Pathology Midterm 2

The unregulated formation and growth of new tissue- uncontrolled proliferation.

TUMOR- mass of cells that have undergone uncontrolled growth.

• Overgrowth of tissue in response to stimuli
• *Stops when the stimuli is removed

Disordered growth

Transport of neoplastic cells to parts of the body remote from the tumor

1. Carcinoma- cancers of epithelial orgin (squamous/basal cell carcinoma)

2. Sarcoma- cancers of connective tissue orgin (osteosarcoma/fibrosarcoma)

• Benign, exophytic or sessile- core fibrous CT
• MC: soft palate/tongue
• White b/c surface keratin

(resembles: warts)

• Generic clinical term- white patch, cannot be rubbed off (b/c hyperkeratosis)
• PREMALIGNANCY (can show epithelial displasia) *always biopsy
• 16%= squamous cell carcinoma (malignant)
• MC: floor of mouth, ventral/lateral tongue

• Generic clinical term- red, premalignant speckled leukoplakia (red and white)
• *Much less common than leukoplakia 60:1, more likely to be dysplasia, squamous cell carcinoma

• Histological diagnosis
• Premalignant
• Histologically: 
• -abnormal maturation
• -hyperplasia of basal cells
• -disorganization of layers
• -hyperchromatic nuclei
• -increased mitotic figures
• -no invasion through the basement membrane

Carcinoma in situ: severe dysplasia involving full thickness of epithelium

Squamous cell cancer: all histological characteristics plus invasion through basement membrane

• Most common malignancy in oral cavity
• -usually metastasizes to lymph nodes
• -invasion through basement membrane; keratin pearls (keratin seen in the cells within the tumor)
• MC: floor of the mouth, ventrolateral tongue, soft palate
• Assoc. w/ solar/actinic cheilitis
• Males > 40 --tobacco/alcohol increases risk

• T: tumor, what is the size of the primary tumor?
• N: nodes, which lymph node involvement?
• M: metastasis, how far has the tumor spread?
• ***Any pt with metastasis = stage IV***

• A squamous cell carcinoma w/ better prognosis due to slow growth
• -Exophytic/pebbly
• -No invasion of basement membrane (rare to metastasize, well differenciated)

• NOT in oral cavity
• Raised pearly boarders w/ visible capillary network surrounding a central depressed, crusted area
• -sun ☀ exposure, ulcer like
• -rare to metastasize

• Most common salivary gland tumor
• 90% benign -- CAN undergo malignant transformation
• -CT and ep
• -Painless, slow enlarging
• MC: palate

• -Benign
• -Epithelium only
• MC: upper lip
• -Warthin's Tumor

• -Special kind of monomorphic adenoma
• -Epithelial and lymphoid tissue
• -Benign

• Malignant
• -infiltrates, pain, slow growing
• -CAN have distant metastasis years later
• MC: parotid gland (extraoral), palate (intraoral)

• Malignant
• Most common malignant salivary tumor in children
• -mucous and epithelial cells
• -slow enlarging
• -uni/mulilocular, radiolucent, invasive
• MC: parotid, palate, in bone
• -low grade tumor 5 year survival: 92%
• -high grade tumor 5 year survival: 49%

Benign

• -Benign, unencapsulated
• -Bone expansion, painless, slow growing
• -Locally aggressive
• -Ameloblast ep cells surrounding stellate reticulum
• -uni/multilocular, soap bubble
• -80% mand (ramus/molar areas)
• -Max (molar areas)

• -Benign, unique sheets of multi-sided ep cells with calcifications
• -Remnants of the enamel organ
• -Uni/multi
• -Mand > 
• -premolar/molar
• -Many assoc w/ impacted teeth

• -Benign, does not recur
• -Duct-like structures, fibrous CT capsule
• -70% females under 20, ant max
• -asymptomatic
• -well defined RL w/ impacted tooth

• -Nonaggressive
• -Radiographic ghost cells (keratin w/ lost nuclei), uni/multi
• -May resemble ameloblastoma
• -Males under 40

• -Benign, unencapsulated
• -Derived from ectomesenchyme, originates from PDL and pulp
• -10-30 years
• -Root resorption and displacement, multi, RL w/ poor margins

• -Benign, fibrous CT calcifications
• -Female 30's and 40's
• -Well defined, RL

• Cementum tumor
• Lesion fused to root, tooth may be vital
• -Well defined RO w/ resorbed apex and RL halo
• -premolar, molar mand
• -Younger than 25
• -Pain

• -Benign, unencapsulated
• -Younger than 20
• -Mandibular premolars
• -RL may be assoc w/ unerupted tooth

• Most common odontogenic tumor
• -Mature enamel, dentin, cementum, pulp
• -Females younger than 20
• -Asymptomatic, found in routine radiographs
• TWO TYPES

1. Compound: resembles small teeth (cluster of calcified material); ant max

2. Complex: Masses of tissue NOT resembling a tooth; post mand

• Well defined sessile/pedunculated/exophytic mass on attatched gingiva
• -Develops from submucosal CT or PDL
• -Surface may be ulcerated

• Most common soft tissue tumor of the body
• -Benign, adipose cells, yellow
• -Soft/palpable
• -Rare recurrence
• -Around 50 years old

***Lipsarcoma: rare in oral cavity, can recur***

• -Benign, solitary nerve tissue neoplasm
• MC: Tongue
• *Neurofibromatosis

Von Recklinghausen's Disease: multiple neurofibromas

• -Proliferation of Schwann cells
• -Nerve pushed aside as tumor grows, slow growing
• -20-50 years of age

• -Large cells w/ granular cytoplasm
• -Tongue, painless

Rhabdomyoma- benign, striated

• Rhabdosarcoma- malignant, striated, rapid, destructive
• Most common malignant soft tissue tumor in children