Oral PathologyOral Pathology

• March. 22. 2015

ORAL PATHOLOGY

• INFECTIONS: HSV, VIRAL, FUNGI• LEUKOPLAKIA/”• SQUAMOUS TUMORS:• ODONTOGENIC

CYSTS/TUMORS

Herpetic vesicles

Herpesvesicle with ulceration & secondary inflammation

Herpes Zoster “shingles”

EBV “glandular fever”.

Monilia, thrush-mouth, candida

•Syphilis “1, 2, 3”.

Aphthous ulcer

Aphthous ulcer. Single ulceration with an erythematous halo surrounding a yellowish fibrinopurulent membrane.

Behcet's disease

hypopyon.

Oral Ulcer.

Pharyngitis

Oropharynx

Tonsillitis & peritonsillar abscess “Quinsy”

Oropharynx

Diphtheria

Oropharynx

Oral Pathology Skin diseases can affect oral mucosa

Lichen planus Erythema multiforme

Pemphigus vulgarisPemphigoid.

Pigmentation of lip & oral mucosa.Peutz–Jeghers syndrome

Oral Pathology

Polypoid nodules in the mouth• Pyogenic granuloma.

• Fibroepithelial polyp

Leukoplakia.

Sq C Ca.

“Irritation” Fibroma

Fibroma. Smooth pink exophytic nodule on the buccal mucosa.

PYOGENIC

GRANULOMA

Pyogenic granuloma. Erythematous, hemorrhagic, and exophytic mass arising from the gingival mucosa

• Leukoplakia is defined by the WHO as;

• “a white patch or plaque that cannot be scraped off and cannot be characterized clinically or pathologically as any other disease.”

• Erythroplakia (red area), associated with a greater risk of malignant transformation than leukoplakia.

• 40 and 70 years, 2 : 1 male preponderance. • Tobacco is the most common risk factor for

leukoplakia and erythroplakia.

leukoplakia

TobaccoAlcoholHPVFamily historychronic irritation

95% are Sq C Ca.

the sites of origin of Sq C Ca of the oral cavity, in numerical order of frequency

the favored locations are the ventral surface of the tongue, floor of the mouth, lower lip, soft palate, and gingiva

3 exophytic masses “SqcCa”, the hyperkeratotic area is lichen planus.

ODONTOGENICCYSTS/TUMORS

• INFLAMMATORY CYSTS (e.g., “Radicular”[periapical] most common)

• DEVELOPMENTAL CYSTS• MALIGNANT TUMORS of ODONTOGENIC ORIGIN

(AMELOBLASTOMAS) (rare)

Odontogenic Cysts• Epithelial-lined cysts are common in the jaws • derived from remnants of odontogenic epithelium present within the jaws. • these cysts are;1. inflammatory or 2. developmental

Salivary glands

Salivary glands

Mucocele of an accessory salivary gland duct

Mucocele of an accessory salivary gland duct

Sialadenitis

DISEASES OF SALIVARY GLANDS

• Xerostomia• autoimmune disorder Sj ِgren syndrome• Rtx• Drugs; anticholinergic, antidepressant/ antipsychotic,

diuretic, antihypertensive, sedative, muscle relaxant, analgesic, & antihistaminic agents

• dental caries & candidiasis, difficulty in swallowing & speaking

Oral Pathology

Salivary glands tumors;• are mostly Benign & affect parotid.parotid.

- “Pleomorphic adenoma” or “ Mixed tumor”

- Adenolymphoma or “Warthin’s tumor” of parotid.

• Malignant; • Affect Minor salivary glands.

• “Mucoepidermoid ca”.

• “Adenoid cystic carcinoma”

• Others.

P

A

R

O

T

I

D

Pleomorphic Adenoma

PLEOMORPHIC ADENOMA

i.e., MIXED TUMOR

Pleomorphic Adenoma

• pleomorphic adenoma contains both epithelial (E) and stromal (S) components.

Pleomorphic Adenoma• This neoplasm is

typically encapsulated, although tumor islands may be found within the fibrous capsule.

WARTHIN TUMOR

Warthin's Tumor

• Warthin's tumor (benign papillary cystadenoma lymphomatosum)

• the second most common benign tumor of the parotid gland

Mucoepidermoid Ca.

• MECs contain two major elements:

• mucin-producing cells and epithelial cells of the epidermoid variety

• Divided into low-grade (well differentiated), & High-grade (poorly differentiated).

Adenoid Cystic Carcinoma

• Adenoid cystic carcinoma with Swiss cheese pattern.

• It is the second-most common malignant tumor of the salivary glands.

• ACC is the most common malignant tumor found in the submandibular, sublingual, and minor salivary glands.

Adenoid Cystic Carcinoma

• Nerve (N) invaded by adenoid cystic carcinoma (the blue area surrounding the nerve).

• Spread may occur by emboli along the nerve lymphatics

• Behcet's (beh-CHETS) disease, also called Behcet's syndrome, is a rare disorder that causes inflammation in blood vessels.

• The signs and symptoms of Behcet's disease — which may include mouth sores, eye inflammation, skin rashes and lesions, and genital sores — vary from person to person and may come and go on their own.

• The exact cause of Behcet's is unknown, but it may be an autoimmune disorder,

• Both genetic and environmental factors may be responsible for Behcet's disease.

• Treatment aims to reduce the signs and symptoms of Behcet's disease and to prevent serious complications, such as blindness.