AGD Oral Diagnosis and Pathology 4 — Questions and Answers
Question 1: Which salivary gland tumor most commonly undergoes perineural invasion and has a pattern of skip lesions?
- Adenoid cystic carcinoma (Correct answer)
- Mucoepidermoid carcinoma
- Pleomorphic adenoma
- Acinic cell carcinoma
Correct answer: Adenoid cystic carcinoma
Adenoid cystic carcinoma is notorious for perineural invasion and skip lesions along nerve sheaths, contributing to its high recurrence rate.
Question 2: Toothpaste-fluoride interaction causing a white, chalky, demarcated enamel lesion is best classified as:
- Dental fluorosis (Correct answer)
- Amelogenesis imperfecta
- Turner tooth
- Enamel hypoplasia from systemic illness
Correct answer: Dental fluorosis
Dental fluorosis results from excess fluoride during enamel formation, producing white opaque to brown-stained, pitted enamel defects.
Question 3: A pigmented lesion on the palate of a patient taking antimalarial medication most likely represents:
- Drug-induced melanosis (Correct answer)
- Amalgam tattoo
- Oral melanoma
- Kaposi sarcoma
Correct answer: Drug-induced melanosis
Antimalarials (e.g., hydroxychloroquine) can cause diffuse drug-induced melanosis of the oral mucosa, especially on the hard palate.
Question 4: The histologic hallmark of pemphigus vulgaris that distinguishes it from mucous membrane pemphigoid is:
- Suprabasilar acantholysis with tombstone cells (Correct answer)
- Subepithelial blister formation
- Band-like lymphocytic infiltrate
- Neutrophilic microabscesses
Correct answer: Suprabasilar acantholysis with tombstone cells
Pemphigus vulgaris shows suprabasilar acantholysis with a row of remaining basal cells giving the 'tombstone' appearance, unlike the subepithelial split in pemphigoid.
Question 5: A patient presents with trismus, fever, and swelling in the submandibular and sublingual spaces bilaterally. This life-threatening condition is called:
- Ludwig angina (Correct answer)
- Masseteric abscess
- Lateral pharyngeal abscess
- Peritonsillar abscess
Correct answer: Ludwig angina
Ludwig angina is a rapidly spreading bilateral cellulitis of the submandibular and sublingual spaces that can cause fatal airway obstruction.
Question 6: Which finding on a panoramic radiograph is most suspicious for an odontogenic keratocyst rather than a simple dentigerous cyst?
- Scalloping along root surfaces with corticated borders (Correct answer)
- Pericoronal location around crown of impacted tooth
- Unilocular appearance
- Association with an unerupted premolar
Correct answer: Scalloping along root surfaces with corticated borders
OKC tends to grow anteroposteriorly along the medullary cavity with scalloped corticated borders, unlike the simple dome shape of a dentigerous cyst.
Question 7: Geographic tongue (benign migratory glossitis) is associated with which systemic condition in some patients?
- Psoriasis (Correct answer)
- Diabetes mellitus
- Hypothyroidism
- Celiac disease
Correct answer: Psoriasis
Geographic tongue shares histologic features with psoriasis and is found at higher prevalence in psoriasis patients, suggesting a common pathogenesis.
AGD Oral Diagnosis and Pathology 4
Which salivary gland tumor most commonly undergoes perineural invasion and has a pattern of skip lesions?