Oral Pathology and Diagnosis Flashcards

A 45-year-old patient presents with a painless, slow-growing swelling of the posterior mandible. Radiograph shows a unilocular radiolucency with a scalloped border around impacted third molar roots. What is the most likely diagnosis?

Answer: Odontogenic keratocyst

Odontogenic keratocysts classically present as unilocular or multilocular radiolucencies with scalloped borders, often associated with impacted teeth, and have a high recurrence rate.

Which of the following is the MOST characteristic microscopic feature of an ameloblastoma?

Answer: Peripheral palisading of columnar cells with reversed polarity and stellate reticulum

Ameloblastoma is characterized histologically by peripheral palisading of columnar ameloblast-like cells with nuclei displaced away from the basement membrane (reversed polarity) surrounding a stellate reticulum-like center.

A biopsy of a white lesion on the floor of the mouth reveals moderate epithelial dysplasia. Which feature is NOT a criterion for epithelial dysplasia?

Answer: Intercellular edema (spongiosis)

Spongiosis (intercellular edema) is a feature of inflammatory conditions like eczema, not a criterion for epithelial dysplasia.

Necrotizing sialometaplasia most commonly affects which location and is most frequently confused with which malignancy?

Answer: Hard palate; mucoepidermoid carcinoma

Necrotizing sialometaplasia typically presents as a crater-like ulcer on the hard palate and can be mistaken for mucoepidermoid carcinoma due to squamous metaplasia of salivary ducts.

A 60-year-old smoker presents with a red, velvety patch on the floor of the mouth that cannot be wiped off. Biopsy shows carcinoma in situ. What is the clinical diagnosis?

Answer: Erythroplakia

Erythroplakia is a red velvety mucosal patch that cannot be attributed to any other condition and carries the highest risk of malignant transformation among oral potentially malignant disorders.

Which odontogenic tumor is derived from remnants of the dental lamina and is characterized by a 'string of pearls' arrangement of epithelial islands with calcifications?

Answer: Calcifying epithelial odontogenic tumor

The calcifying epithelial odontogenic tumor (Pindborg tumor) shows polyhedral epithelial cells with concentric calcifications (Liesegang rings) and amyloid-like material in the stroma.

A patient presents with multiple radiopaque masses in the jaw associated with supernumerary teeth, epidermoid cysts of the skin, and osteomas. What syndrome does this suggest?

Answer: Gardner syndrome

Gardner syndrome is an autosomal dominant condition caused by APC gene mutations featuring intestinal polyposis, osteomas, epidermoid cysts, and supernumerary/impacted teeth.