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? It could be: Hyperplastic lesion Hamartoma Benign neoplasm Malignant neoplasm Cyst inflammation

Case 1

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

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

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.

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

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

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

focal epithelial hyperplasia (HPV types 13 and 32). 

Squamous cell papilloma

Hyperplastic stratified squamous epithelium 2-delicate connective tissue core

Case 2

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

The doctor noticed on clinical examination that this lesion arise as pedunculated ulcerated Tendacy for hemorrage Red color out growth. Also noticed Poor oral hygien and Calculus

The histopathological examination revealed Ecessive formation 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.

Papillary pedunculated pyogenic granuloma

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

Case 3

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

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

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

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

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

Case 4

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

The probable diagnosis of this condition is? Epulis fissuratum 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

Palatal papillomatosis

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

pseudo-epitheliomatous hyperplasia

Case 5

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

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

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

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

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

Fibroma 1-proliferating fibroblasts 2- collagen fibers 3-blood vessels

Case 6

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

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 naevus affecting the iris,

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

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, endoneural fibroblasts)

neurofibromatosis

Case 7

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

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

The probable diagnosis of this condition is? Shwannoma (NEURILEMMOMA) What is the name of acellular eosinophilic area and whatis the nature of this material? Verocay bodies represent reduplicated basement membrane and cytoplasmic processes.

Haemangioma: Diffuse compressible purple enlargement of the left side of the tongue.

Macroglossia, lymphangioma of the tongue

Pigmented nevus

Melanocytic nevus

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