Oral Pathology and Diagnosis Flashcards

A 55-year-old with HIV presents with a white, corrugated lesion on the lateral border of the tongue that cannot be wiped off. EBV is implicated. What is the diagnosis?

Answer: Hairy leukoplakia

Oral hairy leukoplakia is caused by EBV replication in keratinocytes and presents as a corrugated or 'hairy' white lesion on the lateral tongue that cannot be removed by wiping.

Langerhans cell histiocytosis involving the jaw is MOST likely to present radiographically as:

Answer: Floating teeth appearance due to alveolar bone destruction

Langerhans cell histiocytosis causes rapid alveolar bone destruction that gives teeth the appearance of floating in space on radiographs.

A patient presents with burning mouth, angular cheilitis, and a smooth, atrophic, erythematous tongue. Lab results show low serum iron and ferritin. What oral manifestation pattern is this?

Answer: Plummer-Vinson syndrome

Plummer-Vinson syndrome presents with iron-deficiency anemia, dysphagia from esophageal webs, glossitis, and angular cheilitis, and carries increased risk for oral and esophageal carcinoma.

Which of the following is TRUE regarding central giant cell granuloma (CGCG) of the jaws?

Answer: It cannot be distinguished from hyperparathyroidism lesions by histology alone

Central giant cell granuloma and the brown tumor of hyperparathyroidism are histologically identical; clinical and laboratory correlation is essential for differentiation.

A painful vesiculoulcerative lesion affecting the hard palate and attached gingiva with subepithelial bullae and linear IgA deposits at the basement membrane zone on direct immunofluorescence is MOST consistent with:

Answer: Mucous membrane pemphigoid

Mucous membrane pemphigoid shows subepithelial clefting with IgG, IgA, or C3 deposits at the BMZ on DIF and preferentially affects mucosal sites, especially gingiva (desquamative gingivitis) and palate.

Which of the following best describes the histopathologic appearance of a mucocele (mucous extravasation phenomenon)?

Answer: Pool of mucin surrounded by granulation tissue without an epithelial lining

A mucocele (extravasation type) consists of mucin extravasated into connective tissue surrounded by macrophages and granulation tissue, with no true epithelial lining.

A 70-year-old edentulous patient presents with a progressive, painful swelling of the mandible. CT shows ill-defined bone destruction with periosteal reaction. Biopsy reveals nests of malignant squamous cells invading bone. What is the most likely primary source?

Answer: Primary intraosseous squamous cell carcinoma

Primary intraosseous squamous cell carcinoma arises within the jaw from odontogenic epithelial remnants and presents with bone destruction; it must be distinguished from metastatic disease by clinical workup.