Diseases of Oral Cavity & Esophagus

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Questions and Answers

Which of the following tumors is classified as malignant from the odontogenic epithelium category?

  • Ameloblastic carcinoma (correct)
  • Odontogenic fibroma
  • Calcifying epithelial odontogenic tumor
  • Compounded odontoma

What is the most common inflammatory lesion of the salivary gland?

  • Mucocoele (correct)
  • Viral sialadenitis
  • Sialolithiasis
  • Parotitis

Which type of odontogenic tumor is considered a hamartoma rather than a true neoplasm?

  • Ameloblastic fibroma
  • Odontoma (correct)
  • Clear cell odontogenic carcinoma
  • Ameloblastoma

Which major salivary gland is not involved in the formation of mucoceles?

<p>Minor salivary glands (A)</p> Signup and view all the answers

What distinguishes ameloblastic fibrosarcoma from other tumors in the odontogenic epithelium and ectomesenchyme category?

<p>It is a malignant variant (B)</p> Signup and view all the answers

Which virus is primarily responsible for most orofacial herpes infections?

<p>HSV-1 (A)</p> Signup and view all the answers

What is a distinguishing feature of oral candidiasis?

<p>White patches that are easily detached (B)</p> Signup and view all the answers

What condition is associated with a beefy-red tongue and atrophy of papillae?

<p>Glossitis (B)</p> Signup and view all the answers

Which oral manifestation is seen in immunocompromised patients, particularly those with HIV?

<p>Hairy leukoplakia (B)</p> Signup and view all the answers

What characterizes the oral manifestation of diphtheria?

<p>Gray-white exudative membrane and lymph node enlargement (B)</p> Signup and view all the answers

Which of the following is NOT typically associated with apthous ulcers?

<p>They are usually painless (B)</p> Signup and view all the answers

Which systemic condition is linked to an increased risk of opportunistic oral infections?

<p>HIV infection (C)</p> Signup and view all the answers

What typically causes the oral manifestations of hairy leukoplakia?

<p>Epstein-Barr virus (C)</p> Signup and view all the answers

Which type of salivary gland tumor is most commonly associated with a higher likelihood of malignancy?

<p>Mucoepidermoid tumor (B)</p> Signup and view all the answers

What is the primary characteristic of a Warthin tumor?

<p>Rounded mass with cleft-like spaces (B)</p> Signup and view all the answers

What symptom is most commonly associated with esophageal stenosis?

<p>Dysphagia (B)</p> Signup and view all the answers

Which of the following tumors is most likely to recur after enucleation?

<p>Pleomorphic adenoma (C)</p> Signup and view all the answers

Which condition is characterized by a failure of the esophagus to relax?

<p>Achalasia (A)</p> Signup and view all the answers

What is one of the main associations of Plummer-Vinson syndrome?

<p>Mucosal rings and webs (A)</p> Signup and view all the answers

Which bacterial infection is commonly associated with parotid sialadenitis?

<p>Staphylococcus and Streptococcus (B)</p> Signup and view all the answers

Which characteristic describes the malignant transformation of a pleomorphic adenoma?

<p>Aggressive malignant mixed tumor (A)</p> Signup and view all the answers

What is the main characteristic that defines leukoplakia?

<p>A white patch that cannot be scraped off (B)</p> Signup and view all the answers

Which of the following associations is most commonly linked to squamous cell carcinoma of the oral cavity?

<p>Chewing betel quid (D)</p> Signup and view all the answers

Erythroplakia is generally regarded as more serious than leukoplakia because it indicates:

<p>Higher likelihood of dysplasia or cancer (D)</p> Signup and view all the answers

Which histological feature is often observed in squamous cell carcinoma?

<p>Well-differentiated squamous cells (D)</p> Signup and view all the answers

What percentage of leukoplakic lesions are estimated to be premalignant?

<p>Between 5% and 25% (D)</p> Signup and view all the answers

What type of tumor is primarily associated with odontogenic tissue?

<p>Ameloblastoma (C)</p> Signup and view all the answers

What is a common site for squamous cell carcinoma in the oral cavity?

<p>Floor of the mouth, tongue, and others (B)</p> Signup and view all the answers

Which feature distinguishes erythroplakia from other oral lesions?

<p>It often shows dysplasia or early cancer (A)</p> Signup and view all the answers

What is the most important risk factor for developing esophageal adenocarcinoma?

<p>Gastroesophageal reflux disease (GERD) (A)</p> Signup and view all the answers

Which condition is characterized by an outpouching that involves all layers of the esophagus?

<p>Diverticulum (D)</p> Signup and view all the answers

What type of cancer is associated with long-standing use of corrosive agents and is known for early invasion due to rich lymphatic drainage?

<p>Squamous cell carcinoma (B)</p> Signup and view all the answers

Which sign is indicative of reflux esophagitis?

<p>Presence of eosinophils in epithelium (C)</p> Signup and view all the answers

What is a significant complication associated with esophageal varices?

<p>Upper GI bleeding (B)</p> Signup and view all the answers

Which of the following histological features is seen in Barrett esophagus?

<p>Gastric or intestinal type goblet cells (B)</p> Signup and view all the answers

Which type of esophageal cancer shows the highest association with dietary and environmental modifications, particularly in specific regions worldwide?

<p>Squamous cell carcinoma (B)</p> Signup and view all the answers

What is a common complication of chronic gastroesophageal reflux disease leading to Barrett esophagus?

<p>Chronic esophagitis (C)</p> Signup and view all the answers

What is the hallmark clinical presentation of squamous cell carcinoma of the esophagus?

<p>Insidious onset of dysphagia (D)</p> Signup and view all the answers

Which oral manifestation is associated with scarlet fever?

<p>Fiery red tongue with prominent papillae (B)</p> Signup and view all the answers

What clinical feature distinguishes lichen planus in the oral cavity?

<p>Reticulate, lacelike white keratotic lesions (B)</p> Signup and view all the answers

Which statement is true regarding pemphigus and bullous pemphigoid?

<p>Pemphigus lesions are differentiated histologically from those of bullous pemphigoid (D)</p> Signup and view all the answers

What is a significant risk factor for developing leukoplakia?

<p>Tobacco use (A)</p> Signup and view all the answers

What oral condition is characterized by a friable, red, pyogenic granuloma during pregnancy?

<p>Pregnancy tumor (B)</p> Signup and view all the answers

Which hematologic disorder may present with severe oral infections like gingivitis?

<p>Pancytopenia (D)</p> Signup and view all the answers

How can erythroplakia be described clinically?

<p>Red velvety erosions in the mucosa (C)</p> Signup and view all the answers

What genetic condition is associated with multiple aneurysmal telangiectasias in the oral cavity?

<p>Rendu-Osler-Weber syndrome (A)</p> Signup and view all the answers

Flashcards

Herpes Simplex Infections (Oral)

Common viral infections causing cold sores or oral ulcers.

Apthous Ulcers (Oral)

Common, superficial, painful sores in the mouth that often recur.

Oral Candidiasis (Thrush)

Fungal infection of the mouth characterized by white patches.

Glossitis

Inflammation of the tongue, often associated with vitamin deficiencies.

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Hairy Leukoplakia

White patches on the tongue, often linked to weakened immune systems.

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Oral Manifestations of Systemic Infections

Symptoms in the mouth caused by illnesses affecting the rest of the body.

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Oral Manifestations of Systemic Diseases (Diphtheria)

Inflammation causing a gray-white membrane in the throat and tonsils.

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Oral Manifestations of Systemic Diseases (HIV)

HIV can lead to opportunistic oral infections and some cancers.

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Scarlet Fever Tongue

A fiery red tongue with prominent papillae, often described as a 'raspberry tongue'. It can also develop a white coating through which hyperemic papillae protrude, resulting in a 'strawberry tongue'.

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Measles Oral Sign

A spotty enanthema (rash) in the oral cavity often precedes the skin rash. Ulcerations on the buccal mucosa near Stensen's duct form Koplik spots, which are small, white, grain-like lesions.

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Lichen Planus Oral Manifestation

Reticulate, lacelike, white keratotic lesions that rarely become bullous (blister-like) and ulcerate. Often seen in patients with cutaneous lichen planus, but can sometimes be the only manifestation.

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Pemphigus Oral Lesions

Usually vulgaris (common type). Vesicles and bullae (blisters) that rupture easily, leaving red erosions covered with exudate (fluid from the body).

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Bullous Pemphigoid Oral Lesions

Oral lesions resemble those of pemphigus but can be differentiated histologically (under the microscope).

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Erythema Multiforme Oral Manifestation

A maculopapular, vesiculobullous eruption (red spots, blisters) that can be caused by infections, drugs, cancer, or autoimmune disease. When it involves the lips and oral mucosa, it's called Stevens-Johnson syndrome.

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Melanotic Pigmentation

Dark pigmentation (melanin) in the mouth can be associated with Addison disease, hemochromatosis, fibrous dysplasia of bone (Albright syndrome), and Peutz-Jegher syndrome.

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Phenytoin (Dilantin) Gingival Hyperplasia

Striking fibrous enlargement of the gingivae (gums) due to Dilantin (phenytoin) ingestion.

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Leukoplakia

A white patch or plaque in the mouth that can't be scraped off and isn't caused by another condition. It's often a precancerous lesion.

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Erythroplakia

A red, velvety patch in the mouth that can be flat or depressed. It's a more serious precancerous lesion than leukoplakia.

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Oral Squamous Cell Carcinoma (OSCC)

A type of cancer that starts in the flat cells lining the mouth. It's often linked to smoking, alcohol, and some chewing habits.

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Sites of Oral Squamous Cell Carcinoma (OSCC)

Common areas where OSCC develops include the floor of the mouth, tongue, hard palate, and base of the tongue.

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Odontogenic Tumor

A tumor arising from tooth-forming tissues. It can be benign or malignant, and can affect the jaw and surrounding areas.

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Ameloblastoma

A tumor arising from the enamel-forming cells of the teeth. It's usually benign and slow-growing.

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What are the precancerous lesions associated with oral squamous cell carcinoma?

The precancerous lesions associated with oral squamous cell carcinoma are leukoplakia and erythroplakia.

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What are some known associations with oral squamous cell carcinoma?

Some known associations with oral squamous cell carcinoma include smoking, alcohol consumption, betel quid chewing, and sun exposure to the lower lip.

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Odontoma

The most common type of odontogenic tumor, arising from epithelium with depositions of enamel and dentin. It's likely a hamartoma rather than a true neoplasm and is cured by local excision.

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Odontogenic Fibroma

A benign tumor arising from odontogenic ectomesenchyme, composed mainly of fibrous connective tissue.

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Odontogenic Myxoma

A benign tumor originating from odontogenic ectomesenchyme, characterized by a soft, gelatinous, myxomatous tissue.

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Cementoblastoma

A benign tumor of cementoblasts, the cells responsible for forming cementum, usually attached to the root of a tooth.

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Salivary Gland Tumours: Where are they most common?

The majority of salivary gland tumours (65-80%) occur in the parotid gland.

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Salivary Gland Tumours: Malignancy Likelihood

The likelihood of malignancy is greatest in the sublingual gland, followed by the submandibular, and then the parotid gland.

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Pleomorphic Adenoma

The most common parotid tumour (60%), characterized by encapsulation and tongue-like protrusions. It contains both epithelial and mesenchymal elements.

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Warthin Tumour

The second most common salivary tumour, often found as a rounded mass with cleft-like spaces. It's a unique structure with 2 layered epithelium and lymphoid stroma.

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Mucoepidermoid Tumour

The most common malignant salivary gland tumour, sometimes caused by radiation. It features both squamous and mucus cells.

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Adenoid Cystic Carcinoma

A malignant salivary gland tumour, frequently found in the submandibular and sublingual glands. It's characterized by small, dark cells with a solid or cribriform pattern. The tendency for perineural invasion makes it aggressive.

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Dysphagia: What causes it?

Difficulty swallowing can occur due to deranged motor function or narrowing/obstruction of the esophagus.

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Esophageal Atresia and Tracheoesophageal Fistula

Congenital anomalies that are incompatible with life. These babies have difficulty feeding because food cannot pass through the esophagus.

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Progressive Dysphagia

A gradual worsening of difficulty swallowing, often a classic symptom of esophageal disorders.

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Esophageal Carcinoma Risk

Individuals with esophageal motor dysfunctions have an increased risk of developing esophageal cancer.

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Hiatal Hernia

A condition where a portion of the stomach protrudes through the diaphragm, the muscular wall separating the chest and abdomen.

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Esophageal Diverticulum

An outpouching or bulge in the wall of the esophagus, often caused by weakened muscle.

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Mallory-Weiss Tear

A tear in the lining of the esophagus, often caused by forceful vomiting, particularly in individuals who consume excessive alcohol.

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Reflux Esophagitis

Inflammation of the esophagus caused by the backflow (reflux) of stomach acid.

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Barrett's Esophagus

A precancerous condition where the lining of the lower esophagus changes due to chronic acid reflux.

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Esophageal Varices

Enlarged veins in the esophagus, usually formed due to high pressure in the portal vein (portal hypertension), often associated with liver cirrhosis.

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Squamous Cell Carcinoma of Esophagus

A type of cancer that starts in the squamous cells lining the esophagus, often linked to smoking, alcohol, and environmental factors.

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Adenocarcinoma of Esophagus

A type of cancer that arises from glandular cells in the esophagus, frequently a complication of Barrett's esophagus.

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Study Notes

Diseases of Oral Cavity & Esophagus

  • Oral cavity infections frequently involve herpes simplex virus (HSV-1).
  • Common orofacial herpes manifestations are mild cold sores.
  • Acute herpetic gingivostomatitis presents with vesicles and ulcers in the oral cavity.
  • Recurrent herpetic stomatitis is a recurring condition.
  • Apthous ulcers are common, superficial, and painful ulcerations of oral mucosa.
  • These sores tend to heal on their own but can recur.
  • Glossitis typically features a beefy-red tongue, resulting from vitamin B12 or iron deficiency.
  • Oral candidiasis (thrush) shows superficial white patches or a fluffy membrane.
  • This is caused by the fungus Candida, commonly found in the oral cavity.
  • Conditions like diabetes, immunocompromised states (e.g., HIV), and neutropenia increase the risk.

Oral Manifestations of Systemic Disease

  • Hairy leukoplakia appears as white, fluffy thickenings on the tongue's sides, frequently in immunocompromised individuals (especially those with HIV).
  • Epstein-Barr virus is often associated with this.
  • Infections like measles (Koplik spots), infectious mononucleosis, and diphtheria can manifest in the oral cavity.
  • Dermatologic conditions like lichen planus, pemphigus, or erythema multiforme (including Stevens-Johnson syndrome) sometimes show oral manifestations.
  • Hematologic disorders such as pancytopenia and leukemia can cause oral infections and lesions that resemble those seen in pancytopenia.
  • Monocytic leukemia can cause infiltration and enlargement of the gingivae.

Precancerous Lesions

  • Oral leukoplakia is a clinical term for white lesions that cannot be scraped off.
  • It's classified as precancerous unless proven otherwise.
  • Erythroplakia are less common, red, velvety lesions that can be more ominous and are linked to a higher risk of oral cancer.
  • Tobacco use (cigarettes, pipes, cigars, chewing tobacco) is a significant risk factor for both leukoplakia and erythroplakia, particularly for the latter.

Tumors and Precancerous Lesions

  • Other tumors, such as papillomas, hemangiomas, and lymphomas, can also occur in the oral cavity, although less frequently and often not linked to precancerous conditions.
  • The most significant oral tumor is often squamous cell carcinoma (SCC).
  • SCC lesions develop frequently in areas of the mouth like the floor of the mouth, tongue, hard palate, and base of tongue.
  • Oral SCC often manifest as ulcerated or infiltrating lesions.

Oral Cavity Squamous Cell Carcinoma

  • Smoking, tobacco, alcohol, and environmental elements often increase the risk of oral squamous cell carcinoma (OSCC).
  • OSCC spread to cervical, mediastinal lymph nodes, lungs, and liver.
  • OSCC is often classified according to the stage of dysplasia (mild, moderate, severe, or carcinoma in situ [CIS]) and the stage of invasion.

Odontogenic Tumors

  • Odontogenic tumors are an assorted group of lesions classified according to origin (epithelial or ectomesenchymal or both).
  • They can be benign, malignant, or hamartomas.
  • The major groups include ameloblastoma, odontoma, odontogenic fibroma, odontogenic myxoma, and cementoblastoma.

Diseases of Salivary Glands

  • Inflammations (siallinen), like mumps and autoimmune disorders like Sjogren's syndrome, typically affect the parotid gland.
  • Sialolithiasis (stones) can block salivary ducts.
  • Common benign tumors include pleomorphic adenomas (frequently seen in the parotid gland).
  • Other benign tumors (such as Warthin tumor) include epithelial and mesenchymal elements, with mixed appearance.
  • Malignant tumors, such as mucoepidermoid carcinomas and adenoid cystic carcinomas are observed in salivary glands.

Diseases of Esophagus

  • Dysphagia, heartburn, pain, and hematemesis are common symptoms of esophageal diseases.
  • Congenital anomalies, infections, chemicals, motor function alterations, and varices can affect the esophagus.
  • Barrett's esophagus is an issue related to chronic gastroesophageal reflux (GERD) and subsequent esophageal changes.
  • There is a connection to adenocarcinoma, a type of esophageal cancer.
  • The esophageal squamous cell carcinoma is a common issue with various stages of involvement.

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