AGD Oral Diagnosis and Pathology 2 — Questions and Answers
Question 1: A 45-year-old patient presents with a painless, firm swelling on the hard palate that has been present for years. Radiograph shows no bone destruction. The most likely diagnosis is:
- Pleomorphic adenoma (Correct answer)
- Mucoepidermoid carcinoma
- Necrotizing sialometaplasia
- Adenoid cystic carcinoma
Correct answer: Pleomorphic adenoma
Pleomorphic adenoma is the most common benign salivary gland tumor, frequently presenting as a slow-growing, painless firm mass on the hard palate.
Question 2: Which histologic feature is MOST characteristic of oral lichen planus?
- Civatte bodies and band-like lymphocytic infiltrate (Correct answer)
- Acantholysis with suprabasilar clefting
- Spongiosis with eosinophilic infiltrate
- Microabscesses within the spinous layer
Correct answer: Civatte bodies and band-like lymphocytic infiltrate
Oral lichen planus shows characteristic Civatte (colloid) bodies and a band-like subepithelial lymphocytic infiltrate at the basement membrane zone.
Question 3: A patient presents with multiple radiolucent lesions in the jaw and a history of multiple basal cell carcinomas of the skin. This presentation is consistent with:
- Gorlin-Goltz syndrome (Correct answer)
- Gardner syndrome
- Paget disease of bone
- Hyperparathyroidism
Correct answer: Gorlin-Goltz syndrome
Gorlin-Goltz (nevoid basal cell carcinoma) syndrome is characterized by multiple odontogenic keratocysts, multiple basal cell carcinomas, and skeletal anomalies.
Question 4: The 'strawberry gingivitis' pattern with granulomatous inflammation is most associated with which systemic condition?
- Wegener granulomatosis (GPA) (Correct answer)
- Crohn disease
- Sarcoidosis
- Langerhans cell histiocytosis
Correct answer: Wegener granulomatosis (GPA)
Granulomatosis with polyangiitis (Wegener's) classically produces strawberry-like hyperplastic gingivitis with a granulomatous histology.
Question 5: A ranula that dissects through the mylohyoid muscle into the neck is termed:
- Plunging ranula (Correct answer)
- Dermoid cyst
- Thyroglossal duct cyst
- Lateral cervical cyst
Correct answer: Plunging ranula
A plunging ranula occurs when mucous extravasation from the sublingual gland herniates through the mylohyoid muscle to present as a neck mass.
Question 6: Which stain is used to identify amyloid deposits in tissue sections, producing apple-green birefringence under polarized light?
- Congo red (Correct answer)
- PAS stain
- Mucicarmine
- Masson trichrome
Correct answer: Congo red
Congo red stain imparts a salmon-pink color to amyloid that shows characteristic apple-green birefringence under polarized light.
Question 7: Peripheral giant cell granuloma of the gingiva is most accurately classified as:
- Reactive hyperplasia (Correct answer)
- True neoplasm
- Odontogenic cyst
- Inflammatory abscess
Correct answer: Reactive hyperplasia
Peripheral giant cell granuloma is a reactive hyperplastic lesion arising from periosteum or periodontal ligament in response to local irritation.
AGD Oral Diagnosis and Pathology 2
A 45-year-old patient presents with a painless, firm swelling on the hard palate that has been present for years.
Radiograph shows no bone destruction.
The most likely diagnosis is: