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(stratified non keratinized squamous epi)

mucous

Developmental anomalies

(cleft upper lip) Facial clefts (cleft palate) facial processes

Fordyce’s granules sebaceous (spots)

Leukoedema mucosa

macroglossia Macroglossia i amyloid haemangioma lymphangioma

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aglossia Microglossia ii aglossia micoglossia

Fissured tongue iii

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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vugaris Pemphigus vulgaris i

conjunctiva Pemphigoid ii pemphigoid pemphigoid

Erythema Multiforme iii

erythema multiforme Stevens-Johnson syndrome iv sulfa

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 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

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 , denture hyperplasia) 1. Hyperkeratotic leukoplakia 2. 2. Dysplastic leukoplakia 3. Mucocele D. MALIGNANT TUMOURS 4. 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 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)

(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 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 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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() 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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