===Microscopic=== | |||
Features: | |||
*Hyperkeratosis. | |||
*Parakeratosis. | |||
*No nuclear atypia. | |||
*No pigmentation. | |||
*No significant inflammation. | |||
DDx: | |||
*Dysplasia. | |||
*[[Squamous cell carcinoma of the head and neck|Squamous cell carcinoma]]. | |||
*[[Benign alveolar ridge keratosis]]. | |||
===Sign out=== | |||
<pre> | |||
BUCCAL MUCOSA, RIGHT, BIOPSY: | |||
- SQUAMOUS MUCOSA WITH A COMPACT KERATIN LAYER AND PARAKERATOSIS. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Micro==== | |||
The sections show a squamous mucosa with a layer of compact keratin, parakeratosis, and | |||
focal hypergranulosis. There is no inflammation at the interface. Epidermal intercellular | |||
bridges are easily seen. There is no significant nuclear atypia. Mitoses are not evident. | |||
==Oral contact mucositis== | |||
===General=== | |||
*Inflammatory reaction of irritative agent, e.g. cinnamon-flavoured chewing gum.<ref name=pmid19862397 >{{Cite journal | last1 = Siqueira | first1 = AS. | last2 = Santos | first2 = CC. | last3 = Cristino | first3 = MR. | last4 = Silva | first4 = DC. | last5 = Pinheiro | first5 = Md. | last6 = Pinheiro | first6 = JJ. | title = Intraoral contact mucositis induced by cinnamon-flavored chewing gum--a case report. | journal = Quintessence Int | volume = 40 | issue = 9 | pages = 719-21 | month = Oct | year = 2009 | doi = | PMID = 19862397 }}</ref> | |||
*Similar to [[contact dermatitis]].<ref name=pmid2234878/> | |||
Note: | |||
*''Oral mucositis'' be seen in the context of radiation treatment.<ref name=pmid21537592>{{Cite journal | last1 = Lino | first1 = MD. | last2 = Carvalho | first2 = FB. | last3 = Oliveira | first3 = LR. | last4 = Magalhães | first4 = EB. | last5 = Pinheiro | first5 = AL. | last6 = Ramalho | first6 = LM. | title = Laser phototherapy as a treatment for radiotherapy-induced oral mucositis. | journal = Braz Dent J | volume = 22 | issue = 2 | pages = 162-5 | month = | year = 2011 | doi = | PMID = 21537592 }}</ref> | |||
===Microscopic=== | |||
Features: | |||
*+/-Ulceration.<ref name=pmid2234878>{{Cite journal | last1 = Hay | first1 = KD. | last2 = Greig | first2 = DE. | title = Propolis allergy: a cause of oral mucositis with ulceration. | journal = Oral Surg Oral Med Oral Pathol | volume = 70 | issue = 5 | pages = 584-6 | month = Nov | year = 1990 | doi = | PMID = 2234878 }}</ref> | |||
Image: | |||
*[http://lupusimages.com/browser/detail/2488/histopathology-hyperparakeratosis-with-interface-mucositis Interface mucositis with parakeratosis in lupus (lupusimages.com)]. | |||
=Odontogenic tumours and cysts= | =Odontogenic tumours and cysts= | ||
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Images: | Images: | ||
*[http://hardinmd.lib.uiowa.edu/cdc/6061.html Hairy leukoplakia (uiowa.edu)]. | *[http://hardinmd.lib.uiowa.edu/cdc/6061.html Hairy leukoplakia (uiowa.edu)]. | ||
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===General=== | ===General=== | ||
*Benign. | *Benign. | ||
*Sexually transmitted.<ref name=Ref_HaNP246>{{Ref HaNP| | *Sexually transmitted.<ref name=Ref_HaNP246>{{Ref HaNP|246}}</ref> | ||
*Typically seen in young adults. | *Typically seen in young adults. | ||
===Gross=== | ===Gross=== | ||
*Polypoid projection with a broad base. | *Polypoid projection with a broad base. | ||
*Usually palate or labia.<ref name=Ref_HaNP246>{{Ref HaNP| | *Usually palate or labia.<ref name=Ref_HaNP246>{{Ref HaNP|246}}</ref> | ||
===Microscopic=== | ===Microscopic=== | ||
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*No hyperkeratosis. | *No hyperkeratosis. | ||
DDx:<ref name=Ref_HaNP246>{{Ref HaNP| | DDx:<ref name=Ref_HaNP246>{{Ref HaNP|246}}</ref> | ||
*[[Squamous papilloma]] - thinner papillary projections, often branch. | *[[Squamous papilloma]] - thinner papillary projections, often branch. | ||
*[[Verruca vulgaris]] - church spire-like projections, hyperkeratosis and parakeratosis. | *[[Verruca vulgaris]] - church spire-like projections, hyperkeratosis and parakeratosis. | ||
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*[[AKA]] ''focal fibrous hyperplasia'', [[AKA]] ''peripheral ossifying fibroma, [[AKA]] ''fibroid epulis'' (old term), [[AKA]] ''fibroepithelial polyp''.<ref name=Ref_Sternberg5_775>{{Ref Sternberg5|775}}</ref> | *[[AKA]] ''focal fibrous hyperplasia'', [[AKA]] ''peripheral ossifying fibroma, [[AKA]] ''fibroid epulis'' (old term), [[AKA]] ''fibroepithelial polyp''.<ref name=Ref_Sternberg5_775>{{Ref Sternberg5|775}}</ref> | ||
*[[AKA]] ''oral fibroma''.<ref>URL: [http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3 http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3]. Accessed on: 20 August 2012.</ref><ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | *[[AKA]] ''oral fibroma''.<ref>URL: [http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3 http://emedicine.medscape.com/article/1080948-overview#aw2aab6b3]. Accessed on: 20 August 2012.</ref><ref name=Ref_HaNP240>{{Ref HaNP|240}}</ref> | ||
{{Main|Oral fibroma}} | |||
=Pigmented lesions of the oral cavity= | =Pigmented lesions of the oral cavity= | ||
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Image: | Image: | ||
*[http://ocw.tufts.edu/Content/51/lecturenotes/551831/552086 Melanotic macule - labia (tufts.edu)]. | *[http://ocw.tufts.edu/Content/51/lecturenotes/551831/552086 Melanotic macule - labia (tufts.edu)]. | ||
===Stains=== | |||
*[[Fontana-Masson stain]] +ve. | |||
*[[Prussian blue stain]] -ve. | |||
===Sign out=== | ===Sign out=== | ||
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LESION, BUCCAL MUCOSA (LEFT), BIOPSY: | LESION, BUCCAL MUCOSA (LEFT), BIOPSY: | ||
- MELANOTIC MACUOLE. | - MELANOTIC MACUOLE. | ||
- NEGATIVE FOR DYSPLASIA. | |||
- NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||
====Micro==== | |||
The sections show a non-keratinized squamous mucosa. The squamous epithelium has no | |||
significant pathology and does not have noticeable pigmentation. The subepithelial tissue | |||
has pigmented macrophages (melanophages) and is otherwise unremarkable. | |||
A Fontana-Masson stain marks the pigment (confirming it is melanin). A Prussian blue | |||
stain is negative. | |||
==Smoker's melanosis== | ==Smoker's melanosis== | ||
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===General=== | ===General=== | ||
*Benign and common. | *Benign and common. | ||
*Material from a dental filling.<ref name=Ref_HaNP215>Ref HaNP|215</ref> | *Material from a dental filling.<ref name=Ref_HaNP215>{{Ref HaNP|215}}</ref> | ||
*May be confused with a [[melanocytic lesion]]. | *May be confused with a [[melanocytic lesion]]. | ||
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*[[Head and neck cytopathology]]. | *[[Head and neck cytopathology]]. | ||
*[[Odontogenic tumours and cysts]]. | *[[Odontogenic tumours and cysts]]. | ||
*[[Tongue]]. | |||
*[[Tonsil]]. | |||
=References= | =References= |
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