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Benign tumors practical

Benign tumors practical. Learning out comes. To list the different benign swellings To Understand their classification and pathogenesis To diagnose the different benign swellings Ability to perfom differential diagnosis. When dentist see an oral swelling what is the possible diagnosis?.

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Benign tumors practical

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  1. Benign tumors practical

  2. Learning out comes • To list the different benign swellings • To Understand their classification and pathogenesis • To diagnose the different benign swellings • Ability to perfom differential diagnosis

  3. When dentist see an oral swellingwhat is the possible diagnosis? • It could be: • Hyperplastic lesion • Hamartoma • Benign neoplasm • Malignant neoplasm • Cyst • inflammation

  4. Case 1

  5. Patient came to the dental clinic suffering from a lesion present on anterior mucous membrane

  6. The doctor noticed on clinical examination that this lesion arise as sessile keratinized out growth. • Also noticed another lesion on retromolar area

  7. The histopathological examination revealed • Central branching connective tissue core . • Covered by acanthotic, hyperkeratotic epithelium. • The nuclei of the epithelial cells, however, contain inclusion bodies representing virus particles.

  8. Koilocytes in the upper epithelium are a helpful, indication that a lesion is associated with human papillomavirus. • Koilocytesdisplay a dark small nucleus with clear cytoplasm

  9. koilocytes, with perinuclear cytoplasmic halos and irregular and hyperchromatic nuclei (H&E, 400×

  10. The probable diagnosis of this condition is? • Is verruca vulgaris • What is the cause of this condition? • human papilloma virus subtype 2, 4. • What is the name of other lesion carrying the same histopathological picture? • Squamous cell papillomaHPV-6 and HPV-11

  11. focal epithelial hyperplasia (HPV types 13 and 32). 

  12. Squamous cell papilloma

  13. Hyperplastic stratified squamous epithelium • 2-delicate connective tissue core

  14. Case 2

  15. Patient came to the dental clinic suffering from a lesion a lesion on his gingiva with slight bleeding and discomfort

  16. The doctor noticed on clinical examination that this lesion arise as • pedunculated ulcerated • Tendacy for hemorrage • Red colorout growth. • Also noticed Poor oral hygienand Calculus

  17. The histopathological examination revealed Ecessiveformation of granulation tissue • proliferating fibroblasts, • newly formed blood capillaries, c • ollagen fibrils) • Inflammatory cells • The granulation tissue is covered by stratified squamous epithelium which is sometimes ulcerated.

  18. Papillary pedunculated pyogenic granuloma

  19. The probable diagnosis of this condition is? • Pyogenic granuloma • What is the cause of this condition? • Traumatic injury followed by non specific microorganism infection • Hormonal factors: during pregnancy (pregnancy tumor) • Drugs • Poor oral hygien • Calculus

  20. Case 3

  21. The doctor noticed on clinical examination that this lesion arise as • Sessile ulcerated surface • Tendacy for hemorrage • Dark Red colorout growth.

  22. Patient came to the dental clinic suffering from a lesion a large red lesion on his alveolar mucosa, anterior to the molars.

  23. The histopathological examination revealed • Mass of connective tissue contains multinucleated giant cells. • There is a subepithelial giant-cell-free under surface epithelium

  24. The probable diagnosis of this condition is? Peripheral giant cell granuloma • What is the cause of this condition? • It is a reactive proliferative response to trauma

  25. Peripheral giant cell granuloma • 1-Hyperplastic surface) • 2-giant cell free zone: Formed of collagen fibers, fibroblast • 3-giant cell zone: formed of: • Clusters of foreign multinucleated giant cells • Dilated blood capillaries • Extravasated RBCs • Granulation tissue

  26. Case 4

  27. An old age pateint came to the dental clinic suffering from excessive roll of tissue related to the mucolabial fold. • The lesion was seen after the pateint removed his denture

  28. The probable diagnosis of this condition is? Epulisfissuratum • What is the cause of this condition? • ill fitting denture or Sharp denture borders • Whatis the name of another lesion occuring in the palate caused by denture wearing • Palatal papillomatosis

  29. Palatal papillomatosis

  30. What is the characteristic microscopic picture of these lesions? • pseudo-epitheliomatous hyperplasia

  31. pseudo-epitheliomatous hyperplasia

  32. Case 5

  33. A young patient 16 years old came to dental clinic suffering from large tumor in his cheek

  34. The doctor noticed on clinical examination that this lesion is soft not well defind

  35. The histopathological examination revealed • The lesion consists of anastomosing stellate, fusiform or spindle-shaped cells. • The cells are embedded in a myxoidstroma rich in mucopolysaccharides

  36. The probable diagnosis of this condition is? myxoma • What is the name of this condition when undergo fibrosis? Fibromyxoma What is the name of the condition if we found under microscope collagen bundles instead of myxoid tissue? fibroma

  37. Myxoma • spindle cells • 2- stellate cells • 3-star-shaped cells • 4- mucoid matrix

  38. Fibroma • 1-proliferating fibroblasts • 2- collagen fibers • 3-blood vessels

  39. Case 6

  40. Two young brothers came to fill their molars but the dentist noticed • That the first brother had sessile swelling in the tongue which is soft spring in consistency • Also noticed Enlargement of the fungiform papillae

  41. Also noticed 6 or more café au lait spots, 5 mm, in on his skin • Also found axillary freckles • The second brother had the same symptoms in addition to a pigmented naevusaffecting the iris,

  42. The histopathological examination revealed • The lesion consists of spindle-shaped cells with wavy nuclei • The cells arranged in a whorled pattern. • Nerve fibres are seen passing through the mass. • Melanocytes can be seen

  43. The probable diagnosis of this condition is? neurofibromatosis • What is the name of the cell that caused this disorder and name of its cell derivatives involved in the lesion? • Neural crest cell • (Schwann cells, melanocytes, endoneuralfibroblasts)

  44. neurofibromatosis

  45. Case 7

  46. An old age patient came to dental clinic suffering from ovoid swelling in his floor of mouth • The patient reported mild pain

  47. The histopathological examination revealed • streaming fascicles of spindle-shaped cells. • These cells often form a palisaded arrangement around an acellulareosinophilicarea • The nuclei are oriented in a palisaded fashion

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