Malignant Tumors of Connective Tissue / oral surgery courses
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.for more details please visit www.indiandentalacademy.com
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Malignant Tumors of Connective Tissue / oral surgery courses
- 1. Malignant Tumors of Connective Tissue INDIAN DENTAL ACADEMY Leader in continuing Dental Education www.indiandentalacademy.com
- 2. LEARNING OBJECTIVES At the end of the lecture student should be able to: Describe Clinical Features, histopathological features of Non-Hodgkin’s lymphoma. www.indiandentalacademy.com
- 3. Clinical Features Systemic symptoms: Fever, night sweat, weight loss fatigue, pruritis Sign & symptom depend on site of involvement & result from pressure of enlarged lymph node Organ specific symptoms: shortness of breath, ches pain, cough, abdominal pain & distension Extranodal lesion are more common www.indiandentalacademy.com
- 4. Oral manifestations Oral lesions: most commonly –posterior hard palate, buccal vestibule, gingival Rapidly growing swelling ,may ulcerate Large, fungating, necrotic, foul-smelling masses Underlying bone involvement: tooth mobility & pain, paresthesia of mental nerve www.indiandentalacademy.com
- 5. Early soft palate lesion Late lesion in same patient www.indiandentalacademy.com
- 6. Slowly growing palatal swelling in NHL, but not involving bone www.indiandentalacademy.com
- 7. Histopathology Proliferation of lymphocytic appearing cells, showing varying degrees of differentiation, depending on type. Lymphocytic infiltration www.indiandentalacademy.com
- 9. Clinical Ann Arbor staging classification Stage I - Involvement of a one lymph node region (I) or single extralymphatic site (IE) Stage II - Involvement of multiple node regions on the same side of the diaphragm (II) or of one lymph node region and a contiguous extralymphatic site (IIE) www.indiandentalacademy.com
- 10. Stage III - Involvement of lymph node regions on both sides of the diaphragm, which may include the spleen(IIIS) and/or limited to contiguous extralymphatic organ or site (IIIE, IIIES) Stage IV - Disseminated involvement of one or more extralymphatic organs. www.indiandentalacademy.com
- 11. The absence of systemic symptoms is signified by adding 'A' to the stage The presence of systemic symptoms is signified by adding 'B' to the stage. For localized extranodal extension from mass of nodes which does not advance the stage, subscript 'E' is added. www.indiandentalacademy.com
- 12. African jaw lymphoma /Burkitt’s lymphoma Rapidly growing tumor (fastest growing malignancy in humans) & type of NHL Peculiar to children of tropical central Africa Denis Parsons Burkitt in 1950 Primary tumor cell is poorly differentiated B lymphocytes www.indiandentalacademy.com
- 13. Three main clinical variants: 1. Endemic variant 2. Sporadic variant 3. Immunocompromised variant www.indiandentalacademy.com
- 14. Clinical features Endemic variant • Most common malignancy of children in Africa. • Often have chronic malaria • Characteristically involves the jaw or other facial bone, distal ileum, ovaries, kidney or the breast • Age-children (peak prevalence-7 yrs) • M>F www.indiandentalacademy.com
- 15. Oral manifestations African form Maxilla>mandible Swelling of affected jaw or other facial bones Loosening of the teeth Pain Swelling of lymph nodes, rapidly growing www.indiandentalacademy.com
- 16. Radiographic features Bone destruction Ill defined margins Patchy loss of lamina dura-early sign of BL www.indiandentalacademy.com
- 17. Sporadic form Jaw is less commonly involved Abdominal tumors causing swelling & pain in affected area Immunodeficiency associated • Associated with HIV Post-transplant infection • Patients taking immunosuppressant www.indiandentalacademy.com
- 18. Major signs of BL Soft tissue mass associated with involvement of the jaw or other facial bones Enlarged cervical lymph nodes Abdominal masses Ascitis www.indiandentalacademy.com
- 19. Histopathology - Proliferation of B lymphocytes characterized by sheets of uniform tumor cells Tumor cells exhibit round nuclei with minimal cytoplasm www.indiandentalacademy.com
- 20. Histopathology “Starry sky” appearance: Scattered macrophages with abundant clear cytoplasm, containing phagocytic cellular debris Macrophages www.indiandentalacademy.com
- 21. Summary The student is able to differentiate between Hodgkin’s & Non-Hodgkin’s Lymphoma. Enumerate the characteristics features of Burkitt’s lymphoma. www.indiandentalacademy.com