Name:__________________________________________ DAPA 722/ 732 Soft Tissue Oral Pathology Final Examination: Slide Recognition March 11, 2010 1. Squamous Cell Carcinoma 19 Squamous cell carcinoma 2. Hemangioma 20 Systemic sclerosis 3. Orofacial granulomatosis *21 Pyogenic granuloma #21-23 may be in any 4. EM/ Steven’s Johnson Syndrome order 5. Basal cell carcinoma *22 Peripheral ossifying fibroma 6. Actinic keratosis *23 Peripheral giant cell granuloma 7. Squamous papilloma 24 Kaposi sarcoma 8. Melanoacanthoma 25 Recurrent herpes 9. Lichen planus 26 Melanoma 10. Thyroglossal duct cyst 27 Verrucous carcinoma 11. Pemphigus vulgaris 28 Primary herpes simplex 12. Nasolabial cyst 29 Nevus (melanocytic) 13. Allergic contact stomatitis 30 Focal epithelial hyperplasia 14 Mucous membrane pemphigoid 31 Polymorphous low grade adenocarcinoma 15 Mucoepidermoid carcinoma 32 Squamous cell carcinoma 16 Traumatic ulcer 17 Aphthous stomatitis 18 (Oral) hairy leukoplakia MATCHING: Match each of the phrases with the term which BEST corresponds to it. Terms may be used once, more than once, or not at all. A. Sjögren syndrome B. Necrotizing sialometaplasia C. Sialolithiasis D. Sialadenitis E. Mucous duct cyst 41. Microscopically may mimic squamous or salivary gland carcinoma. B 42. May arises after obstruction has caused salivary duct dilation E 43. Predisposing factors include xerostomia and sialoliths D 44. Microscopically the lesions show dense infiltration of lymphocytes which replace glandular tissue. A 45. Signs/ symptoms may include acute pain, swelling, trismus, lymphadenopathy, and possibly fever. A A. Ephelis B. Oral melanoacanthoma C. Melanocytic nevus D. Melanotic macule E. Lentigo simplex 46. Pigmented lesion exhibiting alarming rapid growth, but is benign and often spontaneously resolves. B 47. Also known as a freckle A 48. Composed of a proliferation of cells of neural crest origin; usually appears in later childhood. C 49. Microscopic features include a mildly thickened epithelium with numerous pigmented dendritic cells seen throughout. B A. Pleomorphic Adenoma B. Canalicular Adenoma C. Adenoid Cystic Carcinoma D. Mucoepidermoid Carcinoma E. None of these 50. Most common salivary gland neoplasm A 51. Histology shows ductal epithelial and myoepithelial cells in a stroma of mucoid, myxoid, or even chondroid material. A 52. Most common in upper lip of middle aged females. B 53. The most common malignant salivary gland tumor in children and adults, this lesion occurs as either low or high grade (which predicts patient prognosis). D 54. A high-grade malignancy with a fair to good 5 year survival rate, but a dismal 15-20 survival rate. C 55. This relatively rare benign salivary gland tumor is seen mostly in the parotid and is composed of large polyhedral cells with granular, brightly eosinophilic cytoplasm. The intracellular granules are actually mitochondria. E A. Lichen Planus B. Allergic Contact Stomatitis C. Lupus Erythematosus D. Pyostomatitis Vegetans 56. Chronic pustular oral disease often associated with ulcerative colitis, Crohn disease, and other inflammatory bowel conditions. D 57. Pathophysiology of the systemic form includes formation and deposition of immune complexes in various tissues throughout the body, with markedly elevated titers of antinuclear antibodies in the serum. C 58. The cutaneous lesions of this mucosa-and-skin disease are described as “purple, pruritic, polygonal papules.”A 59. Oral lesions may be reticular or erosive; cutaneous manifestations include koilonychia. A 60. Usually a diffuse erythema and/or hyperkeratosis seen at the site of contact with an allergen. B A. Squamous Cell Carcinoma B. Verrucous Carcinoma C. Actinic Keratosis D. Basal Cell Carcinoma 61. Most common form of skin cancer D 62. Locally aggressive oral tumor which is infiltrative, but unlikely to metastasize B 63. Unique microscopic appearance of large, bulbous, “pushing” epithelial rete with little or no cellular atypia B 64. Lesion on sun exposed skin appearing as scale, ulcer, erosion or crust; microscopic features include replacement of subepithelial collagen with elastin, epithelial atrophy, and dysplasia. C 65. Etiology is not considered to be linked to sun exposure B 66. _____________ is caused by a large DNA pox virus. It presents as 1 to 50 or more papules on the skin 2-3 months after initial inoculation with the virus. Microscopically the lesions show distinct, large epithelial rete composed of keratinocytes with bright pink intracytoplasmic inclusions (“bodies”). a) Focal epithelial hyperplasia b) Molluscum contagiosum c) Verruciform xanthoma d) Condyloma accuminatum e) Seborrheic keratosis 67. Which of the following agents or diseases will NOT likely cause the type of chronic inflammation characterized by focal, organized collections of histiocytes? a) mycobacteria b) fungi c) sarcoidosis d) Crohn disease e) all of these may result in such inflammation 68. A example of a (frequently) pedunculated lesion is a(n) a) ulcer b) varicosity c) abscess d) papilloma 69. The base of a sessile lesion is a) stemlike b) corrugated c) broad and flat d) nodular e) lobulated 70. Repeated trauma or rubbing to an area of the oral epithelium over time results in thickening of the surface keratin, which is called a) frictional keratosis b) idiopathic leukoplakia c) traumatic ulcer d) amalgam tattoo e) none of these 71. At which site is it most common for a mucocele to occur? a) lower lip b) floor of the mouth c) buccal mucosa d) upper lip 72. Which of the following papillary lesions is/are contagious? a) papilloma b) verruca vulgaris c) condyloma accuminatum d) two of the above 73. Lichen planus is a common disorder representing an immune-complex hypersensitivity reaction to a prior infection with Streptococcus. a) True b) False 74. Aphthous ulcers typically occur on/ in a) moveable, non-keratinized oral mucosa b) keratinized mucosa c) lingual papilla d) tonsillar tissue 75. In which of the following situations is an incisional biopsy NOT indicated? a) Large lesions b) Suspected carcinomas c) Diffuse processes d) Removal of previously diagnosed malignant lesions 76. In which of the following anatomic areas is oral squamous cell carcinoma LEAST likely to occur? a) Lateral tongue b) buccal mucosa c) soft palate d) maxillary anterior gingiva e) floor of mouth 77. In considering the “ABCs of melanoma”, “A” stands for ___________________ while “C” stands for ___________________. a) asymmetry of lesion, crusted surface b) accelerated growth, color variegation c) accelerated growth, color of dark brown to black d) asymmetry of lesion, color variegation e) None of these; there is no such thing as the “ABCs” of melanoma. 78. What percentage of (idiopathic) leukoplakias shows dysplasia or carcinoma at the time of diagnosis? a) 1% b) 0. 5% c) 15-20% d) 50% e) 80% 79. Verrucous carcinoma and basal cell carcinoma are two very different neoplasms, but they are similar in that they both a) are locally destructive b) frequently metastasize c) are caused by sun exposure d) most commonly present as painful ulcers on the tongue or oral floor 80. Melkerson-Rosenthal syndrome is characterized by the triad of orofacial granulomatosis, fissured tongue, and a) oral condylomata. b) leukoplakia. c) xerostomia. d) facial paralysis. 81. Oral cancer may have which of the following clinical presentations? a) a painless red macule b) a non-healing ulcer c) an oval plaque with raised, firm, rolled borders d) a submucosal mass fixed to the overlying tissue e) all of these 82. Neurofibromatosis is a/an __________________ disorder which is diagnosed by the presence of neurofibromas and/ or the presence of __________ or more café au lait spots over 5 mm in diameter each. a) acquired, 6 b) acquired, 5 c) autosomal dominant inherited, 6 d) autosomal recessive inherited, 6 e) autoimmune, 6 TRUE or FALSE: State whether the following statements are true (A) or false (B) 83. Lentigo simplex is melanocytic, usually pigmented lesion that often develops on the skin of young children. A 84. A malignant tumor of the loose submucosa (i.e. angiosarcoma, fibrosarcoma) would clinically feel loose and freely moveable in the mouth when palpated. B 85. Oral melanoacanthoma may achieve a large size quickly, and so can be worrisome for malignancy. A 86. Patients with Peutz-Jeghers syndrome develop multiple polyps of the colon which invariably become malignant over time. B 87. “Foam cells” of verruciform xanthoma are actually macrophages filled with phagocytosed viral particles. B 88. A diagnosis of actinic keratosis implies that the lesion microscopically demonstrates epithelial dysplasia. A Extra Credit!!! 1 point each. 89. Herbert Hoover was the American president who underwent hemimaxillectomy surgery for treatment of suspected oral cancer. B 90. This president’s surgery was performed in an open-air float so as to afford the best view possible to the viewing public. B .