This document discusses various malignant tumors of connective tissue origin. It begins by listing the different components of connective tissue that tumors can arise from, including fibroblasts, cartilage, bone, blood vessels, and nerves. It then describes several specific tumor types in detail, including fibrosarcoma, liposarcoma, malignant fibrous histiocytoma, hemangiopericytoma, Kaposi's sarcoma, malignant peripheral nerve sheath tumor, chondrosarcoma, osteosarcoma, Ewing's sarcoma, Hodgkin's lymphoma, and non-Hodgkin's lymphoma. For each tumor type, it discusses clinical features, histopathology, treatment, and prognosis.
benign and malignant tumors of connective tissue originmadhusudhan reddy
This document discusses various connective tissue tumors that can occur in the oral cavity. It describes benign fibrous lesions like fibroma and giant cell fibroma. It also discusses benign adipose tissue lesions like lipoma. Various benign vascular lesions are described, including hemangiomas and lymphangiomas. Finally, it summarizes benign bone tissue tumors like osteoma and osteoid osteoma. For each lesion, the clinical features, histopathology, radiographic appearance, and treatment are summarized.
The document discusses controversies surrounding odontogenic keratocysts (OKCs). It covers the history and terminology of OKCs, their etiology and pathogenesis, clinical and radiographic features, histopathology, treatment and recurrence rates. There is ongoing debate around whether OKCs should be considered cysts or tumors due to their locally aggressive behavior and high recurrence rates. The document also explores theories on malignant transformation of OKCs and biomarkers that may help predict their biological potential.
This document discusses different types of odontogenic tumors. It classifies them into three categories: tumors of odontogenic epithelium, mixed odontogenic tumors, and tumors of odontogenic ectomesenchyme. Key tumors discussed include ameloblastoma, adenomatoid odontogenic tumor (AOT), and calcifying epithelial odontogenic tumor (CEOT). Ameloblastoma is the most common odontogenic tumor and can be solid/multicystic, unicystic, or peripheral. AOT typically occurs in younger females in the anterior maxilla. CEOT accounts for less than 1% of odontogenic tumors and resembles cells of the enamel organ or dental lamina.
This document discusses various types of tumors and tumor-like swellings of the jaws, with a focus on ameloblastoma. It defines key terms like tumor, neoplasm, cyst, and classifies odontogenic tumors. It then describes ameloblastoma in detail - the most common odontogenic tumor. It discusses the clinical, radiographic, and histopathological features of various subtypes of ameloblastoma including follicular, plexiform, basal, granular, and desmoplastic. Treatment typically involves wide excision. Unicystic and peripheral variants are also outlined. Rare malignant variants that can metastasize are mentioned.
This document describes fibroma, a benign mesenchymal tumor that is the most common benign soft tissue neoplasm in the oral cavity. It can occur peripherally or centrally, appears well-defined with a normal or pale color, and has a smooth, non-ulcerated surface. Histologically, it is covered by stretched stratified squamous epithelium with flattened rete pegs and can contain hyperplastic fibrous connective tissue, calcifications, or ossifications. When traumatized, it may develop inflammatory cells, vasodilation, and edema. Treatment is conservative surgical excision, with rare recurrence.
Epithelial dysplasia refers to disturbances in epithelial cell proliferation and differentiation seen microscopically. It is characterized by cellular atypia and graded as mild, moderate, or severe. Key features include basal cell hyperplasia, abnormal mitosis, nuclear hyperchromatism, increased nuclear-cytoplasmic ratio, dyskaryosis, poikilokaryonosis, loss of polarity, anisocytosis, koilocytosis, and individual cell keratinization.
Based on the information provided, the key differentials would be:
- Radicular cyst: Most common cyst in jaws, associated with non-vital tooth. Location and association with tooth fits.
- Dentigerous cyst: Second most common, associated with crown of unerupted tooth. Location fits.
- Odontogenic keratocyst: Aggressive cyst, often multilocular radiolucency. Less likely based on description.
- Aneurysmal bone cyst: Often multilocular "soap bubble" appearance. Less likely based on description.
- Traumatic bone cyst: Often interradicular in location. Possible based on location described.
Further investigation with tooth
This document discusses benign tumors of epithelial tissue origin in the oral cavity. It focuses on squamous papilloma, verruca vulgaris, keratoacanthoma, and oral nevus. Squamous papilloma presents as a cauliflower-like growth caused by HPV. Keratoacanthoma is a low-grade skin malignancy that can occur in the mouth. Oral nevus, or mole, is a pigmented lesion caused by an overgrowth of nevus cells derived from neural crest cells. The document provides details on clinical and histological features to help differentiate these benign growths.
benign and malignant tumors of connective tissue originmadhusudhan reddy
This document discusses various connective tissue tumors that can occur in the oral cavity. It describes benign fibrous lesions like fibroma and giant cell fibroma. It also discusses benign adipose tissue lesions like lipoma. Various benign vascular lesions are described, including hemangiomas and lymphangiomas. Finally, it summarizes benign bone tissue tumors like osteoma and osteoid osteoma. For each lesion, the clinical features, histopathology, radiographic appearance, and treatment are summarized.
The document discusses controversies surrounding odontogenic keratocysts (OKCs). It covers the history and terminology of OKCs, their etiology and pathogenesis, clinical and radiographic features, histopathology, treatment and recurrence rates. There is ongoing debate around whether OKCs should be considered cysts or tumors due to their locally aggressive behavior and high recurrence rates. The document also explores theories on malignant transformation of OKCs and biomarkers that may help predict their biological potential.
This document discusses different types of odontogenic tumors. It classifies them into three categories: tumors of odontogenic epithelium, mixed odontogenic tumors, and tumors of odontogenic ectomesenchyme. Key tumors discussed include ameloblastoma, adenomatoid odontogenic tumor (AOT), and calcifying epithelial odontogenic tumor (CEOT). Ameloblastoma is the most common odontogenic tumor and can be solid/multicystic, unicystic, or peripheral. AOT typically occurs in younger females in the anterior maxilla. CEOT accounts for less than 1% of odontogenic tumors and resembles cells of the enamel organ or dental lamina.
This document discusses various types of tumors and tumor-like swellings of the jaws, with a focus on ameloblastoma. It defines key terms like tumor, neoplasm, cyst, and classifies odontogenic tumors. It then describes ameloblastoma in detail - the most common odontogenic tumor. It discusses the clinical, radiographic, and histopathological features of various subtypes of ameloblastoma including follicular, plexiform, basal, granular, and desmoplastic. Treatment typically involves wide excision. Unicystic and peripheral variants are also outlined. Rare malignant variants that can metastasize are mentioned.
This document describes fibroma, a benign mesenchymal tumor that is the most common benign soft tissue neoplasm in the oral cavity. It can occur peripherally or centrally, appears well-defined with a normal or pale color, and has a smooth, non-ulcerated surface. Histologically, it is covered by stretched stratified squamous epithelium with flattened rete pegs and can contain hyperplastic fibrous connective tissue, calcifications, or ossifications. When traumatized, it may develop inflammatory cells, vasodilation, and edema. Treatment is conservative surgical excision, with rare recurrence.
Epithelial dysplasia refers to disturbances in epithelial cell proliferation and differentiation seen microscopically. It is characterized by cellular atypia and graded as mild, moderate, or severe. Key features include basal cell hyperplasia, abnormal mitosis, nuclear hyperchromatism, increased nuclear-cytoplasmic ratio, dyskaryosis, poikilokaryonosis, loss of polarity, anisocytosis, koilocytosis, and individual cell keratinization.
Based on the information provided, the key differentials would be:
- Radicular cyst: Most common cyst in jaws, associated with non-vital tooth. Location and association with tooth fits.
- Dentigerous cyst: Second most common, associated with crown of unerupted tooth. Location fits.
- Odontogenic keratocyst: Aggressive cyst, often multilocular radiolucency. Less likely based on description.
- Aneurysmal bone cyst: Often multilocular "soap bubble" appearance. Less likely based on description.
- Traumatic bone cyst: Often interradicular in location. Possible based on location described.
Further investigation with tooth
This document discusses benign tumors of epithelial tissue origin in the oral cavity. It focuses on squamous papilloma, verruca vulgaris, keratoacanthoma, and oral nevus. Squamous papilloma presents as a cauliflower-like growth caused by HPV. Keratoacanthoma is a low-grade skin malignancy that can occur in the mouth. Oral nevus, or mole, is a pigmented lesion caused by an overgrowth of nevus cells derived from neural crest cells. The document provides details on clinical and histological features to help differentiate these benign growths.
Peripheral and central giant cell granulomaRijuwana77
This document discusses two types of non-epithelial tumours of the oral cavity: peripheral giant cell granuloma and central giant cell granuloma. Peripheral giant cell granuloma originates from the periodontal membrane or alveolar bone and presents as a soft tissue nodule composed of multinucleated giant cells. Central giant cell granuloma is a rare, benign, intraosseous lesion most commonly found in the mandible of young people that causes expansion of the bone and resorption of tooth roots. Both lesions contain proliferation of multinucleated giant cells and other cells and may require surgical excision, with central giant cell granuloma having a higher rate of recurrence.
This document provides an overview of fibro-osseous lesions of the jaws. It discusses the classification of these lesions, which include fibrous dysplasia, ossifying fibroma, cemento-osseous dysplasia, central giant cell granuloma, cherubism, aneurysmal bone cyst, and solitary bone cyst. It focuses on the etiology, pathophysiology, clinical features, and oral manifestations of fibrous dysplasia, including monostotic fibrous dysplasia, polyostotic fibrous dysplasia, Jaffe's lichtenstein syndrome, McCune-Albright syndrome, and craniofacial fibrous dysplasia.
This document provides an overview of salivary gland tumors. It discusses that salivary gland tumors are heterogeneous and most are benign. The majority originate in the parotid glands. Pleomorphic adenoma is the most common benign tumor and occurs most often in the parotid glands. The document describes the histopathology and classification of various salivary gland tumors including pleomorphic adenoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma. It also discusses the genetics and hypothesized cells of origin for different salivary gland neoplasms.
Definition, classification and evaluation of benign tumours ofthe jaw Zeeshan Arif
This document discusses the classification and evaluation of benign jaw tumors. It begins by defining tumors as abnormal tissue growths that can be benign or malignant. Benign tumors are non-cancerous growths that are usually encapsulated and do not metastasize. The document then covers various classifications of odontogenic (tooth-related) and non-odontogenic benign jaw tumors based on their tissue of origin and histological features. It discusses evaluating tumors through clinical examination of features like location, surface, and consistency as well as radiographical imaging. The goal of examination and diagnosis is to accurately identify abnormal tissue growths in the jaw and plan appropriate treatment.
This document summarizes various diseases that can affect the jaw bone. It discusses inherited conditions like osteogenesis imperfecta and achondroplasia. It also covers infections like osteomyelitis, inflammatory conditions like fibrous dysplasia, and tumors originating from bone or other tissues that can develop in the jaw. For each condition, it provides details on characteristics, clinical presentation, radiographic appearance, and other relevant information.
This document presents a case study of a 30-year-old female patient diagnosed with plexiform ameloblastoma based on a biopsy of her right mandible. It provides background on ameloblastoma, describing it as a benign odontogenic tumor arising from odontogenic epithelium. It discusses the various histological subtypes including follicular, plexiform, unicystic (three groups), peripheral, acanthomatous, granular, basal cell, and desmoplastic. Treatment typically involves radical excision, with curettage having the highest recurrence rates. The case study aims to educate on the clinical, radiographic, and histological features of ameloblastoma.
This document discusses various types of pseudocysts and true cysts found in the body. It begins by defining the key differences between a true cyst and a pseudocyst. Pseudocysts are lined by granulation and/or fibrous tissue rather than an epithelial cell layer. The document then classifies and describes different types of pseudocysts including traumatic bone cysts, aneurysmal bone cysts, and developmental cysts. It provides details on the etiology, location, patient demographics, clinical presentation, radiographic features, histopathology and treatment for each type.
Histopathological variants of squamous cell carcinoma (Doctor Faris Alabeedi ...Doctor Faris Alabeedi
This document summarizes the key histopathological variants of squamous cell carcinoma (SCC), including verrucous carcinoma, spindle cell carcinoma, adenosquamous carcinoma, adenoid SCC, pseudovascular adenoid SCC, and basaloid SCC. It provides diagnostic characteristics for each variant such as growth patterns, cell morphology, associations with other types of carcinoma, and prognosis. Images are also included to illustrate histological features of each variant.
Ameloblastoma is a benign but invasive odontogenic tumor that arises from epithelial tooth-forming cells. It most commonly occurs in the mandible of adults between 30-60 years old. Clinically, it presents as a painless swelling and expansion of the jaw. Radiographically, it appears as a multilocular radiolucency. Histologically, it is characterized by proliferating odontogenic epithelium forming follicles. Treatment ranges from conservative curettage to segmental resection depending on the size and location of the tumor. Unicystic ameloblastoma originates within the lining of an odontogenic cyst and has a better prognosis than the conventional type.
The document discusses various types of oral papillomas including squamous papilloma, verruca vulgaris, and condyloma acuminatum. Squamous papilloma is the most common oral mucosal mass, caused by HPV types 6 and 11, and appears as a soft, painless growth. Verruca vulgaris (common wart) is associated with HPV types 2, 4, 6, and 40 and presents as rough, thickened white lesions. Condyloma acuminatum (genital wart) is sexually transmitted and associated with high-risk HPV types. The clinical and histological features of these lesions are summarized.
- Adenomatoid odontogenic tumor (AOT) is a rare, benign tumor that occurs mostly in the maxilla near unerupted teeth.
- It affects females more than males on average around 18 years of age. Radiographically, it appears as a well-defined radiolucency that may have faint radiopacities from calcification.
- Microscopically, AOT contains duct-like structures lined with epithelial cells and surrounded by stellate reticulum-like cells. Treatment involves conservative surgical excision due to its slow-growing but progressive nature.
This document provides an overview of fibro-osseous lesions, which are characterized by the replacement of normal bone by fibrous tissue containing mineralized products. It discusses the definitions, classifications, specific lesions including fibrous dysplasia and cherubism, radiological differential diagnosis, and references various classification systems proposed over time. The classifications discussed include those proposed by Waldron, Malek, Slootweg & Muller, WHO, Brannon & Fowler, Speight & Carlos, and Eversole. Key lesions like fibrous dysplasia, cherubism, ossifying fibroma, cemento-osseous dysplasia are also defined.
This slide is about oral hairy leukoplakia. it is basically a type of oral manifestation of some viral disease like HIV and HSV 4 (Epstein Barr virus )
This document summarizes various connective tissue lesions, including fibrous lesions such as peripheral fibroma, generalized gingival hyperplasia, and denture-induced fibrous hyperplasia. It also discusses neoplasms like myxoma and fibrosarcoma. Vascular, neural, muscle, and fat lesions are also covered. For each type of lesion, the document discusses etiology, clinical features, histopathology, and treatment.
The document discusses oral potentially malignant disorders (OPMD). It defines OPMD as a group of disorders that may lead to oral cancer. OPMD were previously referred to as precancerous lesions and conditions but this term was abandoned in 2005. The document categorizes OPMD into 4 groups based on etiology and pathogenesis. It provides detailed information about leukoplakia, including definition, risk factors, clinical features, histopathological grading, differential diagnosis and treatment options. Leukoplakia is considered the most common OPMD and accurate diagnosis requires biopsy and histopathological examination.
Odontogenic myxoma is a rare, benign tumor that arises from odontogenic tissue in the jaws. It most commonly presents as a swelling in the posterior mandible or maxilla in females aged 10-40 years. Radiographically, it appears as a well-defined radiolucency that is often multilocular with septa. Histologically, it contains loosely arranged stellate and spindle-shaped cells in a myxoid background. Treatment involves radical surgical excision to prevent a high recurrence rate of 25%, as the lesion infiltrates surrounding bone making complete removal difficult.
This document discusses odontogenic cysts, specifically dentigerous cysts. It provides background on dentigerous cysts, including that they are developmental cysts that surround the crown of an impacted tooth. The pathogenesis involves fluid accumulating between the reduced enamel epithelium and enamel surface of the impacted tooth. Dentigerous cysts most commonly involve the mandibular third molar or maxillary canine. Radiographically, they appear as well-defined radiolucencies surrounding the crown of an unerupted tooth. The cyst lining is non-keratinized stratified squamous epithelium that may demonstrate hyperchromatism or palisading, indicating potential for malignant transformation.
Peripheral giant cell granuloma (giant cell epulisKhin Soe
The document discusses two types of giant cell lesions of the jaw: peripheral giant cell granuloma (PGG) and central giant cell granuloma (CGG). PGG is a reactive lesion caused by local irritation or trauma that occurs on the gingiva. CGG is a benign process that occurs within the jaw bones and can be non-aggressive or aggressive depending on symptoms and growth rate. Both lesions contain multinucleated giant cells and are treated with surgical excision, with CGG having a slightly higher recurrence rate. Key distinguishing features and histological characteristics are provided.
This document discusses bone tumors. It begins by outlining what readers should know, such as tumor classification and management approaches. It then describes characteristics of primary and secondary bone tumors. Key tumor types like osteosarcoma, chondrosarcoma, giant cell tumor, and Ewing's sarcoma are compared based on factors like age group affected, location, histology, behavior, and prognosis. Diagnostic approaches involving age, location, radiology, and pathology are covered. Specific benign and malignant tumors are then examined in more detail.
Tumours of bones, cartilage & joints mbbs lectDr Neha Mahajan
This document discusses bone tumors, classifying them based on the type of tissue they produce. It describes several benign and malignant bone tumors. Benign bone forming tumors discussed include osteoid osteoma and osteoblastoma. Osteosarcoma is described as the most common primary malignant bone tumor that produces osteoid matrix. Cartilage forming tumors described are osteochondroma, chondroma, chondroblastoma, and chondrosarcoma. Giant cell tumor is discussed as a benign but locally aggressive tumor dominated by multinucleated giant cells. Ewing's sarcoma is summarized as the second most common bone malignancy in children that arises in long bone medullary cavities.
Peripheral and central giant cell granulomaRijuwana77
This document discusses two types of non-epithelial tumours of the oral cavity: peripheral giant cell granuloma and central giant cell granuloma. Peripheral giant cell granuloma originates from the periodontal membrane or alveolar bone and presents as a soft tissue nodule composed of multinucleated giant cells. Central giant cell granuloma is a rare, benign, intraosseous lesion most commonly found in the mandible of young people that causes expansion of the bone and resorption of tooth roots. Both lesions contain proliferation of multinucleated giant cells and other cells and may require surgical excision, with central giant cell granuloma having a higher rate of recurrence.
This document provides an overview of fibro-osseous lesions of the jaws. It discusses the classification of these lesions, which include fibrous dysplasia, ossifying fibroma, cemento-osseous dysplasia, central giant cell granuloma, cherubism, aneurysmal bone cyst, and solitary bone cyst. It focuses on the etiology, pathophysiology, clinical features, and oral manifestations of fibrous dysplasia, including monostotic fibrous dysplasia, polyostotic fibrous dysplasia, Jaffe's lichtenstein syndrome, McCune-Albright syndrome, and craniofacial fibrous dysplasia.
This document provides an overview of salivary gland tumors. It discusses that salivary gland tumors are heterogeneous and most are benign. The majority originate in the parotid glands. Pleomorphic adenoma is the most common benign tumor and occurs most often in the parotid glands. The document describes the histopathology and classification of various salivary gland tumors including pleomorphic adenoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma. It also discusses the genetics and hypothesized cells of origin for different salivary gland neoplasms.
Definition, classification and evaluation of benign tumours ofthe jaw Zeeshan Arif
This document discusses the classification and evaluation of benign jaw tumors. It begins by defining tumors as abnormal tissue growths that can be benign or malignant. Benign tumors are non-cancerous growths that are usually encapsulated and do not metastasize. The document then covers various classifications of odontogenic (tooth-related) and non-odontogenic benign jaw tumors based on their tissue of origin and histological features. It discusses evaluating tumors through clinical examination of features like location, surface, and consistency as well as radiographical imaging. The goal of examination and diagnosis is to accurately identify abnormal tissue growths in the jaw and plan appropriate treatment.
This document summarizes various diseases that can affect the jaw bone. It discusses inherited conditions like osteogenesis imperfecta and achondroplasia. It also covers infections like osteomyelitis, inflammatory conditions like fibrous dysplasia, and tumors originating from bone or other tissues that can develop in the jaw. For each condition, it provides details on characteristics, clinical presentation, radiographic appearance, and other relevant information.
This document presents a case study of a 30-year-old female patient diagnosed with plexiform ameloblastoma based on a biopsy of her right mandible. It provides background on ameloblastoma, describing it as a benign odontogenic tumor arising from odontogenic epithelium. It discusses the various histological subtypes including follicular, plexiform, unicystic (three groups), peripheral, acanthomatous, granular, basal cell, and desmoplastic. Treatment typically involves radical excision, with curettage having the highest recurrence rates. The case study aims to educate on the clinical, radiographic, and histological features of ameloblastoma.
This document discusses various types of pseudocysts and true cysts found in the body. It begins by defining the key differences between a true cyst and a pseudocyst. Pseudocysts are lined by granulation and/or fibrous tissue rather than an epithelial cell layer. The document then classifies and describes different types of pseudocysts including traumatic bone cysts, aneurysmal bone cysts, and developmental cysts. It provides details on the etiology, location, patient demographics, clinical presentation, radiographic features, histopathology and treatment for each type.
Histopathological variants of squamous cell carcinoma (Doctor Faris Alabeedi ...Doctor Faris Alabeedi
This document summarizes the key histopathological variants of squamous cell carcinoma (SCC), including verrucous carcinoma, spindle cell carcinoma, adenosquamous carcinoma, adenoid SCC, pseudovascular adenoid SCC, and basaloid SCC. It provides diagnostic characteristics for each variant such as growth patterns, cell morphology, associations with other types of carcinoma, and prognosis. Images are also included to illustrate histological features of each variant.
Ameloblastoma is a benign but invasive odontogenic tumor that arises from epithelial tooth-forming cells. It most commonly occurs in the mandible of adults between 30-60 years old. Clinically, it presents as a painless swelling and expansion of the jaw. Radiographically, it appears as a multilocular radiolucency. Histologically, it is characterized by proliferating odontogenic epithelium forming follicles. Treatment ranges from conservative curettage to segmental resection depending on the size and location of the tumor. Unicystic ameloblastoma originates within the lining of an odontogenic cyst and has a better prognosis than the conventional type.
The document discusses various types of oral papillomas including squamous papilloma, verruca vulgaris, and condyloma acuminatum. Squamous papilloma is the most common oral mucosal mass, caused by HPV types 6 and 11, and appears as a soft, painless growth. Verruca vulgaris (common wart) is associated with HPV types 2, 4, 6, and 40 and presents as rough, thickened white lesions. Condyloma acuminatum (genital wart) is sexually transmitted and associated with high-risk HPV types. The clinical and histological features of these lesions are summarized.
- Adenomatoid odontogenic tumor (AOT) is a rare, benign tumor that occurs mostly in the maxilla near unerupted teeth.
- It affects females more than males on average around 18 years of age. Radiographically, it appears as a well-defined radiolucency that may have faint radiopacities from calcification.
- Microscopically, AOT contains duct-like structures lined with epithelial cells and surrounded by stellate reticulum-like cells. Treatment involves conservative surgical excision due to its slow-growing but progressive nature.
This document provides an overview of fibro-osseous lesions, which are characterized by the replacement of normal bone by fibrous tissue containing mineralized products. It discusses the definitions, classifications, specific lesions including fibrous dysplasia and cherubism, radiological differential diagnosis, and references various classification systems proposed over time. The classifications discussed include those proposed by Waldron, Malek, Slootweg & Muller, WHO, Brannon & Fowler, Speight & Carlos, and Eversole. Key lesions like fibrous dysplasia, cherubism, ossifying fibroma, cemento-osseous dysplasia are also defined.
This slide is about oral hairy leukoplakia. it is basically a type of oral manifestation of some viral disease like HIV and HSV 4 (Epstein Barr virus )
This document summarizes various connective tissue lesions, including fibrous lesions such as peripheral fibroma, generalized gingival hyperplasia, and denture-induced fibrous hyperplasia. It also discusses neoplasms like myxoma and fibrosarcoma. Vascular, neural, muscle, and fat lesions are also covered. For each type of lesion, the document discusses etiology, clinical features, histopathology, and treatment.
The document discusses oral potentially malignant disorders (OPMD). It defines OPMD as a group of disorders that may lead to oral cancer. OPMD were previously referred to as precancerous lesions and conditions but this term was abandoned in 2005. The document categorizes OPMD into 4 groups based on etiology and pathogenesis. It provides detailed information about leukoplakia, including definition, risk factors, clinical features, histopathological grading, differential diagnosis and treatment options. Leukoplakia is considered the most common OPMD and accurate diagnosis requires biopsy and histopathological examination.
Odontogenic myxoma is a rare, benign tumor that arises from odontogenic tissue in the jaws. It most commonly presents as a swelling in the posterior mandible or maxilla in females aged 10-40 years. Radiographically, it appears as a well-defined radiolucency that is often multilocular with septa. Histologically, it contains loosely arranged stellate and spindle-shaped cells in a myxoid background. Treatment involves radical surgical excision to prevent a high recurrence rate of 25%, as the lesion infiltrates surrounding bone making complete removal difficult.
This document discusses odontogenic cysts, specifically dentigerous cysts. It provides background on dentigerous cysts, including that they are developmental cysts that surround the crown of an impacted tooth. The pathogenesis involves fluid accumulating between the reduced enamel epithelium and enamel surface of the impacted tooth. Dentigerous cysts most commonly involve the mandibular third molar or maxillary canine. Radiographically, they appear as well-defined radiolucencies surrounding the crown of an unerupted tooth. The cyst lining is non-keratinized stratified squamous epithelium that may demonstrate hyperchromatism or palisading, indicating potential for malignant transformation.
Peripheral giant cell granuloma (giant cell epulisKhin Soe
The document discusses two types of giant cell lesions of the jaw: peripheral giant cell granuloma (PGG) and central giant cell granuloma (CGG). PGG is a reactive lesion caused by local irritation or trauma that occurs on the gingiva. CGG is a benign process that occurs within the jaw bones and can be non-aggressive or aggressive depending on symptoms and growth rate. Both lesions contain multinucleated giant cells and are treated with surgical excision, with CGG having a slightly higher recurrence rate. Key distinguishing features and histological characteristics are provided.
This document discusses bone tumors. It begins by outlining what readers should know, such as tumor classification and management approaches. It then describes characteristics of primary and secondary bone tumors. Key tumor types like osteosarcoma, chondrosarcoma, giant cell tumor, and Ewing's sarcoma are compared based on factors like age group affected, location, histology, behavior, and prognosis. Diagnostic approaches involving age, location, radiology, and pathology are covered. Specific benign and malignant tumors are then examined in more detail.
Tumours of bones, cartilage & joints mbbs lectDr Neha Mahajan
This document discusses bone tumors, classifying them based on the type of tissue they produce. It describes several benign and malignant bone tumors. Benign bone forming tumors discussed include osteoid osteoma and osteoblastoma. Osteosarcoma is described as the most common primary malignant bone tumor that produces osteoid matrix. Cartilage forming tumors described are osteochondroma, chondroma, chondroblastoma, and chondrosarcoma. Giant cell tumor is discussed as a benign but locally aggressive tumor dominated by multinucleated giant cells. Ewing's sarcoma is summarized as the second most common bone malignancy in children that arises in long bone medullary cavities.
This document provides information on various types of malignant bone tumors. It classifies tumors based on the WHO classification and discusses bone-forming tumors, cartilage-forming tumors, giant cell tumor, marrow tumors, vascular tumors, and other connective tissue tumors. It provides details on osteosarcoma, Ewing's sarcoma, chondrosarcoma, and primary lymphoma of bone including areas of involvement, clinical presentation, radiological features, diagnosis, and treatment options.
Bone tumors can develop at any age and in various locations. Most osteosarcomas occur in adolescents around the knee, while chondrosarcomas tend to develop in mid-to-late adulthood in the trunk and proximal long bones. Bone tumors may be benign like osteomas, osteoid osteomas, or osteoblastomas, or malignant like osteosarcomas. Osteosarcomas are the most common primary bone cancer and often present as painful masses, usually metastasizing to the lungs. Ewing sarcoma and primitive neuroectodermal tumors are small round cell tumors that predominantly affect children and young adults.
Highly malignant tumor of mesenchymal origin.Spindle shaped cells that produce osteoid.2nd most common primary malignant bone tumor after MM.Incidence – 1 to 3 per million per year
Treated by chemo,amputation or rotationplasty
The document discusses several types of malignant connective tissue tumours. It describes fibrosarcoma, osteosarcoma, Hodgkin's lymphoma, Burkitt's lymphoma, Kaposi's sarcoma, plasmacytoma, and multiple myeloma. For each tumour, it covers etiology, clinical features such as presentation and location, histopathology, classification where relevant, and treatment options and prognosis. The document provides detailed information on characteristics and presentation of these malignant connective tissue tumours.
This PPT presentation talks about osteosarcoma from the clinical point of view, summarizing the recent guidelines in diagnosis and treatment of osteosarcoma.
Osteosarcoma is the most common bone cancer that typically affects the legs of teenagers and young adults. It arises from bone-forming cells and presents with bone pain and swelling. Diagnosis is made through x-rays, biopsy, and microscopic examination showing malignant bone-forming cells. Treatment involves chemotherapy before and after surgery to remove the tumor. Outcomes have improved but many patients still experience recurrence.
This document provides an overview of osteosarcoma, the most common primary malignant bone tumor in children and young adults. It defines osteosarcoma as a cancer that produces immature bone, most frequently occurring in the long bones of adolescents and young adults. The document discusses the epidemiology, etiology, genetics, clinical presentation, diagnosis, types, prognosis, treatment including chemotherapy, surgery and radiation therapy, long-term complications, and follow up of osteosarcoma. Prognosis depends on factors like extent of disease, grade, size and location of the primary tumor. Limb salvage surgery combined with chemotherapy is now the standard of care to preserve limb function while effectively treating the cancer.
Osteosarcoma is a malignant bone tumor that produces bone or osteoid. It most commonly occurs in the long bones of adolescents and young adults. The tumor arises from mesenchymal stem cells and develops most often in areas of rapid bone growth. Histologically, osteosarcoma is defined by the presence of malignant osteoid produced by the tumor cells. There are several subtypes including conventional, telangiectatic, small cell and epithelioid osteosarcoma, which can be difficult to diagnose. Prognosis depends on tumor grade and response to chemotherapy.
This is a powerpoint(case presentation) for radiology and imaging resident.There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
D. Firas lecture minimum muhadharaty requirehussainAltaher
This document summarizes various bone imaging techniques and bone pathologies that can be identified on imaging. It discusses radiological techniques for bone imaging including their advantages and disadvantages. It also provides details on identifying characteristics of primary bone tumors like osteosarcoma and chondrosarcoma, metastatic bone lesions, and benign bone conditions including osteoid osteoma, fibrous dysplasia, and aneurysmal bone cyst on imaging studies. Common causes of generalized bone abnormalities such as osteoporosis, rickets/osteomalacia, hyperparathyroidism, and renal osteodystrophy are also summarized.
Osteosarcomas are malignant bone-forming tumors that typically occur in the metaphysis of long bones in young patients. They can be primary tumors or develop secondary to conditions like Paget's disease. Patients usually present with bone pain and swelling. Treatment requires aggressive surgical resection and chemotherapy, with the goal of cure. Imaging plays an important role in evaluating tumor extent, involvement of surrounding tissues, and distant staging.
Primary bone tumors can arise from bone or cartilage cells and are either benign or malignant. The most common primary malignant bone tumors are osteosarcoma, chondrosarcoma, Ewing's sarcoma, and fibrosarcoma. Osteosarcoma typically affects teenagers and presents as pain in the long bones. Chondrosarcoma is usually slow growing and affects older adults, most commonly in the pelvis or shoulder. Ewing's sarcoma affects bone or soft tissue in teenagers and young adults. Fibrosarcoma can occur as a soft tissue or bone tumor, usually in the femur or tibia. Secondary bone tumors most commonly spread from the lung, prostate, breast, or liver and deposit in
Dr. Abdelhady provides a lecture on odontogenic tumors. The lecture aims to help students classify and diagnose odontogenic tumors, examine patients presenting with facial swellings, and determine differential diagnoses and management techniques for mandibular and maxillary swellings. Specific odontogenic tumors discussed include cementoblastoma, odontogenic fibroma, central giant cell granuloma, cherubism, fibrous dysplasia, and ossifying fibroma. Radiographic features, histology, treatment options and prognosis are described for each tumor type.
Non epithelial neoplasms.pptx oral pathologyIshuGupta52
Fibrosarcoma is a malignant tumor composed of fibroblasts that produces collagen. It can be primary, arising from bone tissue, or secondary, arising from a pre-existing lesion. Ewings sarcoma is a small, round cell tumor most common in children and young adults that typically affects long bones. Both tumors are typically treated with radical surgery and sometimes radiation or chemotherapy. Tori are non-cancerous bony growths that most commonly affect the hard palate (torus palatinus) or inside of the lower jaw (torus mandibularis), are more common in females, and may require surgical removal if causing issues.
The document summarizes updates to the 2020 WHO classification of soft tissue tumours. Key changes include more precise definitions of categories through integration of morphology, immunohistochemistry, and molecular genetics. Rare subtypes are challenging to diagnose due to low incidence. The classification aims to support more rational therapeutic approaches through involvement of sarcoma experts and definition of clinicopathological categories. Major changes were made to adipocyte, fibroblastic/myofibroblastic, vascular, pericytic, smooth muscle tumour classifications and new entities were introduced.
Radiological and pathological correlation of bone tumours Dr.Argha BaruahArgha Baruah
Radiological appearances can provide essential information for accurately diagnosing bone tumors in 95% of cases when clinicians, radiologists, and pathologists share information. Key radiological features include the tumor's location in the bone, characteristics of the lesion such as matrix mineralization patterns, effects on the bone cortex, and surrounding soft tissue involvement. A multidisciplinary approach utilizing clinical presentation, radiological findings, histopathological examination, and increasingly molecular analysis is necessary to establish a definitive diagnosis and appropriate treatment plan for bone lesions.
Osteosarcoma is the third most common cancer in adolescence that arises from primitive bone forming cells. It is characterized by the production of osteoid or bone matrix. Conventional osteosarcoma is a high grade malignant tumor occurring most commonly in long bones near growth plates in young individuals between 10 to 25 years of age. Diagnosis is based on histopathological identification of malignant osteoid or bone formation. Treatment involves radical resection of the tumor with chemotherapy having a 5 year survival rate of 25-63% for maxillary lesions and 24-71% for mandibular lesions.
The document discusses various tumors and non-neoplastic conditions that can affect bone. It provides information on the location, symptoms, investigations, treatment and radiographic appearance of primary bone tumors like osteosarcoma, chondrosarcoma, Ewing sarcoma, and benign tumors such as giant cell tumor, osteoid osteoma and bone cysts. It also discusses secondary bone tumors and non-neoplastic bone diseases.
Similar to Malignant tumors of connective tissue origin (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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3. Fibrosarcoma
Malignant tumor of fibroblasts
Earlier days it was considered a common
tumor. Because of separation of other
tumors from the group,, it is less
commonly diagnosed today
10% occur in head and neck.
4. Clinical features
Slow growing
More in femur and tibia
Oro-facial region nose and para nasal
sinus common, produces obstruction
Common in young adults and children.
D/D includes fibrous dysplasia, fibrous
histiocytoma, osteosarcoma, fibrous
histiocytoma,, etc
6. Contd..
Well –differentiated
a) Show typical herring bone pattern
b) Malignant cells don’t show much
pleomorphism
c) But mitotic figures are seen
Intermediate grade- little higher degree of
pleomorphism.
High grade – high pleomorphism, more
mitotic figures, difficult to diagnose without
immunohistochemistry. Less collagen
10. Contd..
Primarily seen in adults
Soft ,slow growing , ill-defined mass
Yellowish colored
Pain is not a common feature, seen during
late stage
Neck is the common region
In oral cavity cheek is the common region
Tongue is second common region
11. Histopathology
5 types
a) Myxoid
b) Round cell type
c) Well differentiated
d) Dedifferentiated
e) Pleomorphic
Common one is myxoid variety
12. Myxoid – stroma is myxoid
Round cell – most aggressive form
Well differentiated- resembles lipoma
De differentiated- combination of well
differentiated and poorly differentiated
Pleomorphic – extreme cellular
pleomorphism with giant cells
15. Malignant fibrous histiocytoma
Most commonly diagnosed of all
sarcomas of adults
50 to 70 years of age
Common in males
Looks moderately firm, with or without
pain or ulceration, irregular nodular lesion.
16. Histopathology
Many histological subtypes described but
STORIFORM-PLEOMORPHIC type is
common
Storiform Pattern ; pattern seen by low-
power light microscopy, which is
characterized by loosely-arranged whorls
of elongated, spindled fibroblast-like cells.
17.
18. Hemangiopericytoma
Stout and Murray described this in 1942
Benign but has a malignant counterpart
Chromosomal translocations are detected
19. Clinical features
Reddish to bluish mass
Arises before to second decade or after
seventh decade
No gender predilection
Soft or rubbery in consistency
Well demarcated from the surroundings
Oral cavity is also one of the common
sites
20. Histopathology
Derived from pericytes
Consists of many vascular channels lined
by plump endothelial cells surrounded by
tightly packed oval and spindle cells
STAGHORN pattern --- branching
vascular channels of varying sizes.
21. Kaposi’s Sarcoma
First described by Moritz Kaposi in 1872.
Earlier to HIV epidemic it was a rare tumor,
but now it is common because of its
propensity to develop in HIV infected
individuals.
It is caused by HHV 8
Lesion arises from endothelial cells
4 types : Classic
Endemic (African)
Iatrogenic immunosuppression –
associated
22. Clinical features
Classic type
Disease of late adult type
90% occurs in men
Multiple bluish purple macules and
plaques are
present on the skin of lower extremities
Lesions grow slowly and develop into
painless
nodules
Oral lesions are rare , if present they
involve the
23. Endemic type
Seen in African people
Varies from classical type presentation to
lymphadenopathic type which shows
tumors of lymphatic system.
IATROGENIC type shows features of classic
form but usually caused several months
after the transplant, as a result of
immunosuppressive drugs
24.
25. Histopathology
3 stages are seen
a) Patch
b) Plaque
c) Nodular
Patch stage – proliferation of immature
vessels which results in irregular jagged
vascular network that surrounds
preexisting vessels
26. Plaque stage : further proliferation of
vascular channels with development of
spindle cell component
Nodular stage: spindle cell population
increases to form a nodular tumor like
mass resembling fibrosarcoma or any
spindle cell tumor
The spindle cells infiltrate through
the collagen, forming slit like spaces,
especially towards the periphery of the
27.
28. Treatment
Depends on the subtype and stage
For skin lesions radiation therapy
For oral lesions it is a combination of
radiation therapy, chemo and surgery
Only 10 to 20 % die
Around 25% die due to secondary
malignancies that develop in
lymphoreticular system
29. Malignant peripheral nerve sheath
tumor
Earlier was called as Neurofibrosarcoma
now designated as MPNST.
Accounts for 10% of all soft tissue
malignancies
Most common on extremities and trunk
Oral tumors are rare , but most common
sites are mandible, lips and buccal
mucosa.
30.
31. Common in young adults
The mean age in patients with
neurofibromatosis (29 to 36 yrs) is about
one decade younger than in those without
this condition ( 40 to 46 yrs)
Tumor enlarges and sometimes exhibits
rapid growth
33. Fascicles of atypical spindle cells
Resemble fibrosarcoma
Cells are more irregular in shape with
wavy or comma shaped nuclei
In some tumors skeletal muscle, cartilage
or bone differentiation can be seen and
these tumors are designated as Malignant
triton tumors
34. Treatment
Radical excision with radiotherapy and
chemotherapy
Prognosis is poor especially in patients
with neurofibromatosis
35. Chondrosarcoma
malignant tumor characterized by the
formation of cartilage
Primarily a tumor of adulthood and
majority of patients are above 50yrs
Long bones involved commonly, oral
involvement is rare
Maxilla is commonly affected than
mandible in a ratio of 4:1
36. Painless mass is a common presenting
sign
Associated with loosening and separation
of teeth
Nasal obstruction, congestion,, epistaxis,,
photophobia, vision loss
38. Radiological features
Ill defined radiolucency with scattered and
variable amounts of radiopaque foci due
to calcification of cartilage matrix
Some cases show densely calcified
masses
39. Histopathology
Chondrosarcoma are composed of cartilage
showing varying degrees of maturation
Typical lacunar formation within the
chondroid matrix is seen
3 histological grades
- Grade 1
- Grade 2
- Grade 3
Grade 1 resembles chondroma while grade3 is
highly cellular with mitosis and plemorphism
Variants like clear cell type,, dedifferentiated
types can be found
40.
41. Treatment
Depends on the size and location of the
tumor
Complete radical excision is the treatment
of choice
Head and neck tumors show very poor
prognosis
42. Osteosarcoma
Malignancy of mesenchymal cellsthat
have the ability to produce osteiod or
immature bone.
Excluding hematopoietic malignancies
osteosarcomas are the common
malignancies that arise within bone.
43. Clinical features
Demonstrate bimodal age distribution – 10
to 20 yrs and in people above 50 yrs.
Osteosarcomas of jaw bone are
uncommon and represent only 6 to 8%.
Common in third decade with a mean age
of 33 yrs.
Male predominance is seen
Maxilla and mandible are involved with
equal frequency
44. Pain and swelling are the common
symptoms
Loosening of teeth, parasthesia and nasal
obstruction are other associated
symptoms
few people are symptomless for a long
period of time before diagnosis, indicating
that jaw osteosarcomas are slow in
growth.
45.
46. Radiographic features
Sunburst appearance
Ill defined borders
Symmetrical widening of the periodontal
ligament space around single or multiple
teeth.
This may be an earlier sign
47. Histopathology
Osteoid material
Round cells to highly pleomorphic cells
Sometimes chondroid material or highly
fibrous connective tissue
Depending on the amount of osteoid,
cartilage or fibers tumor is categorized into
Osteoblastic
Chondroblastic
Fibroblastic
48.
49. Treatment
Excision
Radio therapy
Chemotherapy
If diagnosed early and excision is
achieved totally then 80% survival rate.
50. Ewing’s sarcoma
It’s a distinctive primary malignancy of
bone composed of small round cells
Neuroectodermal in origin
A reciprocal translocation is seen between
chromosome 11 and 22.
6% of all bone malignancies and third
after osteosarcoma and chondrosarcoma
51. Clinical features
Peak prevalence in 2nd decade of life, with
80% younger than 20yrs
Male predilection
Whites more than blacks
Jaw bones – 1% to 2%
Indian data : Ewing sarcoma comprised
around 15 % of all bone malignancies.
68% percent were 0–19 years, with 1.6
times risk of tumor in bones of limbs as
compared to other bones.
The highest incidence rate (per million) was
in the 10–14 years age group (male −4.4,
female −2.9)
52. Pain with swelling is the common feature
Pain is intermittent in nature with dull to
severe
Fever, leukocytosis and elevated ESR
leads to misdiagnosis of osteomyelitis
Usually tumor penetrates the cortex and
lies over the bone as a soft tissue mass
In oral cavity mandible is commonly
affected than maxilla
53.
54. Radiological features
Onion peel appearance seen in long
bones, it’s a periosteal reaction
Jaw bones – ill defined radiolucency
55. Histopathology
Sheets of small round cells with well
delineated nuclear outline and ill defined
cell borders
Nests of tumor cells are separated by
fibrous septa
If large round cells are seen – large cell or
atypical Ewing’s sarcoma
75% contains glycogen granules
Diagnosis is difficult and should be
differentiated from other round cell tumors
IHC is a must – CD99
58. Hodgkin’s lymphoma
Malignant lympho-proliferative disorder
Neoplastic cells are called as Reed-
Sternberg cells
They make up for only 1% to 3% of the
mass, making it difficult for the diagnosis
Linked to Epstein Barr virus
100 % cure achievable
59. Clinical features
Always begins in a lymphnode or a group of
lymph nodes
The common sites are cervical and
supraclavicular nodes upto 75%
Male predilection is observed
Bimodal age presentation one peak – 15 to
35
another – above 50
yrs
Presenting sign is persistently enlarging,
60. Initially the nodes are movable later they
become fixed
If untreated the lesion spreads to other
lymph node group
Finally involves extra lymphatic tissues
like bone, liver, spleen and lungs
Associated with other symptoms like
weight loss, fever, night sweats and
generalized itching
Absence of these signs and symptoms are
considered better in terms of prognosis
61. Staging – Ann Arbor system
Staging is important for the treatment
planning and estimating the prognosis
63. Reed – Sternberg cell
Presence of this cell is very important for
diagnosis
It is an atypical neoplastic lymphocytic cell
Typically bi-nucleated – Owl’s eye
appearance
In lymphocyte pre-dominant type it is
called as ‘POPCORN” cell
64. 1. nodular lymphocyte predominant – popcorn cell
2. classical type ( 5 sub-types)
- lymphocyte rich – sheets of small lymphocytes with few
RS cells
- nodular sclerosis – makes upto 60 to 80% of cases
Gets its name because of the broad fibrotic bands
extending from the lymph node capsule into the
lesional tissue. RS cells appear to reside in lacunae,
so called as lacunar cells
- mixed cellularity – 15% of cases, mixture of small
lymphocytes, plasmacells, eosinophils and histiocytes,
RS cells are abundant.
- lymphocyte depletion – most aggressive form, contains
lot of bizarre RS cells and less lymphocytes
65. Treatment
Radiotherapy
Chemotherapy either MOPP(
mechlorethamine, oncovin, procarbazine
and prednisone)
Or ABVD ( adriamycin, bleomycin,
vinblastin, DTIC)
Survival rate is about 75% for ten years.
66. Non- Hodgkin’s lymphoma
Diverse and complex group of malignancies
of lympho-reticular system
Initially begins in lymph nodes and tend to
grow as solid masses
Most commonly B-cell lineage, T-cell origin
are rare
Three categories based on American system
– “working formulation for clinical use”
- Low grade ( 35to 40%)
- Intermediate grade ( 60%)
- High grade ( 5%)
68. Eitiology
Congenital immunological deficiencies
AIDS
Organ transplants
Auto immune diseases
Epstein Barr virus - Burkit’s lymphoma
HHV type 8
HTLV-1
69. Clinical features
Occurs primarily in adults
Commonly develops in lymph nodes
Non tender mass slowly enlarging for
months
Initially two or three freely movable nodes
are noticed and as the malignancy
progresses nodes become numerous and
are fixed to adjacent structures
Gradually involves two or three lymph
node groups are affected
70. In oral cavity it appears as a extra nodal
disease
It may develop in oral soft tissues or
centrally with in the jaws
Patient complains of ill fitting dentures
Lesions have boggy consistency ( muddy)
Central lesions present with mild pain
which can be mistaken for tooth ache
71.
72. Histopathology
Proliferation of lymphocytic appearing
cells showing varying degrees of
differentiation
Low grade – shows well differentiated
lymphocytes and high grade shows less
differentiated cells
Nodular pattern – germinal center
formation
Diffuse type – no resemblance to normal
architecture
If arises within the node- destroys the
75. Burkitt’s lymphoma
Malignancy of B- lymphocyte origin
Dennis Burkitt was the first person to
document the process.
Types – 1. prevalent in Africa and have
predilection for jaws – African Burkitt’s
lymphoma
2. prevalent in other areas of world
Endemic Burkitt’s lymphoma
3. Sporadic or American Burkitt’s
Lymphoma
76. Clinical features
50 to 70% of African type present in jaws
Usually affects children ( peak prevalence
about 7years of age)
Male predilection
Maxilla is more commonly affected than
mandible
Posterior jaw is commonly
American type – tend to affect wider age
group
- abdominal region is
typically affected, jaw lesions rare
77. Facial swelling
Proptosis
Pain
Tooth mobility
Premature exfoliation of deciduous teeth and
enlargement of gingiva and alveolar bone
Ill defined radiolucency
Burkitt’s lymphoma is a highly
aggressive tumor with a doubling time of
twenty-four hours
78.
79. Histopathology
STARRY SKY appearance
Sheets of small lymphocyte appearing
cells with round nuclei with minimal
cytoplasm
Each nucleus has several prominent
nucleoli and numerous mitosis
80. Starry sky appearance
Starry sky
appearance-
presence of
histiocytes with
abundant cytoplasm
( stars) in the
background of
malignant darkly
staining lymphoma
cells ( night sky)
81. Treatment
Intensive chemotherapeutic regimen, use
of cyclophosphamide – 90% of people
respond to this
Survival rate is increased to 85% due to
intensive multi-agent chemotherapy
82. Multiple myeloma
Malignancy of plasma cell origin with
multi-centric origin within bone
The abnormal plasma cells that compose
this tumor are monoclonal
Since all malignant cells develop from a
single precursor cell , the genetic make up
of neoplastic cells are similar and all
produce same immunoglobulin
83. Clinical features
Typically a disease of adults
Male predilection
Diagnosis will be usually between 60 to
70% of cases
Bone pain is the characteristic presenting
feature
Anemia results in fatigue
Petechial hemorahages of skin and oral
mucosa – due to lack of platelet
production
Metastatic calcifications of the soft tissues
84.
85. Bence-Jones proteins
A Bence Jones protein is a monoclonal
globulin protein or immunoglobulin light
chain found in the urine, with a molecular
weight of 22-24 kDa
Renal failure because of overburdening of
kidneys due to excess circulating Bence –
Jones proteins
86. Amyloid
An abnormal fibrillar protein
It is deposited in various soft tissues in
patients with multiple myeloma
Oral mucosa, tongue- shows diffuse
enlargement
Appear waxy firm and plaque like
89. Congo red stain
To demonstrate amyloid
Apple-green birefringence on viewing with
polarized light
90. Diagnosis
Radiographic picture
Histopathology
Demonstration of ameloid
Demonstration of BENCE-JONES protein
(M-PROTEIN) in urine by immuno
electrophoresis
91. TREATMENT
Chemotherapy by using an alkylating
agent such as melphalan or
cyclophosphamide in conjugation with
prednisone
92. Plasmacytoma
Unifocal, monoclonal, neoplastic
proliferation of plasma cells that arises
within the bone.
Sometimes it is seen in soft tissues –
referred as EXTRA MEDULLARY
PLASMACYTOMA – 90% seen in head
and neck region.
Mild variety of neoplasm but if not
detected and treated early it can give rise
to more serious tumor like multiple
93. It’s a tumor of adult male diagnosed at
age of 55years
In medullary variety spine is commonly
affected.
Bone pain and swelling are the usual
associated symptoms
Extramedullary 90% occurs in head and
neck region- tonsils, nasopharynx,
paranasal sinuses, nose and parotid gland
Radiographically, the lesion is seen as
unilocular radiolucency without proper
97. Leiomyosarcoma
Malignant tumor of smooth muscles
Common sites are uterine wall and
gastrointestinal tract
Leiomyosarcomas of the oral cavity are
rare
Common in middle aged and older adults
Present as an enlarging mass with or
without pain
98.
99. Histopathology
Fascicles of spindle cells with abundant
eosinophilic cytoplasm and blunt – ended,
cigar – shaped nuclei
Pleomorphism present
Presence of five or more mitosis per ten
high power field should be considered
malignant
Glycogen can be demonstrated within
cells by PAS staining
IHC – desmin, smooth muscle actin,
102. Rhabdomyosarcoma
Malignant tumor of skeletal muscle origin
Most common soft tissue sarcoma of
children
Most frequent site is head and neck
Three basic microscopic patterns are seen
1. Embryonic
2. Alveolar
3. pleomorphic
103. Clinical features
Primarily seen in first decade of life
Rare in people older than 45 years of age
60% occurs in males
Embryonal rhabdomyosarcomas are most
common in first 10years of life and account for
60% of all cases
Alveolar type occurs in persons between 10 to
25 years of age and account for 25 to 30% of
cases
Pleomorphic type – over 40 years of age and
104. Painless mass with infiltrative mass that
grow rapidly.
In head and neck region , orbit is the
common location,
Palate is the most frequent intra oral
location
Certain rhabdomyosarcomas show
exophytic, polypoid growth pattern like
clusters of grapes these are called as
BOTRYOID (GRAPE LIKE)
105.
106. Histopathology - Embryonal type
Resembles various stages of
embryogenesis of skeletal muscle
Vary from poorly differentiated to well
differentiated
Poorly differentiated is difficult to diagnose
and consists of small round cells with
hyperchromatic nuclei and indistinct
cytoplasm
Well differentiated shows round to oval
rhabdomyoblasts with distinct eosinophilic
cytoplasm
109. Pleomorphic type
Loosely arranged and
haphazardly oriented
cells of variable
morphology. Both small
and large cells with
round or pleomorphic
shapes are present
IHC stains for desmin
and myoglobin are
positive , so can be
distinguished from other
pleomorphic sarcomas