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 swelling what 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.
Koilocytes display 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 color out growth.
Also noticed Poor oral hygien and Calculus

17. 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.

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 color out 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

25. 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

26. 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

27. Case 4

28. 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

29. 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

30. Palatal papillomatosis

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

32. pseudo-epitheliomatous hyperplasia

34. Case 5

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

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

37. 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

38. 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

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

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

41. Case 6

42. 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

43. 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,

45. 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

46. 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)

47. neurofibromatosis

48. Case 7

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

50. 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

52. 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.

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

55. Macroglossia, lymphangioma of the tongue

56. Pigmented nevus

57. Melanocytic nevus

60. Thank you wishing you all the best