پنځم فصل د خولي د جوف ناروغى
د خولي د جوف د غاښو ناروغى د ناړو د غدواتو ناروغى ناروغى
(stratified non keratinized squamous epi)
mucous
Developmental anomalies
(cleft upper lip) Facial clefts (cleft palate) facial processes
Fordyce’s granules sebaceous (spots)
Leukoedema leukoplakia mucosa
macroglossia Macroglossia i amyloid haemangioma lymphangioma
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aglossia Microglossia ii aglossia micoglossia
Fissured tongue iii glossitis fissured tongue
Bifid Tongue iv
tongue tie fraenum Tongue Tie v
Hairy Tongue vi hairy tongue filiform
Mucocutaneuous Lesion
mucosa
Lichen Planus
keratosis
Vesicular lesions
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pemphigus vugaris Pemphigus vulgaris i
conjunctiva Pemphigoid ii pemphigoid pemphigoid
Erythema Multiforme iii
erythema multiforme Stevens-Johnson syndrome iv sulfa
stomatitis Stomatitis
Aphthous ulcer (canker sore) i stress
inflammatory Bechet’s syndrome bowel disease
Herpes simplex Herpetic stomatitis ii
stress
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cancrum oris Noma Necrotising Stomatitis iii Kwashiorkor stress
marginal gangrene cheek cellulitis
mucosa Mycotic infections iv Candidiasis actinomycosis
(mandible) Cervicofacial actinomycosis candida albicans Candidiasis erythematous palate
glossitis Glossitis Scarlet fever papillae papillae glossitis pernicious anaemia iron deficiency anaemia pellagra malnutrition papillae sprue
congenital syphilis tertiary secondary primary Syphilitic Lesions
primary syphilis i
mucous patches Secondary syphilis ii
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gummas tertiary syphilis iii
fissures congenital syphilis iv
Tuberculous lesions
TB
AIDS HIV Infection Hairy leukoplakia
٥-١ جدول.په AIDS کي د خولې ليژنونه .
A. OPPORTUNISTIC INFECTIONS B. TUMOURS
Fungal : Candidiasis (oral thrush) Kaposi’s sarcoma
Histoplasmosis Squamous cell carcinoma
Cryptococcosis Non-Hodgkin’s lymphoma
Bacterial : Dental caries and periodontitis C. OTHERS
Mycobacterial infections Hairy leukoplakia
Viral : Herpetic stomatitis Recurrent aphthous ulcers
Cytomegalovirus Human papillomavirus Pigmentary Lesions Melanotic pigmentation peutz-Jeghers Albright syndrome Addison’s disease malignant melanoma Haemochromatosis syndrome sufide exogenous pigmentation
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Tumour
٥-٢ جدول. د خولې د ټيومورونو طبقه بندي او ټيومور ته ورته ليژنونه .
A. TUMOUR-LIKE LESIONS
1. Fibrous growths C. PREMALIGNANT LESIONS (Fibroepithelial polyps, fibrous epulis, denture hyperplasia) 1. Hyperkeratotic leukoplakia 2. Pyogenic granuloma 2. Dysplastic leukoplakia 3. Mucocele D. MALIGNANT TUMOURS 4. Ranula 1. Squamous cell (Epidermoid) carcinoma 5. Dermoid cyst 2. Other malignant tumours B. BENIGN TUMOURS
1. Squamous papilloma
2. Haemangioma
3. Lymphangioma
4. Fibroma
5. Fibromatosis gingivae
6. Tumours of minor salivary glands (e.g. Pleomorphic adenoma)
7. Granular cell myoblastoma leukoplakia A
Fibrous Growths
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Fibroepithelial polyps i fibrous stratified squamous
Fibrous epulis ii Giant cell epulis
Denture Hyperplasia iii hyperplasia
hyperplasia
Pyogenic Granuloma
Buccal mucosa fibrous epulis Vasoproliferative
Mucocele
mucous cyst (mucous glands)
Ranula
floor Mucocele
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Dermoid cyst
stratified squamous sebaceous
Extravasated mucous Mucocele B
mesodermal
Squamous Papilloma
Haemangioma
haemangioma Capillary haemangioma macroglossia haemangioma cavernous macroglossia Lymphangioma
macroglossia
macrocheilia
lymphoangioma Cystic hygroma
macrocheilia
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Cystic hygroma
Fibroma
fibroma
Fibromatosis Gingivae
Fibromatosis Gingivae
pleomorphic adenoma
Leukoplakia C
Leukoplakia leukoplakia plaque leukoplakia leukoplakia
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(incidence)
floor mucosa leukoplakia
AIDs Hairy leukoplakia leukoplakia
Leukoplakia
leukoplakia
squamous epithelium Hyperkeratotic A hyperkeratosis
hyperplasia Dysplastic pleomorphism dysplasia B
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Hyperkeratosis A Leukoplakia Dysplastic B Basement membrane
Malignant Tumours D
Squamous cell (epidermoid) carcinoma
90% floor
squamous cell carcinoma
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i
ii
Human papilloma virus (HPV 16 ,18) iii
Squamous cell carcinoma i
fibrosis ii
iii
iv
v
Plummer vinson syndrome iv
Squamous cell carcinoma
Ulcerative i
(wart) verrucous Papillary ii
Nodular iii
Scirrhous iv
squamous well-differentiated
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squamous carcinoma
pleomorphism squamous cell carcinoma
caries Periodontitis Abscess
crown root dentine enamel cementum dental lamina gingiva primitive oral cavity
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ectoderm dental lamina enamel ameloblasts enamel organ matrix dental mesoderm pulp papilla
odontoblasts dental papilla dentin ameloblastic epithelium
Enamel enamel
enamel Dentin
odontoblasts dentin
osteocytes canaliculi
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Cementum periodontal ligament cementum
pulp Dentin Dental pulp
Dental caries calcified dental caries
acidogenic streptococci dentin dentin enamel decalcify
proteolysis dentin
plaques
fluoride
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caries premolars molar
dentin enamel
(pulititis)
Caries
pulpitis
enamel Demtal caries pulpitis pulp
pulpitis
apical foramen pulpitis Apical granuloma
granulation granuloma
Apical abscess
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Periodontal disease
degeneration
epulis fibrous hyperplasia scurvy leukemia
periodontal Dilantin marginal gingivitis plaques
marginal gingivitis
periodontitis hyperplasia pyorrhea resorption alveolar
developmental
A
dental cyst periodontal apical Radicular cyst dental pulp
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odontogenic apical granuloma
radicular cyst
٥-٤ جدول.د ژامي د اپتيليل سيسټونو طبقه بندي .
A. INFLAMMATORY
Radicular (apical, periodontal, dental) cyst
B. DEVELOPMENTAL
1. Odontogenic cysts
(i) Dentigerous (follicular) cyst
(ii) Eruption cyst
(iii) Gingival cyst
(iv) Primordial cyst (odontogenic keratocyst)
2. Non-odontogenic and fissural cysts
(i) Nasopalatine duct (Incisive canal, Median anterior maxillary) cyst
(ii) Nasolabial (nasoalveolar) cyst
(iii) Globulomaxillary cyst
(iv) Dermoid cyst Developmental cysts B
dentigerous Odontogenic cyst mandible enamel randicular canines maxilla molar
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ameloblastoma
Radicular
fibrous dentigerous radicular dentigerous radicular
Eruption cyst
stratified squamous
dentigerous
Gingival cyst
Dentigerous (follicular ) fibrous
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Fissural Non-odontogenic B
nasopalatine duct Nasopalatine duct cyst
maxillary processes Nasolabial cyst ala
Dermoid cyst globulomaxillary cyst
Odontogenic tumours odontogenic WHO
٥-٥ جدول.دWHO په واسطه د Odontogenic ټيومورونو طبقه بندي .
A. BENIGN B. MALIGNANT a) Epithelial origin a) Epithelial origin
1. Ameloblastoma 1. Malignant ameloblastoma
2. Adenomatoid odontogenic tumour (Adenoameloblastoma) 2. Ameloblastic carcinoma
3. Calcifying epithelial odontogenic tumour b) Mesenchymal origin b) Mesenchymal origin Ameloblastic fibrosarcoma
1. Odontogenic myxoma 2. Odontogenic fibroma
3. Cementoma c) Mixed epithelial-mesenchymal origin
1. Ameloblastic fibroma 2. Ameloblastic fibro-odontoma
3. Complex odontomas
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A
Ameloblastoma mandible enamel maxilla ramus
multilocular
Plexiform acnthomatous
plexiform Ameloblastoma
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Calcifying epithelial odontogenic Odontogenic Adenomatoid Cementoma Odontomas Odontogenic Myxoma
B
Odontogenic Carcinoma
Ameloblastoma Malignant ameloblastoma i
ameloblastic Ameloblastic Carcinoma ii
primary intraosseous carcinoma iii odontogenic
Odontogenic Sarcomas ameloblastic Ameloblastic fibrosarcoma fibroma
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(submandibular) (sublingual ) paratiod parotid sublingual submandibular molar
mucous tubuloalveolar serous paratoid serous
acini mixed
ptyalism Sialorrhoea Sialorrhoea(ptyalism) Shizophrenia (stomatitis) Sialosis
xerostomia Xerostomia
Mikulicz’s syndrome Mumps parotitis Sarcoidosis Sjogren’s syndrome antihistamines dehydration Megaloblastic anaemia Anti-depressants antihypertensive
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Sialadenitis
parotid mumps pancreatitis Orchitis- oophoritis mumps
testis
Cytomegalovirus
mycotic
sialadenitis parotitis
acute sialadenitis i
– a
postoperative parotitis b
c
dehydration d
chronic sialadenitis
mumps
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(sialolithiasis) a stricture
b hyposalivation anti-depressants antihypertensives antihistamines
mycoses actinomycosis TB c
autoimmune disease
(triat) Sjogren’s syndrome i rheumatoid arthritis (xyrostomia) keratoconjunctivitis sicca
Lacrimal Mikulicz’ syndrome ii xerostomia
tenderness purulent
vacuolation parotid degeneration
(fibrosis) fibrous
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parotid 85%
acini
٥-٦ جدول.د ناړو د غدواتو د ټيومورونو طبقه بندي .
A. BENIGN B. MALIGNANT
1. Adenomas 1. Mucoepidermoid carcinoma (5-10%) i) Pleomorphic adenoma (Mixed tumour) (65-80%) 2. Malignant mixed tumour ii) Monomorphic adenoma i) Carcinoma in pleomorphic adenoma (2%)
(a) Warthin’s tumour (Papillary cystadenoma ii) Carcinosarcoma (rare) lymphomatosum, Adenolymphoma) (5-10%) iii) Metastasising mixed salivary tumour (rare)
(b) Oxyphil adenoma (Oncocytomas) (< 1%) 3. Adenoid cystic carcinoma (cylindroma) (3-10%)
(c) Other types (Myoepithelioma, Basal cell 4. Acinic cell carcinoma (2-3%) adenoma, Clear cell adenoma) (uncommon) 5. Adenocarcinoma (1-3%)
2. Mesenchymal tumours (rare) 6. Epidermoid carcinoma (1-3%)
7. Undifferentiated carcinoma (< 1%)
8. Miscellaneous (rare)
A
Adenomas Adenoma monomorphic pleomorphic
Mixed salivary tumour Pleomorphic Adenoma
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nodular
Pleomorphic adenoma
B A
myxoid mucoid adenoma
Acini Epithelial component
mucoid myxoid Mesenchymal elements
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acini Pleomorphic adenoma mucoid chondroid myxoid mesenchymal (prognosis)
facial nerve
Monomorphic adenoma
mesenchyme
Warthin’s tumour
adenolymphoma lymphomatosum papillary cystadenoma parotid
parotid
germinal centre
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Oxyphils adenoma acini oncocytoma esinophilic acini oncocyte
cystic papillary eosinophilic Warthin’s tumour
Malignant B
Mcuoepidemoid carcinoma
parotid
therapeutic
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mucin
Malignant Mixed tumour
pleomorphic carcinoma adenoma Carcinosrcoma Mucoepidermoid carcinoma mixed intermediate squamous mucinous pleomorphic adenoma carcinoma Clear
cystic degeneration
anaplasia
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Adeno carcinoma Acinic cell carcinoma Adenoid cystic carcinoma Undifferentated carcinoma Epidemoid carcinoma
1-Forastiere A et al: Head and neck cancer. N Engl J Med 345: 1890, 2001. 2-Kapadia SB: Salivary gland tumours. In Proceedings of III International CME & Update in Surgical Pathology, Gupta RK (Ed). Lucknow, SGPGI, 1998. 3-Mac Donald DG, Browne RM: Tumours of odontogenic epithelium. In 4-Recent Advances in Histopathology, number 17, Anthony PP et al (Eds). London, Churchill Livingstone, pp 139, 1997. 5-Seifert G: WHO Histological Typing of Salivary Gland Tumours, 2nd ed. Berlin, Springer-Verlag, 1991. 6- Simpson RHW: Salivary gland tumours. In Recent Advances in Histopathology, number 17, Anthony PP et al (Eds). London, Churchill Livingstone, pp 167, 1997.
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