Reactive gingival mass resembling pyogenic granuloma, but pushes teeth aside and may erode alveolar bone or involve periodontal membrane
Usually women, mean age 30 years, although may involve children or elderly patients without teeth
Treatment: excision
Peripheral giant cell granuloma
Fibroma (Irritation Fibroma)
Pyogenic Granuloma (Lobular Capillary Hemangioma)
Recurrent Aphtous Stomatitis (Canker Sores)
HSV-1
Candidiasis - Candida Albicans
Hairy Leukoplakia
Leukoplakia - White Plaque
Erythroplakia - Red plaque
95% of cancers of head and neck
Most common in the oral cavity
Strong association with tobacco and alcohol abuse (RR: tobacco 2-4x, alcohol 2-6x, tobacco and alcohol 15x)
Association with HPV and EBV
Head and Neck Squamous Cell Carcinoma (HNSCC)
Squamous Cell Carcinoma
Most common oral cancer (42-45% of cases)
90% occur on lower lip, usually along vermillion border
Risk factors: chronic sunlight, pipe smoking, cigarette smoking, poor oral hygiene, fair complexion, organ transplant recipients
Low risk of metastatic extra
Odontogenic Cysts - Odontogenic Keratocyst
Odontogenic Tumors - Ameloblastoma
(formerly adamantinoma)
Odontogenic Tumors - Ameloblastoma
(formerly adamantinoma)
Endoscopic appearance of sino nasal inflammatory polyps appearing as multiple polypoid masses with a glistening mucoid appearance.
Sino nasal inflammatory polyp. Transected sino nasal inflammatory polyp appearing as tan-white, polypoid-shaped tissue with
Nasal polyps
Relatively common life-threatening fungal infection, associated with diabetic ketoacidosis, poor glycemic control or immunosuppression.
Spreads rapidly across nerves and tissue planes to blood vessels of orbit and brain, causes thrombosis, hemorrhage and
Mucormycosis
Mucormycosis
Wegener's Granulomatosis
Note: lymphocyte rich biopsies are unlikely to be _____ and more likely represent lymphoma.
Wegener's Granulomatosis
Diagnostic for ________ : inflammation, necrosis and vasculitis, in addition to clinical involvement of lung or kidney; OR two of three microscopic features and lung and kidney involvement
Wegener's: granulomatous
Wegener's Granulomatosis
NK / T-Cell Lymphoma
(Lethal Midline Granuloma or Polymorphic Reticulosis)
Most common lymphoma in Asia, Central and South America.
Associated with EBV.
Extensive necrosis, cartilage destruction, vascular thrombosis (perforated septum, palate).
Frequently lethal due to bacterial infection or hemorrhage.
Kartagener's Syndrome
Inherited defect/absence of the dynein arm, which is necessary for ciliary movement. Associated with sinusitis, infertility (poor motility of sperm).
Severe nasal deformity is seen, including destruction of the nasal septum.
Sinonasal (Schneiderian) Papillomas
~Derived from schneiderian mucosa (pseudostratified columnar ciliary epithelium)
~Inverted: 47%, lateral wall - Association with HPV
~Fungiform: 50%, nasal septum - Associated with HPV
~Oncocytic (Cylindrical): 3%, lateral wall/sinuses -No association wit
Nasopharyngeal Angiofibroma
Olfactory Neuroblastoma
~USA: rare, incidence of 0.4 per 100K in whites
~Africa: common; #1 childhood cancer; associated with EBV
~South China: most common cancer in adults (18% of cancers in Hong Kong, 21.4 per 100K in Hong Kong), rare in children
~70% male
~Strongly associated
Nasopharyngeal Carcinoma
Reactive Nodules (Vocal Cord Nodules and Polyps)
Squamous Papillomas and Papillomatosis
Laryngeal Squamous Cell Carcinoma
Branchial Cleft Cyst
Paraganglioma
Thyroglossal Duct Cyst
Paraganglioma
Vascular tumor mass at the bifurcation of the common carotid artery; B. resected carotid body tumor (paraganglioma) showing continuity with resected large artery; C. on cut section the tumor is ovoid, rubbery, with a red-brown appearance.
Paraganglioma
Inflammation of the Salivary Glands (Parotid, Submandibular, Sublingual).
May be due to viral causes (i.e. mumps), bacterial causes or
autoimmune (Sjorgen's Syndrome).
Sialadenitis
Mumps (Paramyxovirus)
Mucocele
Mucus extravasation phenomenon of the lip, appearing as superficial raised vesicles with a bluish appearance.
Ranula
Sialolithiasis
L: Oral cavity showing a white stone situated within the orifice of the parotid (Stensen's) duct causing an obstructive sialadenitis.
R: In this example a calculus is present within a duct surrounded by a marked inflammatory cell infiltrate
Sialolithiasis
Sjogren Syndrome
Sjogren Syndrome
Sjogren Syndrome
CLINICAL FINDINGS
~Most commonly affects women between 50 and 60.
~Blurring of vision, burning, itching, and thick secretions (keratoconjunctivitis), together with difficulty in swallowing solid foods, a decrease in the ability to taste, cracks and fissur
About 5% of these patients (40 fold increased risk compared to normal) develop marginal zone lymphoma (a B-cell lymphoma that often arises in the setting of chronic lymphocytic inflammation).
Sjogren Syndrome patients
Salivary Gland Neoplasms
Salivary Gland Neoplasms
Pleomorphic Adenoma
Recurrence and malignant transformation increases with duration of the tumor.
Pleomorphic Adenoma.
Glistening appearance where there are cartiligenous or myxochondroid area, well defined ovoid or round often encapsulated.
Warthin's Tumor
(Papillary Cystadenoma Lymphomatosum)
Adenoid Cystic Carcinoma
Adenoid Cystic Carcinoma - Histology
Mucoepidermoid carcinoma (MEC)
Mucoepidermoid Carcinoma (MEC)