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! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
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| colspan="2" rowspan="10" |White Lesions
| colspan="2" rowspan="10" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''White Lesions'''
|'''Leukoedema'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Leukoedema]]<ref name="pmid19444343">{{cite journal |vauthors=Jahanbani J, Sandvik L, Lyberg T, Ahlfors E |title=Evaluation of oral mucosal lesions in 598 referred Iranian patients |journal=Open Dent J |volume=3 |issue= |pages=42–7 |date=March 2009 |pmid=19444343 |doi=10.2174/1874210600903010042 |url=}}</ref><ref name="pmid27042583">{{cite journal |vauthors=Abidullah M, Raghunath V, Karpe T, Akifuddin S, Imran S, Dhurjati VN, Aleem MA, Khatoon F |title=Clinicopathologic Correlation of White, Non scrapable Oral Mucosal Surface Lesions: A Study of 100 Cases |journal=J Clin Diagn Res |volume=10 |issue=2 |pages=ZC38–41 |date=February 2016 |pmid=27042583 |pmc=4800649 |doi=10.7860/JCDR/2016/16950.7226 |url=}}</ref>
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* White or whitish grey edematous lesion
* White or whitish grey edematous lesion
* Diffuse or patchy
* [[Diffuse]] or patchy
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* Variant of normal oral mucosa
* Variant of normal [[oral mucosa]]
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* Buccal and labial oral mucosa
* [[Buccal]] and [[labial]] [[oral mucosa]]
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* Intracellular edema or vacuolization of Malpighian cells.
* [[Intracellular]] [[edema]] or [[vacuolization]] of Malpighian cells
|[[File:Leukoedema_001.jpg|219x219px]]
|[[File:Leukoedema.jpg|center]]
|- |
|- |
|'''Fordyce granules'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Fordyce granules<ref name="pmid22363169">{{cite journal |vauthors=Lee JH, Lee JH, Kwon NH, Yu DS, Kim GM, Park CJ, Lee JD, Kim SY |title=Clinicopathologic Manifestations of Patients with Fordyce's Spots |journal=Ann Dermatol |volume=24 |issue=1 |pages=103–6 |date=February 2012 |pmid=22363169 |pmc=3283840 |doi=10.5021/ad.2012.24.1.103 |url=}}</ref><ref name="pmid16711559">{{cite journal |vauthors=Olivier JH |title=Fordyce granules on the prolabial and oral mucous membranes of a selected population |journal=SADJ |volume=61 |issue=2 |pages=072–4 |date=March 2006 |pmid=16711559 |doi= |url=}}</ref><ref name="pmid15879014">{{cite journal |vauthors=De Felice C, Parrini S, Chitano G, Gentile M, Dipaola L, Latini G |title=Fordyce granules and hereditary non-polyposis colorectal cancer syndrome |journal=Gut |volume=54 |issue=9 |pages=1279–82 |date=September 2005 |pmid=15879014 |doi=10.1136/gut.2005.064881 |url=}}</ref><ref name="pmid25213213">{{cite journal |vauthors=Ponti G, Meschieri A, Pollio A, Ruini C, Manfredini M, Longo C, Mandel VD, Ciardo S, Tomasi A, Giannetti L, Pellacani G |title=Fordyce granules and hyperplastic mucosal sebaceous glands as distinctive stigmata in Muir-Torre syndrome patients: characterization with reflectance confocal microscopy |journal=J. Oral Pathol. Med. |volume=44 |issue=7 |pages=552–7 |date=August 2015 |pmid=25213213 |doi=10.1111/jop.12256 |url=}}</ref>
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* White or yellow discrete papules
* White or yellow discrete [[papules]]
* Symmetrically distributed
* Symmetrically distributed
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* Variant of normal oral mucosa
* Variant of normal [[oral mucosa]]
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* Buccal mucosa
* [[Buccal mucosa]]
* Vermillion border of the lips
* [[Vermillion border]] of the [[lips]]
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* Similar to normal sebaceous glands of skin
* Similar to normal [[sebaceous glands]] of [[skin]]
* Lacks hair follicles and almost always lack ductal communication with surface.
* Lacks [[hair follicles]] and almost always lack ductal communication with surface.
|[[File:Leukoedema.jpg|center]]
|[[File:Fospot.jpg|center|219x219px]]
|-
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|'''Benign migratoy glossitis'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Benign migratory glossitis<ref name="pmid12517366">{{cite journal |vauthors=Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M |title=Benign migratory glossitis or geographic tongue: an enigmatic oral lesion |journal=Am. J. Med. |volume=113 |issue=9 |pages=751–5 |date=December 2002 |pmid=12517366 |doi= |url=}}</ref><ref name="pmid27579734">{{cite journal |vauthors=Picciani BL, Domingos TA, Teixeira-Souza T, Santos Vde C, Gonzaga HF, Cardoso-Oliveira J, Gripp AC, Dias EP, Carneiro S |title=Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review |journal=An Bras Dermatol |volume=91 |issue=4 |pages=410–21 |date=2016 |pmid=27579734 |pmc=4999097 |doi=10.1590/abd1806-4841.20164288 |url=}}</ref><ref name="pmid25584342">{{cite journal |vauthors=Tarakji B, Umair A, Babaker Z, Sn A, Gazal G, Sarraj F |title=Relation between psoriasis and geographic tongue |journal=J Clin Diagn Res |volume=8 |issue=11 |pages=ZE06–7 |date=November 2014 |pmid=25584342 |pmc=4290356 |doi=10.7860/JCDR/2014/9101.5171 |url=}}</ref>
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* Red patches with white distinct border
* Red patches with white distinct border
* Map like appearance  
* Map like appearance  
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* Psoriasis
* [[Psoriasis]]
* Diabetes
* [[Diabetes]]
* Reiter's syndrome
* [[Reiter's syndrome]]
* Medications such as Oral contraceptive pills and lithium carbonate
* [[Medications]] such as [[Oral contraceptive pills]] and [[lithium carbonate]]
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* Dorsal/Lateral surface of the tongue
* Dorsal/Lateral surface of the [[tongue]]
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* Acanthosis with neutrophils throughout epithelium and surface  
* Acanthosis with [[neutrophils]] throughout [[epithelium]] and surface  
* Microabscesses, plus inflammatory infiltrate in lamina propria
* Microabscesses, plus [[inflammatory]] infiltrate in [[lamina propria]]
* Resembles psoriasis
* Resembles [[psoriasis]]
|[[File:Geographic tongue 01.JPG|center|219x219px]]
|[[File:Geographic tongue 01.JPG|center|219x219px]]
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|'''Hairy tongue'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hairy tongue<ref name="pmid20706544">{{cite journal |vauthors=Kobayashi K, Takei Y, Sawada M, Ishizaki S, Ito H, Tanaka M |title=Dermoscopic features of a black hairy tongue in 2 Japanese patients |journal=Dermatol Res Pract |volume=2010 |issue= |pages= |date=2010 |pmid=20706544 |pmc=2913535 |doi=10.1155/2010/145878 |url=}}</ref><ref name="pmid27298505">{{cite journal |vauthors=Jhaj R, Gour PR, Asati DP |title=Black hairy tongue with a fixed dose combination of olanzapine and fluoxetine |journal=Indian J Pharmacol |volume=48 |issue=3 |pages=318–20 |date=2016 |pmid=27298505 |pmc=4900008 |doi=10.4103/0253-7613.182894 |url=}}</ref><ref name="pmid25152586">{{cite journal |vauthors=Gurvits GE, Tan A |title=Black hairy tongue syndrome |journal=World J. Gastroenterol. |volume=20 |issue=31 |pages=10845–50 |date=August 2014 |pmid=25152586 |pmc=4138463 |doi=10.3748/wjg.v20.i31.10845 |url=}}</ref><ref name="pmid27011938">{{cite journal |vauthors=Erriu M, Pili FM, Denotti G, Garau V |title=Black hairy tongue in a patient with amyotrophic lateral sclerosis |journal=J Int Soc Prev Community Dent |volume=6 |issue=1 |pages=80–3 |date=2016 |pmid=27011938 |pmc=4784070 |doi=10.4103/2231-0762.175408 |url=}}</ref>
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* Elongated filliform lingual papillae
* Elongated [[Filiform papillae|filiform]] [[lingual]] [[papillae]]
* Carpet like appearance
* Carpet like appearance
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* Xerostomia
* [[Xerostomia]]
* Medications such as anti-psychotics
* Medications such as [[anti-psychotics]]
* HIV
* [[HIV]]
* Amyotropic lateral sclerosis
* [[Amyotropic lateral sclerosis]]
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* Dorsum of the tongue  
* Dorsum of the [[tongue]]
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* Marked elongation and hyperparakeratosis of the filiform papillae
* Marked elongation and hyperparakeratosis of the [[filiform papillae]]
|[[File:Black tounge.jpg|center|291x291px]]
|[[File:Black tounge.jpg|center|291x291px]]
|-
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|'''Hairy leukoplakia'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hairy leukoplakia<ref name="pmid21398239">{{cite journal |vauthors=Kreuter A, Wieland U |title=Oral hairy leukoplakia: a clinical indicator of immunosuppression |journal=CMAJ |volume=183 |issue=8 |pages=932 |date=May 2011 |pmid=21398239 |pmc=3091903 |doi=10.1503/cmaj.100841 |url=}}</ref><ref name="pmid27109280">{{cite journal |vauthors=Greenspan JS, Greenspan D, Webster-Cyriaque J |title=Hairy leukoplakia; lessons learned: 30-plus years |journal=Oral Dis |volume=22 Suppl 1 |issue= |pages=120–7 |date=April 2016 |pmid=27109280 |doi=10.1111/odi.12393 |url=}}</ref>
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White patches
White patches
* Corrugated in appearance
* [[Corrugated plastic|Corrugated]] in appearance
* Hairy, hair-like growths
* Hairy, hair-like growths
* Permanent
* Permanent
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* [[Immunosupression]]
* [[Immunosupression]]
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* Buccal mucosa
* [[Buccal mucosa]]
* Lateral surface of the tongue
* Lateral surface of the [[tongue]]
* Floor of the mouth
* Floor of the [[Mouth (human)|mouth]]
* Palate
* [[Palate]]
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* Hyperkeratotic oral mucosa due to piling of keratotic squamous epithelium
* Hyperkeratotic [[oral mucosa]] due to piling of keratotic [[squamous epithelium]]
* Cowdry type A intranuclear inclusions
* Cowdry type A intranuclear inclusions
* Balloon cells with margination of chromatin  
* Balloon cells with margination of [[chromatin]]
|[[File:Oral-Hairy leukoplakia.jpeg|219x219px]]
|[[File:Oral-Hairy leukoplakia.jpeg|219x219px]]
|-
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|'''White sponge nevus'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[White sponge nevus]]<ref name="pmid23230487">{{cite journal |vauthors=Aghbali A, Pouralibaba F, Eslami H, Pakdel F, Jamali Z |title=White sponge nevus: a case report |journal=J Dent Res Dent Clin Dent Prospects |volume=3 |issue=2 |pages=70–2 |date=2009 |pmid=23230487 |pmc=3517290 |doi=10.5681/joddd.2009.017 |url=}}</ref><ref name="pmid2381643">{{cite journal |vauthors=Nichols GE, Cooper PH, Underwood PB, Greer KE |title=White sponge nevus |journal=Obstet Gynecol |volume=76 |issue=3 Pt 2 |pages=545–8 |date=September 1990 |pmid=2381643 |doi= |url=}}</ref>
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* White patches of [[tissue]] ([[nevi]])
* White patches of [[tissue]] ([[nevi]])
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* Thickened, velvety, [[sponge]]-like appearance
* Thickened, velvety, [[sponge]]-like appearance
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* Heriditarary
* [[Hereditary]]
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* Buccal mucosa
* [[Buccal mucosa]]
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* Parakeratosis, acanthosis  
* Parakeratosis, acanthosis  
* Extensive vacuolation
* Extensive [[vacuolization]]
* Dyskeratotic cells exhibit dense peri and paranuclear eosinophilic condensations
* Dyskeratotic cells exhibit dense peri and paranuclear [[eosinophilic]] condensations
* Abundant Odland bodies  
* Abundant Odland bodies  
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|-
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|'''Lichen Planus'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lichen Planus]]<ref name="pmid24672362">{{cite journal |vauthors=Gorouhi F, Davari P, Fazel N |title=Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis |journal=ScientificWorldJournal |volume=2014 |issue= |pages=742826 |date=2014 |pmid=24672362 |pmc=3929580 |doi=10.1155/2014/742826 |url=}}</ref><ref name="pmid26120146">{{cite journal |vauthors=Gupta S, Jawanda MK |title=Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management |journal=Indian J Dermatol |volume=60 |issue=3 |pages=222–9 |date=2015 |pmid=26120146 |pmc=4458931 |doi=10.4103/0019-5154.156315 |url=}}</ref>
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* [[Reticular]] or papular lace like white lesions
* [[Reticular]] or papular lace like white lesions
* Multiple, Painful
* Multiple, Painful
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* Autoimmune disorders disorders
* [[Autoimmune disorders]] 
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* Posterior buccal mucosa
* Posterior [[buccal mucosa]]
* Gingival margin
* [[Gingival]] margin
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* Hyperkeratosis and acanthosis
* Hyperkeratosis and acanthosis
* Granular cell layer, sawtoothing of rete pegs, bandlike chronic inflammatory infiltrate
* [[Granular cell]] layer, saw toothing of [[rete pegs]], bandlike chronic [[inflammatory]] infiltrate
* Civatte bodies  
* Civatte bodies  
* Artifactual cleft formation  
* Artifactual [[cleft]] formation  
* No atypia
* No [[atypia]]
|[[File:Lichen Planus Fig7.tiff.jpg|center|219x219px]]
|[[File:Lichen Planus Fig7.tiff.jpg|center|219x219px]]
|-
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|'''Frictional hyperkeratosis'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Frictional hyperkeratosis<ref name="pmid22545331">{{cite journal |vauthors=Cam K, Santoro A, Lee JB |title=Oral frictional hyperkeratosis (morsicatio buccarum): an entity to be considered in the differential diagnosis of white oral mucosal lesions |journal=Skinmed |volume=10 |issue=2 |pages=114–5 |date=2012 |pmid=22545331 |doi= |url=}}</ref><ref name="pmid21216078">{{cite journal |vauthors=Mignogna MD, Fortuna G, Leuci S, Adamo D, Siano M, Makary C, Cafiero C |title=Frictional keratoses on the facial attached gingiva are rare clinical findings and do not belong to the category of leukoplakia |journal=J. Oral Maxillofac. Surg. |volume=69 |issue=5 |pages=1367–74 |date=May 2011 |pmid=21216078 |doi=10.1016/j.joms.2010.05.087 |url=}}</ref>
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* White shaggy plaques
* White shaggy [[plaques]]
* Could be easily peeled without any pain leaving normal [[mucosa]]
* Could be easily peeled without any pain leaving normal [[mucosa]]
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* Bite trauma  
* Bite [[trauma]]
* Grinding of the teeth  
* Grinding of the [[teeth]]
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* Buccal mucosa
* [[Buccal mucosa]]
* Limited to line of dental occlusion
* Limited to line of [[dental]] [[occlusion]]
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* Hyperkeratinization and acanthosis
* [[Hyperkeratinization]] and acanthosis
* Smooth, corrugated, or ragged, epthelial surfac with multiple keratin projections
* Smooth, corrugated, or ragged, epthelial surface with multiple [[keratin]] projections
|[[File:Frictional hyperkeratosis.jpg|center|219x219px]]
|[[File:Frictional hyperkeratosis.jpg|center|219x219px]]
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|'''Leukoplakia'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Leukoplakia]]
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* White or grayish in patches that can't be wiped away
* White or grayish in patches that can't be wiped away
* Irregular or flat-textured
* Irregular or flat-textured
* Thickened or hardened in areas
* Thickened or hardened in areas
* Along with raised, red lesions (speckled leukoplakia or erythroplakia), which are more likely to show precancerous changes
* Along with raised, red lesions (speckled [[leukoplakia]] or [[erythroplakia]]), which are more likely to show [[precancerous]] changes
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* Smoking
* [[Smoking]]
*  
*  
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* Soft palate
* [[Soft palate]]
* Floor of mouth
* Floor of mouth
* Ventral surface of tongue and the retromolar area  
* Ventral surface of [[tongue]] and the retromolar area  
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* Varies histologically from acanthosis, hyperkeratosis, dysplasia or carcinoma in situ
* Varies histologically from acanthosis, [[hyperkeratosis]], [[dysplasia]] or [[carcinoma in situ]]
* Carcinoma in situ is associated with lymphocytes and macrophages
* [[Carcinoma in situ]] is associated with [[lymphocytes]] and [[macrophages]]
|[[File:Leukoplakia02-04-06.jpg|center|219x219px]]
|[[File:Leukoplakia02-04-06.jpg|center|219x219px]]
|-
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|'''Erythroplakia'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Erythroplakia]]
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* Fiery red patch  
* Fiery red patch  
** Smooth, velvety, granular or nodular lesions
** Smooth, velvety, [[Granularity|granular]] or [[nodular]] lesions
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* Highest risk of malignant transformation
* Highest risk of [[malignant transformation]]
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* Soft palate
* [[Soft palate]]
* Floor of mouth
* Floor of mouth
* Ventral surface of tongue and the retromolar area  
* Ventral surface of [[tongue]] and the retromolar area  
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* Thin atrophic epithelium with prominent subepithelial vascularity and inflammation.
* Thin [[atrophic]] [[epithelium]] with prominent subepithelial [[vascularity]] and [[inflammation]]
* Almost all erythroplakic lesions contain dysplastic cells
* Almost all erythroplakic lesions contain [[Dysplastic change|dysplastic]] cells
|[[File:Erythroplakia1.jpg|center|219x219px]]
|[[File:Erythroplakia1.jpg|center|219x219px]]
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! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Oral lesions
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Oral lesions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Characterestic features
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Appearance
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions  
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions  
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Location
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Location
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! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
|-
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| rowspan="11" |Pigmented lesions
| rowspan="10" style="background: #DCDCDC; padding: 5px; text-align: center; " |'''Pigmented lesions'''
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Ephelis
* Ephelis
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* Poorly defined and may merge into large patches
* Poorly defined and may merge into large patches
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* Sun exposed skin
* Sun exposed [[skin]]
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* Predominant in outer [[lips]]
* Predominant in outer [[lips]]
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* Mild hyperpigmentation of basal keratinocytes, normal architecture
* Mild [[hyperpigmentation]] of [[Basal (medicine)|basal]] [[keratinocytes]], normal architecture
|[[File:Vesnuschki.jpg|center|219x219px]]
|[[File:Vesnuschki.jpg|center|219x219px]]
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Oral melanocytic macule
* Oral melanocytic macule<ref name="pmid17767102">{{cite journal |vauthors=Carlos-Bregni R, Contreras E, Netto AC, Mosqueda-Taylor A, Vargas PA, Jorge J, León JE, de Almeida OP |title=Oral melanoacanthoma and oral melanotic macule: a report of 8 cases, review of the literature, and immunohistochemical analysis |journal=Med Oral Patol Oral Cir Bucal |volume=12 |issue=5 |pages=E374–9 |date=September 2007 |pmid=17767102 |doi= |url=}}</ref><ref name="pmid15491090">{{cite journal |vauthors=Pais S, Hegde SK, Bhat SS |title=Oral melanotic macule--a case report |journal=J Indian Soc Pedod Prev Dent |volume=22 |issue=2 |pages=73–5 |date=June 2004 |pmid=15491090 |doi= |url=}}</ref>
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* Focal [[Pigmented Lesions|pigmented]] brown [[lesions]] similar to ephelides
* Focal [[Pigmented Lesions|pigmented]] brown [[lesions]] similar to ephelides
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* Characterised by a focal increase in [[melanin]] production
* Characterised by a focal increase in [[melanin]] production
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* Idiopathic
* Laugier Hunziker syndrome
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* Gingiva, with the buccal mucosa and palate
* [[Gingiva]],  
* [[Lower lip]]
* [[buccal mucosa]]
* [[palate]]
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* No atypia.
* No [[atypia]]
* Melanin pigmentation tends to be present in significant amounts in the basal-cell layer.
* [[Melanin]] [[pigmentation]] tends to be present in significant amounts in the basal-cell layer
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|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Oral melanoacanthoma
* Oral melanoacanthoma<ref name="pmid27398186">{{cite journal |vauthors=Cantudo-Sanagustín E, Gutiérrez-Corrales A, Vigo-Martínez M, Serrera-Figallo MÁ, Torres-Lagares D, Gutiérrez-Pérez JL |title=Pathogenesis and clinicohistopathological caractheristics of melanoacanthoma: A systematic review |journal=J Clin Exp Dent |volume=8 |issue=3 |pages=e327–36 |date=July 2016 |pmid=27398186 |pmc=4930645 |doi=10.4317/jced.52860 |url=}}</ref><ref name="pmid29387765">{{cite journal |vauthors=Peters SM, Mandel L, Perrino MA |title=Oral melanoacanthoma of the palate: An unusual presentation of an uncommon entity |journal=JAAD Case Rep |volume=4 |issue=2 |pages=138–139 |date=March 2018 |pmid=29387765 |doi=10.1016/j.jdcr.2017.11.023 |url=}}</ref><ref name="pmid23248484">{{cite journal |vauthors=Gupta AA, Nainani P, Upadhyay B, Kavle P |title=Oral melanoacanthoma: A rare case of diffuse oral pigmentation |journal=J Oral Maxillofac Pathol |volume=16 |issue=3 |pages=441–3 |date=September 2012 |pmid=23248484 |doi=10.4103/0973-029X.102514 |url=}}</ref>
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* Rapidly enlarging, [[asymptomatic]], [[Pigmented Lesions|pigmented]] [[Macules|macule]].
* Rapidly enlarging, [[asymptomatic]], [[Pigmented Lesions|pigmented]] [[Macules|macule]].
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* Strong female predilection
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* [[Buccal mucosa]]
* [[Buccal mucosa]]
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* Proliferation of benign dendritic melanocytes scattered throughout the epithelium, acanthosis and spongiosis
* Proliferation of benign [[Dendritic cell|dendritic]] [[melanocytes]] scattered throughout the [[epithelium]], acanthosis and spongiosis
|[[File:Melanocanthoma.png|center|219x219px]]
|[[File:Melanocanthoma.png|center|219x219px]]
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Smoker's melanosis
* [[Smoker's melanosis]]<ref name="pmid25954535">{{cite journal |vauthors=Monteiro LS, Costa JA, da Câmara MI, Albuquerque R, Martins M, Pacheco JJ, Salazar F, Figueira F |title=Aesthetic Depigmentation of Gingival Smoker's Melanosis Using Carbon Dioxide Lasers |journal=Case Rep Dent |volume=2015 |issue= |pages=510589 |date=2015 |pmid=25954535 |pmc=4410537 |doi=10.1155/2015/510589 |url=}}</ref><ref name="pmid26528364">{{cite journal |vauthors=Moravej-Salehi E, Moravej-Salehi E, Hajifattahi F |title=Relationship of Gingival Pigmentation with Passive Smoking in Women |journal=Tanaffos |volume=14 |issue=2 |pages=107–14 |date=2015 |pmid=26528364 |pmc=4629424 |doi= |url=}}</ref><ref name="pmid1920020">{{cite journal |vauthors=Brown FH, Houston GD |title=Smoker's melanosis. A case report |journal=J. Periodontol. |volume=62 |issue=8 |pages=524–7 |date=August 1991 |pmid=1920020 |doi=10.1902/jop.1991.62.8.524 |url=}}</ref>
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* Irregular [[macular]] [[hyperpigmentation]] of the [[oral mucosa]].
* Irregular [[macular]] [[hyperpigmentation]] of the [[oral mucosa]].
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* [[Smoking]]
* [[Smoking]]
* Tobacco chewing
* [[Tobacco]] chewing
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* [[Mandibular]] anterior [[gingiva]]<nowiki/>in cigarette smokers
* [[Mandibular]] anterior [[gingiva]]<nowiki/>in cigarette smokers
* [[Buccal mucosa]] in pipe smokers.
* [[Buccal mucosa]] in pipe smokers.
* [[Hard palate]] in those who engage in reverse smoking
* [[Hard palate]] in those who engage in reverse [[smoking]]
|
|
* Increased melanin pigmentation is noted in the basal cell layer of the epithelium.
* Increased melanin [[pigmentation]] is noted in the [[basal cell layer]] of the [[epithelium]]
* Melanin incontinence may also be noted in the underlying lamina propria
* [[Melanin]] incontinence may also be noted in the underlying [[lamina propria]]
|[[File:Smoker milanosis.jpg|center|219x219px]]
|[[File:Smoker milanosis.jpg|center|219x219px]]
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Melanoma
* [[Melanoma]]
|
|
* Varies from dark brown to blue-black
* Varies from dark brown to blue-black
* Mucosa-colored and white lesions are occasionally noted
* [[Mucosa]]-colored and white lesions are occasionally noted
* Erythema is observed when the lesions are inflamed.
* [[Erythema]] is observed when the [[lesions]] are inflamed.
|
|
* Idiopathic
* [[Idiopathic]]
|
|
* 80% cases involve palate and maxillary gingiva  
* 80% cases involve [[palate]] and [[maxillary]] [[gingiva]]
* Buccal mucosa, mandibular gingiva, and tongue lesions
* [[Buccal mucosa]], [[mandibular]] [[gingiva]], and tongue lesions
|
|
* Acral lentiginous  
* [[Acral lentiginous melanoma|Acral lentiginous]]
* Malignant cells often nest or cluster in groups in an organoid fashion
* [[Malignant]] cells often nest or cluster in groups in an organoid fashion
|[[File:Mm.jpg|center|219x219px]]
|[[File:Mm.jpg|center|219x219px]]
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Kaposi sarcoma
* [[Addison's disease]]<ref name="pmid23893277">{{cite journal |vauthors=Puttanna A, Cunningham AR, Dainty P |title=Addison's disease and its associations |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=July 2013 |pmid=23893277 |pmc=3736622 |doi=10.1136/bcr-2013-010473 |url=}}</ref><ref name="pmid23633816">{{cite journal |vauthors=Sarkar SB, Sarkar S, Ghosh S, Bandyopadhyay S |title=Addison's disease |journal=Contemp Clin Dent |volume=3 |issue=4 |pages=484–6 |date=October 2012 |pmid=23633816 |pmc=3636818 |doi=10.4103/0976-237X.107450 |url=}}</ref>
|
* Purplish, reddish blue or dark brown [[macules]]
* [[Plaques]] and [[nodules]] that may [[Ulcerated lesion|ulcerate]]
|
* HIV and HHV-8.
|
* Hard palate is most frequently affected, followed by the [[gums]]
|
* S[[Spindle cell|pindle cells]] with minimal [[nuclear]] atypia
|[[File:Kaposi’s sarcoma intraoral AIDS 072 lores.jpg|center|219x219px]]
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Addison's disease
|
|
* [[Mucosal]] [[hyperpigmentation]]
* [[Mucosal]] [[hyperpigmentation]]
Line 292: Line 283:
* [[Buccal mucosa]], [[palate]]<nowiki/>and [[tongue]]
* [[Buccal mucosa]], [[palate]]<nowiki/>and [[tongue]]
|
|
* Hyperparakeratinized areas showing acanthosis, spongiosis, exocytosis, vacuolar degeneration,  
* Hyperparakeratinized areas showing acanthosis, spongiosis, [[exocytosis]], vacuolar degeneration,  
* Substantial deposition of melanin in all epithelial layers
* Substantial deposition of [[melanin]] in all epithelial layers
* Melanocytic hyperplasia
* [[Melanocytic nevus|Melanocytic]] [[hyperplasia]]
* Dendritic melanocytes in all epithelial layers.  
* [[Dendritic cell|Dendritic]] [[melanocytes]] in all epithelial layers.  
|[[File:Addisons hyperpigmentation.jpg|center|219x219px]]
|[[File:Addisons hyperpigmentation.jpg|center|219x219px]]
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Peutz jeghers syndrome
* [[Peutz jeghers syndrome]]<ref name="pmid27195155">{{cite journal |vauthors=Mozaffari HR, Rezaei F, Sharifi R, Mirbahari SG |title=Seven-Year Follow-Up of Peutz-Jeghers Syndrome |journal=Case Rep Dent |volume=2016 |issue= |pages=6052181 |date=2016 |pmid=27195155 |pmc=4852371 |doi=10.1155/2016/6052181 |url=}}</ref><ref name="pmid10102516">{{cite journal |vauthors=Choi HS, Park YJ, Park JG |title=Peutz-Jeghers syndrome: a new understanding |journal=J. Korean Med. Sci. |volume=14 |issue=1 |pages=2–7 |date=February 1999 |pmid=10102516 |pmc=3054160 |doi=10.3346/jkms.1999.14.1.2 |url=}}</ref>
|
|
* Flat, painless brown [[Pigmented lesions|pigmented]] patches
* Flat, painless brown [[Pigmented lesions|pigmented]] patches
Line 306: Line 297:
|
|
[[Perioral]]
[[Perioral]]
* Freckling of the skin around lips and [[Vermillion border|vermillion]]<nowiki/>zone of the lips.
* Freckling of the skin around lips and [[Vermillion border|vermillion]]<nowiki/> zone of the [[lips]].
Intraorally
Intraorally
* [[Buccal mucosa]]
* [[Buccal mucosa]]
Line 318: Line 309:
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Neurofibromatosis
* [[Neurofibromatosis]]<ref name="pmid21731277">{{cite journal |vauthors=Janardhanan M, Rakesh S, Vinod Kumar R |title=Intraoral presentation of multiple malignant peripheral nerve sheath tumors associated with neurofibromatosis-1 |journal=J Oral Maxillofac Pathol |volume=15 |issue=1 |pages=46–51 |date=January 2011 |pmid=21731277 |pmc=3125655 |doi=10.4103/0973-029X.80025 |url=}}</ref><ref name="pmid21977094">{{cite journal |vauthors=Thammaiah S, Manjunath M, Rao K, Uma DH |title=Intraoral plexiform neurofibroma involving the maxilla - pathognomonic of neurofibromatosis type I |journal=J Pediatr Neurosci |volume=6 |issue=1 |pages=65–8 |date=January 2011 |pmid=21977094 |pmc=3173921 |doi=10.4103/1817-1745.84413 |url=}}</ref>
|
|
* [[Nodular]] [[neurofibroma]]
* [[Nodular]] [[neurofibroma]]
Line 338: Line 329:
* Floor of the mouth or the [[pharynx]]
* Floor of the mouth or the [[pharynx]]
|
|
* Proliferation of all elements of peripheral nerves
* [[Proliferation]] of all elements of [[peripheral nerves]]
* Schwann cells with wire like collagen fibrils,fibroblasts and collagen
* Schwann cells with wire like collagen fibrils, [[fibroblasts]] and [[collagen]]
* Perineurial cells in plexiform types, mitotic figures are rare
* Perineurial cells in plexiform types, mitotic figures are rare
|
|[[File:Oral neurofibromatosis.jpg|center]]
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Polyostotic fibrous dysplasia
* [[Polyostotic fibrous dysplasia]]<ref name="pmid217312772">{{cite journal |vauthors=Janardhanan M, Rakesh S, Vinod Kumar R |title=Intraoral presentation of multiple malignant peripheral nerve sheath tumors associated with neurofibromatosis-1 |journal=J Oral Maxillofac Pathol |volume=15 |issue=1 |pages=46–51 |date=January 2011 |pmid=21731277 |pmc=3125655 |doi=10.4103/0973-029X.80025 |url=}}</ref><ref name="pmid219770942">{{cite journal |vauthors=Thammaiah S, Manjunath M, Rao K, Uma DH |title=Intraoral plexiform neurofibroma involving the maxilla - pathognomonic of neurofibromatosis type I |journal=J Pediatr Neurosci |volume=6 |issue=1 |pages=65–8 |date=January 2011 |pmid=21977094 |pmc=3173921 |doi=10.4103/1817-1745.84413 |url=}}</ref>
|
|
* Orofacial deformity
* Orofacial deformity
Line 356: Line 347:
* Gingiva
* Gingiva
|
|
* Curvilinear trabeculae of metaplastic woven bone in hypocellular, fibroblastic stroma
* Curvilinear [[trabeculae]] of metaplastic woven bone in hypocellular, [[fibroblastic]] [[stroma]]
|
|
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Amalgam tattoo
* [[Amalgam]] [[tattoo]]<ref name="pmid23533829">{{cite journal |vauthors=Lundin K, Schmidt G, Bonde C |title=Amalgam tattoo mimicking mucosal melanoma: a diagnostic dilemma revisited |journal=Case Rep Dent |volume=2013 |issue= |pages=787294 |date=2013 |pmid=23533829 |pmc=3606745 |doi=10.1155/2013/787294 |url=}}</ref><ref name="pmid6928285">{{cite journal |vauthors=Buchner A, Hansen LS |title=Amalgam pigmentation (amalgam tattoo) of the oral mucosa. A clinicopathologic study of 268 cases |journal=Oral Surg. Oral Med. Oral Pathol. |volume=49 |issue=2 |pages=139–47 |date=February 1980 |pmid=6928285 |doi= |url=}}</ref>
|
|
* Blue-black [[macules]]
* Blue-black [[macules]]
|
|
* [[Dental]] [[Implant]][[surgery]]
* [[Dental]] [[Implant]] [[surgery]]
|
|
* [[Gingival]] margin or proximal [[buccal mucosa]]<nowiki/>near [[amalgam]] dental fillings
* [[Gingival]] margin or proximal [[buccal mucosa]]<nowiki/>near [[amalgam]] dental fillings
|
|
* Pigmented fragments of metal within connective tissue
* [[Pigmented layer|Pigmented]] fragments of metal within connective tissue
* A scattered arrangement of black or dark brown granules
* A scattered arrangement of black or dark brown [[granules]]
* Large particles may be surrounded by chronically inflamed fibrous tissue
* Large particles may be surrounded by chronically inflamed [[fibrous tissue]]
|[[File:Oral Melanthocoma.png|center|219x219px]]
|[[File:Oral Melanthocoma.png|center|219x219px]]
|-
|-
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Oral lesions
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Oral lesions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Characteristic features
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Appearance
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Location  
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Location  
Line 380: Line 371:
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
|-
|-
| rowspan="17" |Vesicular/
| rowspan="17" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Vesicular'''/'''Erythematous'''
 
'''Ulcerative''' '''lesions'''
Ulcerative  
| rowspan="9" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infections]]
| rowspan="9" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vesicular/Ulcerative oral lesions|Infections]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Herpes simplex virus]]<nowiki/>[[infections]]<ref name="pmid23839615">{{cite journal |vauthors=Mohan RP, Verma S, Singh U, Agarwal N |title=Acute primary herpetic gingivostomatitis |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=July 2013 |pmid=23839615 |pmc=3736476 |doi=10.1136/bcr-2013-200074 |url=}}</ref><ref name="pmid19169443">{{cite journal |vauthors=Tovaru S, Parlatescu I, Tovaru M, Cionca L |title=Primary herpetic gingivostomatitis in children and adults |journal=Quintessence Int |volume=40 |issue=2 |pages=119–24 |date=February 2009 |pmid=19169443 |doi= |url=}}</ref><ref name="pmid9334868">{{cite journal |vauthors=Amir J, Nussinovitch M, Kleper R, Cohen HA, Varsano I |title=Primary herpes simplex virus type 1 gingivostomatitis in pediatric personnel |journal=Infection |volume=25 |issue=5 |pages=310–2 |date=1997 |pmid=9334868 |doi= |url=}}</ref>
|[[Herpes simplex virus]]<nowiki/>infections
|
|
[[Herpetic gingivostomatitis]]
[[Herpetic gingivostomatitis]]
Line 400: Line 390:
|
|
* [[Keratinized]] and non-keratinized [[mucosa]].  
* [[Keratinized]] and non-keratinized [[mucosa]].  
|
*Intra and intercellular edema (acantholysis)
*Intranuclear inclusions
*Multinucleate polykaryons (giant cells)
|[[File:Herpes labialis.jpg|center|219x219px]]
|-
|-
|[[Herpes zoster Infection|Herpes zoster]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Herpes zoster Infection|Herpes zoster]]<ref name="pmid23771975">{{cite journal |vauthors=Mohan RP, Verma S, Singh U, Agarwal N |title=Herpes zoster |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=June 2013 |pmid=23771975 |pmc=3702907 |doi=10.1136/bcr-2013-010246 |url=}}</ref><ref name="pmid23559842">{{cite journal |vauthors=Patil S, Srinivas K, Reddy BS, Gupta M |title=Prodromal herpes zoster mimicking odontalgia--a diagnostic challenge |journal=Ethiop J Health Sci |volume=23 |issue=1 |pages=73–7 |date=March 2013 |pmid=23559842 |pmc=3613819 |doi= |url=}}</ref><ref name="pmid11314207">{{cite journal |vauthors=Kolokotronis A, Louloudiadis K, Fotiou G, Matiais A |title=Oral manifestations of infections of infections due to varicella zoster virus in otherwise healthy children |journal=J Clin Pediatr Dent |volume=25 |issue=2 |pages=107–12 |date=2001 |pmid=11314207 |doi= |url=}}</ref>
|
|
* Clustered small [[ulcers]] with characteristic unilateral pattern
* Clustered small [[ulcers]] with characteristic unilateral pattern
Line 413: Line 406:
*[[Gingival|Gingiva]]
*[[Gingival|Gingiva]]
|
|
|
* Keratinocytes are multinucleated, acantholytic with distinct nuclear inclusions, found initially in follicular epithelium
* Late epidermal necrosis or full-thickness acantholysis
* Dermal nerve twigs may exhibit a perineural infiltrate of lymphocytes and neutrophils, sometimes associated with intraneural involvement
* Schwann cell hypertrophy and frank neural necrosis are occasionally encountered
|[[File:HZV.jpg|center|219x219px]]
|-
|-
|[[Hand foot mouth disease]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hand foot mouth disease]]<ref name="pmid21911958">{{cite journal |vauthors=Muppa R, Bhupatiraju P, Duddu M, Dandempally A |title=Hand, foot and mouth disease |journal=J Indian Soc Pedod Prev Dent |volume=29 |issue=2 |pages=165–7 |date=2011 |pmid=21911958 |doi=10.4103/0970-4388.84692 |url=}}</ref><ref name="pmid26155357">{{cite journal |vauthors=Kashyap RR, Kashyap RS |title=Hand, foot and mouth disease - a short case report |journal=J Clin Exp Dent |volume=7 |issue=2 |pages=e336–8 |date=April 2015 |pmid=26155357 |pmc=4483348 |doi=10.4317/jced.52031 |url=}}</ref><ref name="pmid26302092">{{cite journal |vauthors=Liu B, Luo L, Yan S, Wen T, Bai W, Li H, Zhang G, Lu X, Liu Y, He L |title=Clinical Features for Mild Hand, Foot and Mouth Disease in China |journal=PLoS ONE |volume=10 |issue=8 |pages=e0135503 |date=2015 |pmid=26302092 |pmc=4547800 |doi=10.1371/journal.pone.0135503 |url=}}</ref>
|
|
*Oval-shaped, pale papules with a rim of [[erythema]]
*Irregularly shaped shallow [[ulcers]] with yellow-grey base and hyperemic margin.
*Small aphthae
|
|
* Coxsackievirus
|
|
* Lesions spare the [[lips]] and [[gingiva]], in contrast to [[HSV]]
*Margings of [[tongue]]
|
*Inside of [[cheeks]]
*Anterior [[fauces]]
*On the [[mandible]] above the posterior [[molar teeth]]
*[[Soft palate]]
|
|
* Vesicular lesions will demonstrate loose strands of fibrin, lymphocytes and neutrophils in the vesicular fluid.
* The presence of acantholysis in the epidermis and perivascular infiltration of leukocytes is seen in hand foot and mouth disease.
* The absence of intracelluar inclusion bodies differentiates it from the herpes simplex infection.
|[[File:Hand foot mouth disease 07a.jpg|center|219x219px]]
|-
|-
|[[Infectious mononucliosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Infectious mononucliosis]]<ref name="pmid21233512">{{cite journal |vauthors=Odumade OA, Hogquist KA, Balfour HH |title=Progress and problems in understanding and managing primary Epstein-Barr virus infections |journal=Clin. Microbiol. Rev. |volume=24 |issue=1 |pages=193–209 |date=January 2011 |pmid=21233512 |pmc=3021204 |doi=10.1128/CMR.00044-10 |url=}}</ref><ref name="pmid27588199">{{cite journal |vauthors=Grimm JM, Schmeling DO, Dunmire SK, Knight JA, Mullan BD, Ed JA, Brundage RC, Hogquist KA, Balfour HH |title=Prospective studies of infectious mononucleosis in university students |journal=Clin Transl Immunology |volume=5 |issue=8 |pages=e94 |date=August 2016 |pmid=27588199 |doi=10.1038/cti.2016.48 |url=}}</ref>
|
|
*Tonsillar exudates
*Tonsillar exudates
Line 431: Line 435:
*Palatal [[petechiae]] with streaky [[hemorrhages]] and blotchy red [[macules]]  
*Palatal [[petechiae]] with streaky [[hemorrhages]] and blotchy red [[macules]]  
|
|
* Epstein-Barr virus infection
* Kissing's Disease
|
|
* [[Pharynx]]
* [[Pharynx]]
* [[Tonsils]]
* [[Tonsils]]
|
|
|
* Reactive lymphoid hyperplasia
* Extensive immunoblastic proliferation in sheets and nodules, marked atypia resembling Reed-Sternberg cells
|[[File:1200px-Mono tonsils.JPG|center|219x219px]]
|-
|-
|Erosive [[lichen planus]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Erosive [[lichen planus]]<ref name="pmid22615505">{{cite journal |vauthors=Omal P, Jacob V, Prathap A, Thomas NG |title=Prevalence of oral, skin, and oral and skin lesions of lichen planus in patients visiting a dental school in southern India |journal=Indian J Dermatol |volume=57 |issue=2 |pages=107–9 |date=March 2012 |pmid=22615505 |pmc=3352630 |doi=10.4103/0019-5154.94276 |url=}}</ref><ref name="pmid26681847">{{cite journal |vauthors=Belal MH |title=Management of symptomatic erosive-ulcerative lesions of oral lichen planus in an adult Egyptian population using Selenium-ACE combined with topical corticosteroids plus antifungal agent |journal=Contemp Clin Dent |volume=6 |issue=4 |pages=454–60 |date=2015 |pmid=26681847 |pmc=4678540 |doi=10.4103/0976-237X.169837 |url=}}</ref><ref name="pmid26538905">{{cite journal |vauthors=Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy BV, Dineshshankar J, Yoithapprabhunath TR |title=A clinical study on oral lichen planus with special emphasis on hyperpigmentation |journal=J Pharm Bioallied Sci |volume=7 |issue=Suppl 2 |pages=S495–8 |date=August 2015 |pmid=26538905 |pmc=4606647 |doi=10.4103/0975-7406.163513 |url=}}</ref>
|
|
* [[Ulcerative stomatitis]]
* [[Ulcerative stomatitis]]
Line 449: Line 457:
|
|
|-
|-
|Pseudomembranous [[candidiasis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pseudomembranous [[candidiasis]]<ref name="pmid21547018">{{cite journal |vauthors=Williams D, Lewis M |title=Pathogenesis and treatment of oral candidosis |journal=J Oral Microbiol |volume=3 |issue= |pages= |date=January 2011 |pmid=21547018 |pmc=3087208 |doi=10.3402/jom.v3i0.5771 |url=}}</ref><ref name="pmid26538978">{{cite journal |vauthors=Warrier SA, Sathasivasubramanian S |title=Human immunodeficiency virus induced oral candidiasis |journal=J Pharm Bioallied Sci |volume=7 |issue=Suppl 2 |pages=S812–4 |date=August 2015 |pmid=26538978 |pmc=4606720 |doi=10.4103/0975-7406.163577 |url=}}</ref><ref name="pmid22111010">{{cite journal |vauthors=Byadarahally Raju S, Rajappa S |title=Isolation and identification of Candida from the oral cavity |journal=ISRN Dent |volume=2011 |issue= |pages=487921 |date=2011 |pmid=22111010 |pmc=3205665 |doi=10.5402/2011/487921 |url=}}</ref>
|
|
Insert paragraph
* Known as [[thrush]].
* Known as [[thrush]].
* Usually [[asymptomatic]].
* Usually [[asymptomatic]].
Line 457: Line 464:
* Superficially the plaques can be wiped off and the underlying [[mucosa]] often exhibits an [[erythematous]] appearance.
* Superficially the plaques can be wiped off and the underlying [[mucosa]] often exhibits an [[erythematous]] appearance.
|
|
* Chronic medications
* Immuno-suppressive conditions
|
|
*[[Oral mucosa]],
*[[Oral mucosa]],
Line 463: Line 472:
*[[Hard palate]]
*[[Hard palate]]
|
|
|
* Wet mount  examination with 10% KOH or saline demonstrates [[hyphae]], pseudohyphae, and [[Yeast|blastospores]].
|[[File:Human tongue infected with oral candidiasis--By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|center|285x285px]]
|-
|-
|[[Histoplasmosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Histoplasmosis]]<ref name="pmid28255468">{{cite journal |vauthors=Chatterjee D, Chatterjee A, Agarwal M, Mathur M, Mathur S, Mallikarjun R, Banerjee S |title=Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient |journal=Case Rep Dent |volume=2017 |issue= |pages=1323514 |date=2017 |pmid=28255468 |pmc=5306962 |doi=10.1155/2017/1323514 |url=}}</ref><ref name="pmid23798850">{{cite journal |vauthors=Vidyanath S, Shameena P, Sudha S, Nair RG |title=Disseminated histoplasmosis with oral and cutaneous manifestations |journal=J Oral Maxillofac Pathol |volume=17 |issue=1 |pages=139–42 |date=January 2013 |pmid=23798850 |pmc=3687172 |doi=10.4103/0973-029X.110722 |url=}}</ref><ref name="pmid20379415">{{cite journal |vauthors=Patil K, Mahima VG, Prathibha Rani RM |title=Oral histoplasmosis |journal=J Indian Soc Periodontol |volume=13 |issue=3 |pages=157–9 |date=September 2009 |pmid=20379415 |pmc=2848788 |doi=10.4103/0972-124X.60230 |url=}}</ref><ref name="pmid23853464">{{cite journal |vauthors=Brazão-Silva MT, Mancusi GW, Bazzoun FV, Ishisaki GY, Marcucci M |title=A gingival manifestation of histoplasmosis leading diagnosis |journal=Contemp Clin Dent |volume=4 |issue=1 |pages=97–101 |date=January 2013 |pmid=23853464 |pmc=3703707 |doi=10.4103/0976-237X.111621 |url=}}</ref><ref name="pmid29267463">{{cite journal |vauthors=Souza BC, Munerato MC |title=Oral manifestation of histoplasmosis on the palate |journal=An Bras Dermatol |volume=92 |issue=5 Suppl 1 |pages=107–109 |date=2017 |pmid=29267463 |pmc=5726694 |doi=10.1590/abd1806-4841.20175751 |url=}}</ref>
|
|
*Disease affect the lungs and cause [[acute]] or [[chronic]] [[respiratory]] problems in the [[immunocompromised]] population.
*Disease affect the lungs and cause [[acute]] or [[chronic]] [[respiratory]] problems in the [[immunocompromised]] population.
Line 480: Line 490:
*[[Lips]]
*[[Lips]]
|
|
|
* Characterized by a budding [[yeast]] connected with a narrow base and is mostly identified within the [[macrophages]] and [[monocytes]].
|[[File:Histoplasmosis.png|center|219x219px]]
|-
|-
|[[Blastomycosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Blastomycosis]]<ref name="pmid20072023">{{cite journal |vauthors=Kruse AL, Zwahlen RA, Bredell MG, Gengler C, Dannemann C, Grätz KW |title=Primary blastomycosis of oral cavity |journal=J Craniofac Surg |volume=21 |issue=1 |pages=121–3 |date=January 2010 |pmid=20072023 |doi=10.1097/SCS.0b013e3181c4680c |url=}}</ref><ref name="pmid24899035">{{cite journal |vauthors=Thomas J, Munson E, Christianson JC |title=Unexpected Blastomyces dermatitidis etiology of fungal sinusitis and erosive palatal infection in a diabetic patient |journal=J. Clin. Microbiol. |volume=52 |issue=8 |pages=3130–3 |date=August 2014 |pmid=24899035 |pmc=4136175 |doi=10.1128/JCM.01392-14 |url=}}</ref><ref name="pmid24963249">{{cite journal |vauthors=Webber LP, Martins MD, de Oliveira MG, Munhoz EA, Carrard VC |title=Disseminated paracoccidioidomycosis diagnosis based on oral lesions |journal=Contemp Clin Dent |volume=5 |issue=2 |pages=213–6 |date=April 2014 |pmid=24963249 |pmc=4067786 |doi=10.4103/0976-237X.132340 |url=}}</ref>
|
|
*Ulcerative [[mucosal]] lesions
*Ulcerative [[mucosal]] lesions
Line 491: Line 502:
* Mississippi, Missouri and Ohio River valleys and the Great lakes region.
* Mississippi, Missouri and Ohio River valleys and the Great lakes region.
|
|
* Ginguve
* Mostly Pulmonary Nodules
|
|
|
Classic appearance on modified Wright's stain
* [[Multinucleated]] [[Yeast|yeas]]<nowiki/>t [[cell]]
* Single broad-based bud
* Round to oval in shape with 12 um diameter
|[[File:Blastomycosis cropped.JPG|center|219x219px]]
|-
|-
|[[Coccidiodomycosis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Coccidiodomycosis]]<ref name="pmid28386282">{{cite journal |vauthors=Mendez LA, Flores SA, Martinez R, de Almeida OP |title=Ulcerated Lesion of the Tongue as Manifestation of Systemic Coccidioidomycosis |journal=Case Rep Med |volume=2017 |issue= |pages=1489501 |date=2017 |pmid=28386282 |pmc=5366790 |doi=10.1155/2017/1489501 |url=}}</ref><ref name="pmid15628927">{{cite journal |vauthors=Rodriguez RA, Konia T |title=Coccidioidomycosis of the tongue |journal=Arch. Pathol. Lab. Med. |volume=129 |issue=1 |pages=e4–6 |date=January 2005 |pmid=15628927 |doi=10.1043/1543-2165(2005)129<e4:COTT>2.0.CO;2 |url=}}</ref><ref name="pmid28228898">{{cite journal |vauthors=McConnell MF, Shi A, Lasco TM, Yoon L |title=Disseminated coccidioidomycosis with multifocal musculoskeletal disease involvement |journal=Radiol Case Rep |volume=12 |issue=1 |pages=141–145 |date=March 2017 |pmid=28228898 |pmc=5310389 |doi=10.1016/j.radcr.2016.11.017 |url=}}</ref><ref name="pmid16707052">{{cite journal |vauthors=Valdivia L, Nix D, Wright M, Lindberg E, Fagan T, Lieberman D, Stoffer T, Ampel NM, Galgiani JN |title=Coccidioidomycosis as a common cause of community-acquired pneumonia |journal=Emerging Infect. Dis. |volume=12 |issue=6 |pages=958–62 |date=June 2006 |pmid=16707052 |pmc=3373055 |doi= |url=}}</ref>
|
|
*[[Asymptomatic]]
*[[Asymptomatic]]
Line 502: Line 519:
*[[Ulcers]] appear nonspecific and usually heal by hyalinization and [[scar]]
*[[Ulcers]] appear nonspecific and usually heal by hyalinization and [[scar]]
|
|
* Dust exposure in endemic areas, due to occupational activities agricultural or construction workers
* Military personnel training in endemic areas
* Construction work, and model airplane competitions
* Natural disasters such as earthquakes and windstorms
|
|
* Tongue
|
|
|
It is a dimorphic fungus and on microscopy, the following can be seen
* Spherule with [[endospores]]
* Rarely as [[hyphae]] in lung biopsy
|[[File:Coccidioidomycosis 01.jpg|center|219x219px]]
|-
|-
| rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vesicular/Ulcerative oral lesions|Autoimmune conditions]]
| rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Autoimmune diseases]]
|[[Pemphigus vulgaris]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pemphigus vulgaris]]<ref name="pmid26949302">{{cite journal |vauthors=Arpita R, Monica A, Venkatesh N, Atul S, Varun M |title=Oral Pemphigus Vulgaris: Case Report |journal=Ethiop J Health Sci |volume=25 |issue=4 |pages=367–72 |date=October 2015 |pmid=26949302 |doi= |url=}}</ref><ref name="pmid27721634">{{cite journal |vauthors=Kumar SJ, Nehru Anand SP, Gunasekaran N, Krishnan R |title=Oral pemphigus vulgaris: A case report with direct immunofluorescence study |journal=J Oral Maxillofac Pathol |volume=20 |issue=3 |pages=549 |date=2016 |pmid=27721634 |doi=10.4103/0973-029X.190979 |url=}}</ref><ref name="pmid23493851">{{cite journal |vauthors=Rath SK, Reenesh M |title=Gingival pemphigus vulgaris preceding cutaneous lesion: A rare case report |journal=J Indian Soc Periodontol |volume=16 |issue=4 |pages=588–91 |date=October 2012 |pmid=23493851 |pmc=3590732 |doi=10.4103/0972-124X.106922 |url=}}</ref>
|
|
*Superficial [[ulcers]] to small [[vesicles]] or [[blisters]].
*Superficial [[ulcers]] to small [[vesicles]] or [[blisters]].
Line 523: Line 548:
*Less frequently, at the [[gingiva]]
*Less frequently, at the [[gingiva]]
|
|
|
* Intraepithelial blister with acantholysis and chronic inflammation
|[[File:Pemphigus vulgaris.jpeg|center|219x219px]]
|-
|-
|[[Mucous membrane pemphigoid]] (Cicatricial pemphigoid)
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mucous membrane pemphigoid]] (Cicatricial pemphigoid)<ref name="pmid27563211">{{cite journal |vauthors=Vijayan V, Paul A, Babu K, Madhan B |title=Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid |journal=J Indian Soc Periodontol |volume=20 |issue=3 |pages=340–3 |date=2016 |pmid=27563211 |doi=10.4103/0972-124X.182602 |url=|first=|via=}}</ref><ref name="pmid20161882">{{cite journal |vauthors=Trimarchi M, Bellini C, Fabiano B, Gerevini S, Bussi M |title=Multiple mucosal involvement in cicatricial pemphigoid |journal=Acta Otorhinolaryngol Ital |volume=29 |issue=4 |pages=222–5 |date=August 2009 |pmid=20161882 |pmc=2816372 |doi= |url=}}</ref><ref name="pmid19905946">{{cite journal |vauthors=Schellinck AE, Rees TD, Plemons JM, Kessler HP, Rivera-Hidalgo F, Solomon ES |title=A comparison of the periodontal status in patients with mucous membrane pemphigoid: a 5-year follow-up |journal=J. Periodontol. |volume=80 |issue=11 |pages=1765–73 |date=November 2009 |pmid=19905946 |doi=10.1902/jop.2009.090244 |url=}}</ref>
|
|
*[[Desquamative gingivitis]]
*[[Desquamative gingivitis]]
Line 539: Line 565:
* [[Palate]]
* [[Palate]]
|
|
* Subepidermal vesicle contains edema fluid, fibrin and variable inflammatory cells
* Perivascular lymphohistiocytic infiltrate, plasma cells and neutrophils
* Fewer eosinophils than generalized bullous pemphigoid
* Conjunctival squamous metaplasia with foci of hyperkeratosis and parakeratosis, accompanied by goblet cell depletion; conjunctival vesicles or bulla are rare
|
|
|-
|-
|[[Aphthous ulcer]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Aphthous ulcer]]<ref name="pmid25346356">{{cite journal |vauthors=Altenburg A, El-Haj N, Micheli C, Puttkammer M, Abdel-Naser MB, Zouboulis CC |title=The treatment of chronic recurrent oral aphthous ulcers |journal=Dtsch Arztebl Int |volume=111 |issue=40 |pages=665–73 |date=October 2014 |pmid=25346356 |pmc=4215084 |doi=10.3238/arztebl.2014.0665 |url=}}</ref><ref name="pmid26880080">{{cite journal |vauthors=Vaillant L, Samimi M |title=[Aphthous ulcers and oral ulcerations] |language=French |journal=Presse Med |volume=45 |issue=2 |pages=215–26 |date=February 2016 |pmid=26880080 |doi=10.1016/j.lpm.2016.01.005 |url=}}</ref><ref name="pmid16449028">{{cite journal |vauthors=Bucci P, Carile F, Sangianantoni A, Sangianantoni A, D'Angiò F, Santarelli A, Lo Muzio L |title=Oral aphthous ulcers and dental enamel defects in children with coeliac disease |journal=Acta Paediatr. |volume=95 |issue=2 |pages=203–7 |date=February 2006 |pmid=16449028 |doi=10.1080/08035250500355022 |url=}}</ref>
|
|


Line 547: Line 577:
* In chronic [[ulcer]] grey membrane may replace the yellow pseudomembrane
* In chronic [[ulcer]] grey membrane may replace the yellow pseudomembrane
|
|
* [[SLE]]
* [[IBD]]
|
|
* Appear on the non-keratinizing epithelial surfaces in the mouth.
* '''Except''' the attached [[gingiva]], the [[hard palate]] and the dorsum of the [[tongue]]
|
|
* Non-keratinized [[oral mucosa]] along the [[labial]] or [[buccal]] surfaces, [[soft palate]], floor of the [[mouth]], ventral or lateral surface of the [[tongue]] and [[oropharynx]]
* Non-keratinized [[oral mucosa]] along the [[labial]] or [[buccal]] surfaces, [[soft palate]], floor of the [[mouth]], ventral or lateral surface of the [[tongue]] and [[oropharynx]]
|
|[[File:Canker sore.jpg|center|240x240px]]
|-
|-
|[[Erythema multiforme]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Erythema multiforme]]<ref name="pmid17767983">{{cite journal |vauthors=Scully C, Bagan J |title=Oral mucosal diseases: erythema multiforme |journal=Br J Oral Maxillofac Surg |volume=46 |issue=2 |pages=90–5 |date=March 2008 |pmid=17767983 |doi=10.1016/j.bjoms.2007.07.202 |url=}}</ref><ref name="pmid22434953">{{cite journal |vauthors=Joseph TI, Vargheese G, George D, Sathyan P |title=Drug induced oral erythema multiforme: A rare and less recognized variant of erythema multiforme |journal=J Oral Maxillofac Pathol |volume=16 |issue=1 |pages=145–8 |date=January 2012 |pmid=22434953 |pmc=3303512 |doi=10.4103/0973-029X.92995 |url=}}</ref>
|
|
* [[Prodromal]] [[skin]] target lesions, bullae and [[ulcerations]] with irregular borders and [[inflammatory]] halos, bloody encrustations on the [[lips]]
* [[Prodromal]] [[skin]] target lesions, bullae and [[ulcerations]] with irregular borders and [[inflammatory]] halos, bloody encrustations on the [[lips]]
|
|
* [[Infections]] e.g. [[EBV]], [[CMV]] [[herpes]], and [[mycoplasma]] etc
* Drugs e.g. [[sulfonamides]], [[anticonvulsants]] etc
|
|
*[[Lips]]
*[[Lips]]
Line 561: Line 597:
*[[Tongue]]
*[[Tongue]]
|
|
|
* Subepidermal bullae with [[basement membrane]] in bullae roof due to [[dermal]] [[edema]]
* Severe [[dermal]] [[inflammatory]] infiltrate (includes [[lymphocytes]], [[histiocytes]])
* [[Eosinophils]] may be present, but [[neutrophils]] are sparse or absent
* Overlying [[epidermis]] often demonstrates [[liquefactive necrosis]] and degeneration, dyskeratotic [[keratinocytes]]
* May also have dermoepidermal bullae with [[basal lamina]] at floor of bullae
* Variable epidermal spongiosis and [[eosinophils]]
* No leukocytoclasis, no microabscesses, no festooning of [[dermal papillae]]
|[[File:EM oral.png|center|219x219px]]
|-
|-
|[[Sjogren's Syndrome]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sjogren's Syndrome]]
|
|
Affects salivary and [[lacrimal glands]]
Affects salivary and [[lacrimal glands]]
Line 572: Line 615:
*[[Edema]] and inflammations of the [[gingiva]] are frequent clinical signs. Moreover, a salivary flow decrease can develop [[opportunistic infections]].  
*[[Edema]] and inflammations of the [[gingiva]] are frequent clinical signs. Moreover, a salivary flow decrease can develop [[opportunistic infections]].  
|
|
* [[Crohn's disease]]
|
|
*[[Gingiva]]
*[[Gingiva]]
Line 577: Line 621:
*[[Tooth]]
*[[Tooth]]
|
|
|
* Extensive lymphoid infiltrate with [[germinal centers]], often [[interstitial fibrosis]] and [[acinar]] [[atrophy]]
|[[File:Sjorgen's.png|center|219x219px]]
|-
|-
|[[Bullous pemphigoid]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Bullous pemphigoid]]
|
|
*Discrete [[Vesicles|vesicle]] formation with Multiple [[ulcers]]
*Discrete [[Vesicles|vesicle]] formation with Multiple [[ulcers]]
*[[Desquamative gingivitis]] as the most common presentation
*[[Desquamative gingivitis]] as the most common presentation
|
|
* Psoriasis
* Parkinson's disease
* Dementia
* Certain drugs e.g. spironolactone, loop diuretics and neuroleptics
* Malignancies e.g. breast cancer
|
|
* [[Gingiva]]
* [[Gingiva]]
|
|
|
* Unilocular, subepidermal, nonacantholytic blisters with festooning (suspended in a loop between two points) of dermal papillae, infiltrate including eosinophils located in blister cavity and in the dermis
* Early erythematous lesion shows upper papillary dermal edema, perivascular lymphohistiocytic infiltrate, accompanied by conspicuous eosinophils
|[[File:Skinbullousflores2.jpg|center|219x219px]]
|-
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Vesicular/Ulcerative oral lesions|Idiopathic conditions]]
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Idiopathic]] conditions
|Allergic contact stomatitis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Allergic contact stomatitis
| rowspan="2" |
| rowspan="2" |
* [[Erythema]], [[Vesicles|vesicle]] formation, [[Erosion (dental)|erosion]], [[ulcer]] formation and shaggy [[hyperkeratosis]]
* [[Erythema]], [[Vesicles|vesicle]] formation, [[Erosion (dental)|erosion]], [[ulcer]] formation and shaggy [[hyperkeratosis]]
Line 597: Line 649:
* [[Tongue]]
* [[Tongue]]
* [[Gums]]
* [[Gums]]
* H[[Hard palate|ard palate]]  
* [[Hard palate|Hard palate]]  
* [[Buccal mucosa]]
* [[Buccal mucosa]]
| rowspan="2" |
| rowspan="2" |
Line 606: Line 658:
|
|
|-
|-
|Irritant contact stomatitis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Irritant contact stomatitis
|
|
|
|
|-
|-
|}
|}
{| class="wikitable"
{| class="wikitable"
|+
|+
! colspan="6" style="background:#4479BA; color: #FFFFFF;" align="center" + |Soft tissue oral lesions
! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" + |Soft tissue oral lesions
|-
|-
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Reactive lesions
! colspan="2" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Reactive lesions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Symptoms
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Appearance
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Characterstic features
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Location
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Location
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Microscopic
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
|-
|-
| rowspan="1" style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" rowspan="1" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Inflammatory papillary hyperplasia]]
* Leukoedema
|
|
* [[Benign]] lesion characterized by hyperemic [[mucosa]]
* One or more bulbous or [[nodular]] growth measuring less than 2 mm
|
|
* [[Torus palatinus]]
* [[Candida albicans]] infections
* Use of upper [[dentures]]
* [[smoking]]
* poor oral condition
|
|
* [[Hard palate]]
|
|
* [[Papillary]] projections
* [[Stratified squamous epithelium]]
* Edematous [[connective tissue]]
* Chronic inflammatory infiltrate
|[[File:L08.jpg|center|219x219px]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Fibrous]] [[hyperplasia]]
* Fordyce granules
|
|
* Presents as a yellowish–white or [[mucosal]] colored, [[sessile]], smooth-surfaced, [[asymptomatic]], soft nodule.
* The surface may be hyperkeratotic or [[Ulcerated lesion|ulcerated]], owing to repeated trauma.
|
|
* [[Diphenylhydantoin]] ingestion
* [[Cyclosporine|Cyclosporine A]]
* [[Nifedipine]]
|
|
* The most common intraoral site is along the occlusal line of the [[buccal mucosa]]
* It also affects the [[lower lip]], [[tongue]], [[hard palate]] and [[edentulous]] [[alveolar ridge]]
|
* Unencapsulated, solid, [[nodular]] mass of dense and sometimes hyalinized [[fibrous]] [[connective tissue]].
* The surface [[epithelium]] is usually [[atrophic]],
* Show signs of continued trauma, such as, excess [[keratin]], [[intracellular]] [[edema]] of the superficial layers or traumatic [[ulceration]]
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mucocele]]
* Hairy tongue
|
|
* Mucus cyst is a distinct, fluctuant, painless swelling of the mucosa.
* <1 cm in diameter
* Superficial lesions take on a bluish to translucent hue
* Deep lesions have normal mucosal coloration
* Bleeding into the swelling may impart a bright red and vascular appearance.
|
|
* Rupture of [[salivary gland]] duct by blockade of salivary gland duct.
|
|
* [[Lower lip]]
* [[Tongue]]
* Floor of [[mouth]] ([[ranula]])
* [[Buccal mucosa]]
|
|
* [[Inflammatory cells]] and [[mucin]] lift [[epithelium]] of [[sinus]] and [[periosteum]] away from underlying bone
* [[Epithelium]] may undergo [[squamous metaplasia]]
* Extravasation of mucin into [[lamina propria]] with muciphages
|[[File:1024px-Mucocele02-17-06cropped.jpg|center|219x219px]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Necrotizing sialometaplasia]]
* Hairy leukoplakia
|
|
* Non-ulcerated swelling that transforms into crater like [[ulcer]]
* 1-5cms
|
|
|
* Inflammation of [[salivary gland]]
* [[Dental]] injuries
|
|
* [[Hard palate]] >> [[Soft palate]]
|
* [[Acinar]] [[necrosis]] in early lesions
* [[Squamous metaplasia]] of [[salivary glands]]
|[[File:Necrotizing sialometaplasia 001.jpg|center|219x219px]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Periodontal|Periodonta]]<nowiki/>l [[abscess]]
* White sponge nevus
|
|
* The [[oral mucosa]] covering an  abscess appears [[erythematous]] and painful to touch.
* The surface may be shiny due to stretching of the [[mucosa]] over the [[abscess]].
* Before [[pus]] has formed, the lesion will not be fluctuant, and there will be no [[purulent]] [[discharge]].
|
|
* Originates in the [[dental pulp]]
* Associated with living tooth
|
|
* [[Dental]] line
* [[Gingiva]]
|
|
* [[Neutrophils]] are found surrounding a central area of soft tissue debris and destroyed leukocytes.
* At later stage, a pyogenic membrane is organized [[macrophages]] and [[neutrophils]]
|[[File:GingivalAbscess.jpg|center|219x219px]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Periapical abscess|Periapical]] [[abscess]]
* Lichen planus
|
|
* Usually attached to tooth root
* Firm or have deflated capsule
* Lumen can contain thin serous or straw colored fluid, opaque yellow-white debris, muddy brown fluid from old [[hemorrhage]] or frank purulent debris
|
|
* Originates in the [[dental pulp]]
* Associated with '''dead tooth'''
|
|
* [[Dental]] line
* [[Gingiva]]
|
|
* Lined by [[stratified squamous epithelium]] of variable thickness, often with scattered [[ciliated]] cells
* Exception is when [[epithelium]] is derived from [[maxillary sinus]] and thus lined with [[respiratory epithelium]] ([[Pseudostratified ciliated columnar epithelium|pseudostratified ciliated columnar]] epithelium), may have acute [[Inflammatory cells|inflammatory cell]] infiltrate
|[[File:Abces parulique.jpg|center|219x219px]]
|-
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Tumors
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Appearance
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Associated conditions
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Locations
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Microscopic
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Epithelial tumors'''
* Focal keratosis
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Squamous cell carcinoma]]
|  
|
|
* Initially it may present as a painless, rough white or red lesion with [[induration]]
* In advanced stages it presents as a painful [[ulcerated lesion]] with elevated margins and increased nodularity and feels hard on palpation
* It may also appear as a fixed exophytic lesion with irregular margins, delayed healing after [[dental extraction]] or as a [[Cervical lymph nodes|cervical lymph node]] enlargement
|
|
* [[Tobacco use]]
* [[Alcohol]]
* [[HPV infection]]
|
|
* [[Lip]] [[SCC]] arise  almost exclusively  on the [[lower lip]]
* [[Buccal mucosa]]
* Upper and lower  [[gingiva]]
* [[Hard palate]]
* Anterior two-thirds  of the [[tongue]],  including dorsal, ventral and lateral surfaces, and the floor of mouth
|[[Squamous cell carcinoma]] may be well, moderately or poorly differentiated.
[[SCC]] variants:
'''Basaloid''':
* Bimorphic i.e. both basaloid and squamous cell component. Solid basaloid appearing [[Dysplastic change|dysplastic]] island with [[biphasic]] pattern showing comedo type [[necrosis]] and pseudoglandular pattern. Abrupt foci of squamous differentiation with or without [[keratin]] pearls.
'''Verrucous'''
* Intense [[keratinization]], compressive pattern and minimal [[atypia]].
'''Papillary'''
'''Spindle cell'''
'''Adenosquamous'''
'''Acantholytic'''
'''Cunniculatum'''
|[[File:Squamous cell carcinoma.jpg|center|219x219px]]
|-
|-
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Tumors
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Oral epithelial dysplasia<ref name="pmid20614284">{{cite journal |vauthors=Speight PM |title=Update on oral epithelial dysplasia and progression to cancer |journal=Head Neck Pathol |volume=1 |issue=1 |pages=61–6 |date=September 2007 |pmid=20614284 |pmc=2807503 |doi=10.1007/s12105-007-0014-5 |url=}}</ref>
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |etiology
|
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |location
* Lesion may appear as a [[homogeneous]] white or red patch, mixed white/red speckled area or as an [[ulcer]]
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Clinical appearance
|
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Gold standard/Diagnosis
* HPV-16, HPV-33
! rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" + |Image
|Common sites:
* [[Tongue]]
* Floor of the mouth
* [[Buccal mucosa]]
* [[Lips]]
* Other less common sites are [[gingiva]], retromolar area and [[palate]]
|Histopathologically it may be classified as
 
Mild:
* [[Hyperkeratosis]]
* [[Basilar]] [[hyperplasia]]
* Increased hyperchromaticity
* Lower third of epithelial thickness involved
Moderate:
* Parakeratosis
* Disorganization of the strata with [[basilar]] [[hyperplasia]]
* Nuclear enlargement and hyperchromaticity
* Drop shaped [[rete]] ridges involving one half of epithelial thickness
Severe:
* Loss of cellular organization and polarity
* [[Basilar]] [[hyperplasia]]
* nuclear enlargement and hyperchromaticity
* Drop shaped [[rete]] ridges involving two-third of epithelial thickness
|[[File:Leukoplakia 003.jpg|center|219x219px]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Proliferative verrucous leukoplakia
|
* Initially it may present as a white hyperkeratotic [[plaque]] that ultimately proliferates and becomes multifocal with confluent exophytic mass
|
* HPV
 
* EBV
 
* Candida
|
* [[Buccal mucosa]]
 
* [[Tongue]]
* [[Gingiva]]
* [[Alveolar ridge]]
|
* Microscopic findings depends on the stage of the dsease as it progresses from [[leukoplakia]] to verrucous [[hyperplasia]] then to [[verrucous carcinoma]] and then [[papillary]] [[squamous cell carcinoma]].
The histopathological findings associated with PVL are as under:
* Hyperkeratotic epithelium showing [[basilar]] [[hyperplasia]] and hyperchromatic cells extending upto lower third of epithelium
* [[Stroma]] consisting of [[collagen]] fibres with plum to spindle shaped [[fibroblasts]] with patchy distribution of [[lymphocytes]] and [[plasma cells]]
|[[File:Proliferative verrucous leukoplakia.jpg|center|219x219px]]
|-
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Papillomas'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Condyloma acuminatum]]
|
* Painless, rounded, dome-shaped  exophytic [[nodules]]
 
* 15 mm in diameter
 
* Have a broad base and a [[nodular]] or mulberry-like  surface that is  slightly red, pink  or of normal  [[Mucous membrane|mucosal]] color.
 
* Lesions may be  multiple and are usually clustered
|[[HPV]], most commonly types 6,11,16 and 18
|
* [[Labial]] [[mucosa]]
* [[Tongue]]
* [[Palate]]
|Several [[sessile]], [[Cauliflower ear|cauliflower]]-like swellings forming a cluster
|[[File:Condyloma acuminatum.jpg|center|219x219px]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Verrucous vulgaris
|Soft, [[Pedunculated|pedunculated  lesions]] formed by a  cluster of finger-like  fronds or a [[sessile]],  dome-shaped lesion with a [[nodular]], [[papillary]] or [[Verrucous carcinoma|verrucous]]  surface
|[[HPV]] subtype
 
2,4,6,7,10,40.
|
Any oral site may be affected mostly:
* [[Hard palate|Hard]] and [[soft  palate]]
 
* [[Labial]] [[Mucous membrane|mucosa]]
* [[Tongue]]
* [[Gingiva]]
|
* Exophytic and  comprise folds of [[hyperplastic]] [[stratified epithelium]]
* Cluster of finger-like projections
|[[File:Verrucous vulgaris.jpg|center|219x219px]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Multifocal epithelial hyperplasia
|
* Multiple asymptomatic [[lesions]]
 
* Soft rounded or flat plaque-like [[sessile]] swelling.
* Usually pink or white in color
* 2-10 mm in  diameter
|[[HPV]]
 
13 and 32
|
* All areas of the [[oral cavity]]
* [[Labia]]
* [[Buccal mucosa]]
* [[Tongue]]
|
* Rounded [[sessile]]  swelling formed by a sharply demarcated zone of [[epithelial]]  acanthosis
 
* [[Koilocyte|Koilocytes]] similar  to those of  squamous papilloma are  usually present
 
* “Mitosoid bodies”,  which are [[nuclei]]  with coarse clumped [[heterochromatin]] resembling a mitotic figure
|[[File:Hecks disease.jpg|center|219x219px]]
|-
|-
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tumors|Benign tumors]]
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Salivary type tumors'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mucoepidermoid carcinoma]]
* Epithelial tumors
|
|
* Asymptomatic
* Bluish, domed  swellings that  resemble  mucoceles or [[Hemangioma|haemangiomas]]
* High-grade tumors result in [[ulceration]], loosening of teeth, [[Paresthesia|paraesthesia]] or [[Anesthesia|anaesthesia]]
|
|
|
|
* [[Palate]] (most common site)
* [[Buccal mucosa]]
* [[Lips]]: upper>lower
* Floor of [[oral cavity]]
* Retromolar pad
|Low power [[microscopy]] shows low-grade tumor with both [[cystic]] and solid areas and an inflamed, fibrous [[stroma]]
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pleomorphic adenoma]]
* Mesenchymal tumors
|Painless, slow growing,  [[Submucosa|submucosal]] masses,  but when
 
traumatized may  [[bleed]] or [[Ulcer|ulcerate]]
|
|
|
* [[Palate]]
* [[Lips]] and
* [[Buccal mucosa]]
|Histopathological findings shows cellular, and [[hyaline]] or [[plasmacytoid]] cell
|[[File:Pleomorphic adenoma (Benign mixed tumor) oral 001.jpg|center|358x358px]]
|-
| rowspan="6" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Soft tissue and Neural tumors'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Granular cell tumor]]
|
|
* Lesion presents  as a smooth, [[sessile]] [[Mucous membrane|mucosal swelling]]
* 1-2 cm in diameter with a firm texture.
* The overlying  [[epithelium]] is of  normal color or may be slightly pale
|
|
|
|
* [[Tongue]] is the  most common  single site
* [[Buccal mucosa]]
* Floor of [[oral cavity]]
* [[Palate]]
* [[Salivary gland]]
|Plump [[eosinophilic]] cells with central small dark nuclei and abundant [[Cytoplasm|granular cytoplasm]]
|[[File:Granular cell tumor oral 001.jpg|center|219x219px]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Rhabdomyoma]]<ref name="pmid22305873">{{cite journal |vauthors=Zhang GZ, Zhang GQ, Xiu JM, Wang XM |title=Intraoral multifocal and multinodular adult rhabdomyoma: report of a case |journal=J. Oral Maxillofac. Surg. |volume=70 |issue=10 |pages=2480–5 |date=October 2012 |pmid=22305873 |doi=10.1016/j.joms.2011.12.006 |url=}}</ref>
* Salivary gland tumors
|
|
* It usually presents as a non tender smooth, [[solitary]] or rarely multifocal [[nodule]]. Or as a confined intramuscular mass in the [[tongue]]
|
|
* Floor of the mouth
* Base of the [[tongue]]
* [[Buccal mucosa]]
* [[Pharynx]]
* [[Larynx]]
|
* Histopathologically, adult type [[rhabdomyoma]] is composed of large, polygonal vacuolated cells with [[eosinophilic]] cytoplasm. [[Vacuolization]] varies among cells and gives it a spider web appearance
* While fetal type [[rhabdomyoma]] has [[striated muscle]] fibres in different stage of [[maturation]] mixed with undifferentiated [[mesenchymal]] cells arranged randomly in a edematous [[stroma]]
|[[File:Fetal intermediate cellular type rhabdomyoma.jpg|center|219x219px]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lymphangioma]]
|
|
* Circumscribed painless swelling
* Soft and fluctuant  on palpation
* Irregular nodularity of the dorsum of the [[tongue]]
|
|
* [[Developmental abnormality|Developmental  malformation]]
* [[Genetic disorder|Genetic  abnormalities]]
* [[Turner's syndrome]]
|
|
* [[Tongue]]
|Thin-walled, dilated  [[lymphatic vessels]]  of different size, which  are lined by a  flattened [[endothelium]]
|[[File:Lymphangioma oral 001.jpg|center|219x219px]]
|-
|-
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tumors|Malignant tumors]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Hemangioma]]<ref name="pmid24263242">{{cite journal |vauthors=da Silva WB, Ribeiro AL, de Menezes SA, de Jesus Viana Pinheiro J, de Melo Alves-Junior S |title=Oral capillary hemangioma: a clinical protocol of diagnosis and treatment in adults |journal=Oral Maxillofac Surg |volume=18 |issue=4 |pages=431–7 |date=December 2014 |pmid=24263242 |doi=10.1007/s10006-013-0436-z |url=}}</ref><ref name="pmid20181211">{{cite journal |vauthors=Dilsiz A, Aydin T, Gursan N |title=Capillary hemangioma as a rare benign tumor of the oral cavity: a case report |journal=Cases J |volume=2 |issue= |pages=8622 |date=September 2009 |pmid=20181211 |pmc=2827094 |doi=10.1186/1757-1626-0002-0000008622 |url=}}</ref><ref name="pmid23998020">{{cite journal |vauthors=Agarwal S |title=Treatment of oral hemangioma with 3% sodium tetradecyl sulfate: study of 20 cases |journal=Indian J Otolaryngol Head Neck Surg |volume=64 |issue=3 |pages=205–7 |date=September 2012 |pmid=23998020 |pmc=3431531 |doi=10.1007/s12070-011-0249-z |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
|
*  
* Flat, and [[erythematous]] red patches.
|
* [[POEMS syndrome]]
* [[Castleman disease]]
* PHACES syndrome
|
|
* [[Buccal mucosa]]
* [[Gums]]
* [[Lips]]
|
|
* Increased number of [[vessels]] (normal / abnormal)
* Readily recognizable [[vascular]] structures with [[red blood cells]] or [[Transudates|transudate]]
* Lined by single layer of non atypical [[endothelial cells]]
|[[File:Buccal hemangioma 001.jpg|center|219x219px]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Kaposi sarcoma]]<ref name="pmid26283853">{{cite journal |vauthors=Arul AS, Kumar AR, Verma S, Arul AS |title=Oral Kaposi's sarcoma: Sole presentation in HIV seropositive patient |journal=J Nat Sci Biol Med |volume=6 |issue=2 |pages=459–61 |date=2015 |pmid=26283853 |doi=10.4103/0976-9668.160041 |url=}}</ref><ref name="pmid22021973">{{cite journal |vauthors=Mehta S, Garg A, Gupta LK, Mittal A, Khare AK, Kuldeep CM |title=Kaposi's sarcoma as a presenting manifestation of HIV |journal=Indian J Sex Transm Dis AIDS |volume=32 |issue=2 |pages=108–10 |date=July 2011 |pmid=22021973 |pmc=3195171 |doi=10.4103/0253-7184.85415 |url=}}</ref>
|
|
* Purplish, reddish blue or dark brown [[macules]]
* [[Plaques]] and [[nodules]] that may [[Ulcerated lesion|ulcerate]]
|[[HIV]] and [[HHV-8]]
|
|
* [[Hard palate]] is most frequently affected, followed by the [[gums]]
|[[Spindle cell|Spindle cells]] with minimal [[nuclear]] atypia
|[[File:Kaposi's sarcoma oral 001.jpg|center|219x219px]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Myofibroblastic sarcoma<ref name="pmid17376304">{{cite journal |vauthors=Meng GZ, Zhang HY, Bu H, Zhang XL, Pang ZG, Ke Q, Liu X, Yang G |title=Myofibroblastic sarcomas: a clinicopathological study of 20 cases |journal=Chin. Med. J. |volume=120 |issue=5 |pages=363–9 |date=March 2007 |pmid=17376304 |doi= |url=}}</ref><ref name="pmid9777985">{{cite journal |vauthors=Mentzel T, Dry S, Katenkamp D, Fletcher CD |title=Low-grade myofibroblastic sarcoma: analysis of 18 cases in the spectrum of myofibroblastic tumors |journal=Am. J. Surg. Pathol. |volume=22 |issue=10 |pages=1228–38 |date=October 1998 |pmid=9777985 |doi= |url=}}</ref><ref name="pmid22935748">{{cite journal |vauthors=Yamada T, Yoshimura T, Kitamura N, Sasabe E, Ohno S, Yamamoto T |title=Low-grade myofibroblastic sarcoma of the palate |journal=Int J Oral Sci |volume=4 |issue=3 |pages=170–3 |date=September 2012 |pmid=22935748 |doi=10.1038/ijos.2012.49 |url=}}</ref>
*  
|
* Painless swelling or an enlarged mass
|
|
* [[Tongue]]
|
* Infiltrative tumor  with a diffuse growth pattern on a myxoid background
* [[Spindle]] shaped [[Tumor cell|tumor]] cells arranged in intertwined [[fascicles]] of varying length
* [[Tumor cell]] have scant amount of [[eosinophilic]] [[cytoplasm]] with a oval shaped nuclei
|
|
|-
| rowspan="3" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Hematolymphoid tumors'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Plasmablastic lymphoma<ref name="pmid25636338">{{cite journal |vauthors=Castillo JJ, Bibas M, Miranda RN |title=The biology and treatment of plasmablastic lymphoma |journal=Blood |volume=125 |issue=15 |pages=2323–30 |date=April 2015 |pmid=25636338 |doi=10.1182/blood-2014-10-567479 |url=}}</ref><ref name="pmid15578069">{{cite journal |vauthors=Vega F, Chang CC, Medeiros LJ, Udden MM, Cho-Vega JH, Lau CC, Finch CJ, Vilchez RA, McGregor D, Jorgensen JL |title=Plasmablastic lymphomas and plasmablastic plasma cell myelomas have nearly identical immunophenotypic profiles |journal=Mod. Pathol. |volume=18 |issue=6 |pages=806–15 |date=June 2005 |pmid=15578069 |doi=10.1038/modpathol.3800355 |url=}}</ref><ref name="pmid18756521">{{cite journal |vauthors=Castillo J, Pantanowitz L, Dezube BJ |title=HIV-associated plasmablastic lymphoma: lessons learned from 112 published cases |journal=Am. J. Hematol. |volume=83 |issue=10 |pages=804–9 |date=October 2008 |pmid=18756521 |doi=10.1002/ajh.21250 |url=}}</ref>
|It may appear as thickened ulcerative lesion that may invade the adjacent bone
|
|
* [[HIV]]
* [[EBV]]
* [[HHV-8]]
|Intraoally:
* [[Gingival]] [[mucosa]]
* [[Palatal]] [[mucosa]]
|
|
* Diffuse sheet of large immunoblastic, plasmablastic cells with abundant [[eosinophilic]] [[cytoplasm]] having peripheral nuclei and [[vesicular]] [[chromatin]]
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Langerhan cell histiocytosis]]<ref name="pmid14556926">{{cite journal |vauthors=Aricò M, Girschikofsky M, Généreau T, Klersy C, McClain K, Grois N, Emile JF, Lukina E, De Juli E, Danesino C |title=Langerhans cell histiocytosis in adults. Report from the International Registry of the Histiocyte Society |journal=Eur. J. Cancer |volume=39 |issue=16 |pages=2341–8 |date=November 2003 |pmid=14556926 |doi= |url=}}</ref><ref name="pmid7473016">{{cite journal |vauthors=Piattelli A, Paolantonio M |title=Eosinophilic granuloma of the mandible involving the periodontal tissues. A case report |journal=J. Periodontol. |volume=66 |issue=8 |pages=731–6 |date=August 1995 |pmid=7473016 |doi=10.1902/jop.1995.66.8.731 |url=}}</ref><ref name="pmid12907208">{{cite journal |vauthors=Eckardt A, Schultze A |title=Maxillofacial manifestations of Langerhans cell histiocytosis: a clinical and therapeutic analysis of 10 patients |journal=Oral Oncol. |volume=39 |issue=7 |pages=687–94 |date=October 2003 |pmid=12907208 |doi= |url=}}</ref>
*  
|
* [[Swelling]]
* [[Pain]]
* [[Gingivitis]]
* Loose teeth  and
* [[Ulceration]]
|
Associated with:
* [[Eosinophilic granuloma|Eosinophilic  granulomas]]
* Multifocal  multisystem  disease
|
|
* [[Jaw]] bone
* Intraoral soft tissues
* [[Gingiva]]
* [[Palate]]
* Floor of mouth
* [[Buccal mucosa]]
* [[Tonsil cancer|Tonsil]]
|Biopsy shows ovoid  [[langerhans cells]]
with deeply grooved [[nuclei]], thin [[nuclear membrane]] and abundant [[Eosinophilic|eosinophilic cytoplasm]]
|[[File:Langerhans cell histiocytosis - high mag.jpg|center|219x219px]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Extramedullary myeloid sarcoma<ref name="pmid24574662">{{cite journal |vauthors=Kurdoğlu B, Oztemel A, Barış E, Sengüven B |title=Primary oral myeloid sarcoma: Report of a case |journal=J Oral Maxillofac Pathol |volume=17 |issue=3 |pages=413–6 |date=September 2013 |pmid=24574662 |pmc=3927345 |doi=10.4103/0973-029X.125209 |url=}}</ref><ref name="pmid28361861">{{cite journal |vauthors=Kumar P, Singh H, Khurana N, Urs AB, Augustine J, Tomar R |title=Diagnostic challenges with intraoral myeloid sarcoma: report of two cases & review of world literature |journal=Exp. Oncol. |volume=39 |issue=1 |pages=78–85 |date=March 2017 |pmid=28361861 |doi= |url=}}</ref><ref name="pmid20512638">{{cite journal |vauthors=Papamanthos MK, Kolokotronis AE, Skulakis HE, Fericean AM, Zorba MT, Matiakis AT |title=Acute myeloid leukaemia diagnosed by intra-oral myeloid sarcoma. A case report |journal=Head Neck Pathol |volume=4 |issue=2 |pages=132–5 |date=June 2010 |pmid=20512638 |pmc=2878628 |doi=10.1007/s12105-010-0163-9 |url=}}</ref>
|Isolated tumor-forming intraoral mass
|History of acute  [[myeloid leukemia]],
predominantly in the [[Monocyte|monocytic]]or myelomonocytic subtypes
|
|
* [[Palate]]
* [[Gingiva]]
|
|
* [[Diffuse]] [[Infiltration (medical)|infiltration]] of the [[connective tissue]] by poorly differentiated [[hematopoietic]] cells
* the cells are large, round to oval with [[basophilic]] [[cytoplasm]] and dense [[nuclei]]
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Tumors of uncertain histiogenesis'''
*
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Congenital granular cell [[epulis]]<ref name="pmid20130770">{{cite journal |vauthors=Bosanquet D, Roblin G |title=Congenital epulis: a case report and estimation of incidence |journal=Int J Otolaryngol |volume=2009 |issue= |pages=508780 |date=2009 |pmid=20130770 |pmc=2809329 |doi=10.1155/2009/508780 |url=}}</ref><ref name="pmid19205730">{{cite journal |vauthors=Vered M, Dobriyan A, Buchner A |title=Congenital granular cell epulis presents an immunohistochemical profile that distinguishes it from the granular cell tumor of the adult |journal=Virchows Arch. |volume=454 |issue=3 |pages=303–10 |date=March 2009 |pmid=19205730 |doi=10.1007/s00428-009-0733-y |url=}}</ref>
|
|
* [[Solitary]]
* [[Pedunculated]] [[fibroma]] like lesion
|
|
* [[Congenital]]
* Spontaneously regresses over first 8 months of life
|
|
* [[Gum line|Gum]] pads
* Attached to the [[alveolar ridge]] near the midline
|
|
* Sheets of polygonal cells
* Abundant [[Granular cell|granular]], [[eosinophilic]] cytoplasm
* Single [[basophilic]] nucleus
* Scant fibrous [[stroma]]
|[[File:Eplis.png|center|231x231px]]
|-
|-
| rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tumors|Cysts]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Ectomesenchymal chondromyxoid tumor<ref name="pmid21115924">{{cite journal |vauthors=Angiero F |title=Ectomesenchymal chondromyxoid tumour of the tongue. A review of histological and immunohistochemical features |journal=Anticancer Res. |volume=30 |issue=11 |pages=4685–9 |date=November 2010 |pmid=21115924 |doi= |url=}}</ref><ref name="pmid8899780">{{cite journal |vauthors=Kannan R, Damm DD, White DK, Marsh W, Allen CM |title=Ectomesenchymal chondromyxoid tumor of the anterior tongue: a report of three cases |journal=Oral Surg Oral Med Oral Pathol Oral Radiol Endod |volume=82 |issue=4 |pages=417–22 |date=October 1996 |pmid=8899780 |doi= |url=}}</ref>
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
* Gingival cyst
|
|
* [[Asymptomatic]]
* Slow growing [[solitary]] [[nodule]]
|
|
|
|
*  [[Tongue]], mainly on its anterior side
|
* Tumor cells in myxoid, chondroid or hyalinized background
* Round, cup-shaped, [[fusiform]], or polygonal cells  with uniform small  [[nuclei]] and moderate amounts of [[Basophilic|faintly basophilic cytoplasm]]
* Some tumors may show nuclear  [[pleomorphism]],  hyperchromatism, and multinucleation
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| rowspan="4" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Cysts'''
* Lymphoepithelial cyst
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Oral Lymphoepithelial cyst ([[Branchial cleft cyst]])<ref name="pmid28936296">{{cite journal |vauthors=Sykara M, Ntovas P, Kalogirou EM, Tosios KI, Sklavounou A |title=Oral lymphoepithelial cyst: A clinicopathological study of 26 cases and review of the literature |journal=J Clin Exp Dent |volume=9 |issue=8 |pages=e1035–e1043 |date=August 2017 |pmid=28936296 |pmc=5601105 |doi=10.4317/jced.54072 |url=}}</ref><ref name="pmid22452887">{{cite journal |vauthors=Stramandinoli-Zanicotti RT, de Castro Ávila LF, de Azevedo Izidoro AC, Izidoro FA, Schussel JL |title=Lymphoepithelial cysts of oral mucosa: two cases in different regions |journal=Bull. Tokyo Dent. Coll. |volume=53 |issue=1 |pages=17–22 |date=2012 |pmid=22452887 |doi= |url=}}</ref>
|
|
* Painless
* White to yellow
* Soft to firm submucosal nodule
* Less than 1 cm
|
|
* [[HIV]]
|
|
* Floor of the mouth
* Laterla margin of the [[tongue]]
|Cystic cavity lined with:
* [[Stratified squamous]] and/or [[pseudostratified columnar]] epithelial cells containing desquamative epithelial and [[inflammatory cells]]
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Oral [[Epidermoid cyst]]<ref name="pmid12000893">{{cite journal |vauthors=De Ponte FS, Brunelli A, Marchetti E, Bottini DJ |title=Sublingual epidermoid cyst |journal=J Craniofac Surg |volume=13 |issue=2 |pages=308–10 |date=March 2002 |pmid=12000893 |doi= |url=}}</ref><ref name="pmid17351686">{{cite journal |vauthors=Ozan F, Polat HB, Ay S, Goze F |title=Epidermoid cyst of the buccal mucosa: a case report |journal=J Contemp Dent Pract |volume=8 |issue=3 |pages=90–6 |date=March 2007 |pmid=17351686 |doi= |url=}}</ref><ref name="pmid27721628">{{cite journal |vauthors=Puranik SR, Puranik RS, Prakash S, Bimba M |title=Epidermoid cyst: Report of two cases |journal=J Oral Maxillofac Pathol |volume=20 |issue=3 |pages=546 |date=2016 |pmid=27721628 |pmc=5051311 |doi=10.4103/0973-029X.190965 |url=}}</ref>
* Epidermoid cyst
|
* A slow growing nonfluctuating mass
* Soft and painless
|
|
|
|
* Commonly Midline or [[sublingual]] region of the floor of the [[mouth]]
* Rarely [[buccal mucosa]]
|
|
Histopathologically:
* The cavity is lined with [[stratified squamous epithelium]] and lumen containing lamellar [[keratin]]
|
|
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[ Lingual thyroglossal tract cyst]]<ref name="pmid8943128">{{cite journal |vauthors=Urao M, Teitelbaum DH, Miyano T |title=Lingual thyroglossal duct cyst: a unique surgical approach |journal=J. Pediatr. Surg. |volume=31 |issue=11 |pages=1574–6 |date=November 1996 |pmid=8943128 |doi= |url=}}</ref><ref name="pmid19598216">{{cite journal |vauthors=Burkart CM, Richter GT, Rutter MJ, Myer CM |title=Update on endoscopic management of lingual thyroglossal duct cysts |journal=Laryngoscope |volume=119 |issue=10 |pages=2055–60 |date=October 2009 |pmid=19598216 |doi=10.1002/lary.20534 |url=}}</ref>
* Thyroglossal tract cyst
|
|
* Painless or minimally painful
* Well defined, smooth and cystic mass
|
|
* Airway obstruction in infants
|
|
* Base of the tongue
|
|
* Cystic mass lined with non-keratinized stratified squamous epithelium with underlying stroma consisting of mucus glands, muscle fibres and inflammatory infiltrate
|[[File:Thyroglossal duct cyst.jpg|center]]
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Nasolabial cyst]] ( Klestadt cyst)<ref name="pmid4745964">{{cite journal |vauthors=Zucker SH, Altman R |title=An on-the-job vocational training program for adolescent trainable retardates |journal=Train Sch Bull (Vinel) |volume=70 |issue=2 |pages=106–10 |date=August 1973 |pmid=4745964 |doi= |url=}}</ref><ref name="pmid27604349">{{cite journal |vauthors=Sato M, Morita K, Kabasawa Y, Harada H |title=Bilateral nasolabial cysts: a case report |journal=J Med Case Rep |volume=10 |issue=1 |pages=246 |date=September 2016 |pmid=27604349 |pmc=5015322 |doi=10.1186/s13256-016-1024-2 |url=}}</ref><ref name="pmid20034824">{{cite journal |vauthors=Sumer AP, Celenk P, Sumer M, Telcioglu NT, Gunhan O |title=Nasolabial cyst: case report with CT and MRI findings |journal=Oral Surg Oral Med Oral Pathol Oral Radiol Endod |volume=109 |issue=2 |pages=e92–4 |date=February 2010 |pmid=20034824 |doi=10.1016/j.tripleo.2009.09.034 |url=}}</ref>
* Nasolabial cyst
|
* Non-tender distension of the [[nasolabial fold]] due to swelling and elevation of the lateral [[nasal]] [[ala]]
* It may extend inferiorily into [[labial]] [[sulcus]] or laterally widening the [[nasal]] [[vestibule]].
* Elevation of the bridge of the nose
|
|
|
* [[Nasal]] [[alar]] and sublabial region
* Anterior [[maxillary]] region
|
|
|  
* [[Pseudostratified columnar]] [[epithelium]] with intermittent occurrence of goblet like [[mucin]] producing cells and also [[Cuboidal epithelium|cuboidal]] epithelial lining
* [[Stroma]] consisiting of non-specific chronic inflammatory infiltrate and cholesterol cleft formation
|
|
|-
|-
Line 768: Line 1,188:


==References==
==References==
<references />
{{reflist|2}}

Latest revision as of 14:15, 26 February 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Muhammad Affan M.D.[2]

Surface oral lesions
Oral lesions Appearance Associated conditions Location Microscopic Image
White Lesions Leukoedema[1][2]
  • White or whitish grey edematous lesion
  • Diffuse or patchy
Fordyce granules[3][4][5][6]
  • White or yellow discrete papules
  • Symmetrically distributed
Benign migratory glossitis[7][8][9]
  • Red patches with white distinct border
  • Map like appearance
  • Dorsal/Lateral surface of the tongue
Hairy tongue[10][11][12][13]
Hairy leukoplakia[14][15]

White patches

  • Corrugated in appearance
  • Hairy, hair-like growths
  • Permanent
White sponge nevus[16][17]
  • White patches of tissue (nevi)
  • Singular or multiple
  • Thickened, velvety, sponge-like appearance
  • Parakeratosis, acanthosis
  • Extensive vacuolization
  • Dyskeratotic cells exhibit dense peri and paranuclear eosinophilic condensations
  • Abundant Odland bodies
Lichen Planus[18][19]
  • Reticular or papular lace like white lesions
  • Multiple, Painful
Frictional hyperkeratosis[20][21]
  • White shaggy plaques
  • Could be easily peeled without any pain leaving normal mucosa
Leukoplakia
  • White or grayish in patches that can't be wiped away
  • Irregular or flat-textured
  • Thickened or hardened in areas
  • Along with raised, red lesions (speckled leukoplakia or erythroplakia), which are more likely to show precancerous changes
Erythroplakia
Oral lesions Appearance Associated conditions Location Microscopic Image
Pigmented lesions
  • Ephelis
  • Flat red or light brown spots
  • 3–10 mm in diameter
  • Poorly defined and may merge into large patches
  • Predominant in outer lips
  • Focal pigmented brown lesions similar to ephelides
  • Flat and mostly smaller than 1 cm
  • Characterised by a focal increase in melanin production
  • Laugier Hunziker syndrome
  • Strong female predilection
  • Varies from dark brown to blue-black
  • Mucosa-colored and white lesions are occasionally noted
  • Erythema is observed when the lesions are inflamed.

Perioral

Intraorally

  • Orofacial deformity
  • Dental disorders
  • Bone pains
  • Compromised oral health
  • Predominantly involves musculo-skeletal defects of oral cavity
  • Gingiva
  • Pigmented fragments of metal within connective tissue
  • A scattered arrangement of black or dark brown granules
  • Large particles may be surrounded by chronically inflamed fibrous tissue
Oral lesions Appearance Associated conditions Location Microscopic Image
Vesicular/Erythematous

Ulcerative lesions

Infections Herpes simplex virusinfections[40][41][42]

Herpetic gingivostomatitis

  • Painful ulcers covered by a yellowish pseudomembrane
  • Ulcers that may coalesce to form bigger lesions
  • Self limiting after 7 days
  • HSV 1 Infection
  • Keratinized and non-keratinized mucosa.
  • Intra and intercellular edema (acantholysis)
  • Intranuclear inclusions
  • Multinucleate polykaryons (giant cells)
Herpes zoster[43][44][45]
  • Clustered small ulcers with characteristic unilateral pattern
  • Keratinocytes are multinucleated, acantholytic with distinct nuclear inclusions, found initially in follicular epithelium
  • Late epidermal necrosis or full-thickness acantholysis
  • Dermal nerve twigs may exhibit a perineural infiltrate of lymphocytes and neutrophils, sometimes associated with intraneural involvement
  • Schwann cell hypertrophy and frank neural necrosis are occasionally encountered
Hand foot mouth disease[46][47][48]
  • Irregularly shaped shallow ulcers with yellow-grey base and hyperemic margin.
  • Coxsackievirus
  • Vesicular lesions will demonstrate loose strands of fibrin, lymphocytes and neutrophils in the vesicular fluid.
  • The presence of acantholysis in the epidermis and perivascular infiltration of leukocytes is seen in hand foot and mouth disease.
  • The absence of intracelluar inclusion bodies differentiates it from the herpes simplex infection.
Infectious mononucliosis[49][50]
  • Epstein-Barr virus infection
  • Kissing's Disease
  • Reactive lymphoid hyperplasia
  • Extensive immunoblastic proliferation in sheets and nodules, marked atypia resembling Reed-Sternberg cells
Erosive lichen planus[51][52][53]
Pseudomembranous candidiasis[54][55][56]
  • Known as thrush.
  • Usually asymptomatic.
  • Confluent white wipeable plaques resembling curdled milk
  • Superficially the plaques can be wiped off and the underlying mucosa often exhibits an erythematous appearance.
  • Chronic medications
  • Immuno-suppressive conditions
  • Wet mount examination with 10% KOH or saline demonstrates hyphae, pseudohyphae, and blastospores.
Histoplasmosis[57][58][59][60][61]
  • Ohio and Mississippi river valleys
Blastomycosis[62][63][64]
  • Mississippi, Missouri and Ohio River valleys and the Great lakes region.
  • Ginguve
  • Mostly Pulmonary Nodules

Classic appearance on modified Wright's stain

Coccidiodomycosis[65][66][67][68]
  • Dust exposure in endemic areas, due to occupational activities agricultural or construction workers
  • Military personnel training in endemic areas
  • Construction work, and model airplane competitions
  • Natural disasters such as earthquakes and windstorms
  • Tongue

It is a dimorphic fungus and on microscopy, the following can be seen

Autoimmune diseases Pemphigus vulgaris[69][70][71]
  • Intraepithelial blister with acantholysis and chronic inflammation
Mucous membrane pemphigoid (Cicatricial pemphigoid)[72][73][74]
  • Subepidermal vesicle contains edema fluid, fibrin and variable inflammatory cells
  • Perivascular lymphohistiocytic infiltrate, plasma cells and neutrophils
  • Fewer eosinophils than generalized bullous pemphigoid
  • Conjunctival squamous metaplasia with foci of hyperkeratosis and parakeratosis, accompanied by goblet cell depletion; conjunctival vesicles or bulla are rare
Aphthous ulcer[75][76][77]
  • Shallow, round to oval ulcer with white or yellow pseudomembrane surrounded by halo
  • In chronic ulcer grey membrane may replace the yellow pseudomembrane
  • Appear on the non-keratinizing epithelial surfaces in the mouth.
  • Except the attached gingiva, the hard palate and the dorsum of the tongue
Erythema multiforme[78][79]
Sjogren's Syndrome

Affects salivary and lacrimal glands

Bullous pemphigoid
  • Psoriasis
  • Parkinson's disease
  • Dementia
  • Certain drugs e.g. spironolactone, loop diuretics and neuroleptics
  • Malignancies e.g. breast cancer
  • Unilocular, subepidermal, nonacantholytic blisters with festooning (suspended in a loop between two points) of dermal papillae, infiltrate including eosinophils located in blister cavity and in the dermis
  • Early erythematous lesion shows upper papillary dermal edema, perivascular lymphohistiocytic infiltrate, accompanied by conspicuous eosinophils
Idiopathic conditions Allergic contact stomatitis
Irritant contact stomatitis
Soft tissue oral lesions
Reactive lesions Appearance Associated conditions Location Microscopic Image
Inflammatory papillary hyperplasia
  • Benign lesion characterized by hyperemic mucosa
  • One or more bulbous or nodular growth measuring less than 2 mm
Fibrous hyperplasia
  • Presents as a yellowish–white or mucosal colored, sessile, smooth-surfaced, asymptomatic, soft nodule.
  • The surface may be hyperkeratotic or ulcerated, owing to repeated trauma.
Mucocele
  • Mucus cyst is a distinct, fluctuant, painless swelling of the mucosa.
  • <1 cm in diameter
  • Superficial lesions take on a bluish to translucent hue
  • Deep lesions have normal mucosal coloration
  • Bleeding into the swelling may impart a bright red and vascular appearance.
Necrotizing sialometaplasia
  • Non-ulcerated swelling that transforms into crater like ulcer
  • 1-5cms
Periodontal abscess
  • Originates in the dental pulp
  • Associated with living tooth
  • Neutrophils are found surrounding a central area of soft tissue debris and destroyed leukocytes.
  • At later stage, a pyogenic membrane is organized macrophages and neutrophils
Periapical abscess
  • Usually attached to tooth root
  • Firm or have deflated capsule
  • Lumen can contain thin serous or straw colored fluid, opaque yellow-white debris, muddy brown fluid from old hemorrhage or frank purulent debris
  • Originates in the dental pulp
  • Associated with dead tooth
Tumors Appearance Associated conditions Locations Microscopic Image
Epithelial tumors Squamous cell carcinoma
  • Initially it may present as a painless, rough white or red lesion with induration
  • In advanced stages it presents as a painful ulcerated lesion with elevated margins and increased nodularity and feels hard on palpation
  • It may also appear as a fixed exophytic lesion with irregular margins, delayed healing after dental extraction or as a cervical lymph node enlargement
  • Hard palate
  • Anterior two-thirds of the tongue, including dorsal, ventral and lateral surfaces, and the floor of mouth
Squamous cell carcinoma may be well, moderately or poorly differentiated.

SCC variants:

Basaloid:

  • Bimorphic i.e. both basaloid and squamous cell component. Solid basaloid appearing dysplastic island with biphasic pattern showing comedo type necrosis and pseudoglandular pattern. Abrupt foci of squamous differentiation with or without keratin pearls.

Verrucous

Papillary

Spindle cell

Adenosquamous

Acantholytic

Cunniculatum

Oral epithelial dysplasia[80]
  • Lesion may appear as a homogeneous white or red patch, mixed white/red speckled area or as an ulcer
  • HPV-16, HPV-33
Common sites: Histopathologically it may be classified as

Mild:

Moderate:

  • Parakeratosis
  • Disorganization of the strata with basilar hyperplasia
  • Nuclear enlargement and hyperchromaticity
  • Drop shaped rete ridges involving one half of epithelial thickness

Severe:

  • Loss of cellular organization and polarity
  • Basilar hyperplasia
  • nuclear enlargement and hyperchromaticity
  • Drop shaped rete ridges involving two-third of epithelial thickness
Proliferative verrucous leukoplakia
  • Initially it may present as a white hyperkeratotic plaque that ultimately proliferates and becomes multifocal with confluent exophytic mass
  • HPV
  • EBV
  • Candida

The histopathological findings associated with PVL are as under:

Papillomas Condyloma acuminatum
  • Painless, rounded, dome-shaped exophytic nodules
  • 15 mm in diameter
  • Have a broad base and a nodular or mulberry-like surface that is slightly red, pink or of normal mucosal color.
  • Lesions may be multiple and are usually clustered
HPV, most commonly types 6,11,16 and 18 Several sessile, cauliflower-like swellings forming a cluster
Verrucous vulgaris Soft, pedunculated lesions formed by a cluster of finger-like fronds or a sessile, dome-shaped lesion with a nodular, papillary or verrucous surface HPV subtype

2,4,6,7,10,40.

Any oral site may be affected mostly:

Multifocal epithelial hyperplasia
  • Soft rounded or flat plaque-like sessile swelling.
  • Usually pink or white in color
  • 2-10 mm in diameter
HPV

13 and 32

  • Rounded sessile swelling formed by a sharply demarcated zone of epithelial acanthosis
  • Koilocytes similar to those of squamous papilloma are usually present
Salivary type tumors Mucoepidermoid carcinoma Low power microscopy shows low-grade tumor with both cystic and solid areas and an inflamed, fibrous stroma
Pleomorphic adenoma Painless, slow growing, submucosal masses, but when

traumatized may bleed or ulcerate

Histopathological findings shows cellular, and hyaline or plasmacytoid cell
Soft tissue and Neural tumors Granular cell tumor
  • The overlying epithelium is of normal color or may be slightly pale
Plump eosinophilic cells with central small dark nuclei and abundant granular cytoplasm
Rhabdomyoma[81]
  • It usually presents as a non tender smooth, solitary or rarely multifocal nodule. Or as a confined intramuscular mass in the tongue
  • Floor of the mouth
Lymphangioma
  • Circumscribed painless swelling
  • Soft and fluctuant on palpation
  • Irregular nodularity of the dorsum of the tongue
Thin-walled, dilated lymphatic vessels of different size, which are lined by a flattened endothelium
Hemangioma[82][83][84]
Kaposi sarcoma[85][86] HIV and HHV-8 Spindle cells with minimal nuclear atypia
Myofibroblastic sarcoma[87][88][89]
  • Painless swelling or an enlarged mass
Hematolymphoid tumors Plasmablastic lymphoma[90][91][92] It may appear as thickened ulcerative lesion that may invade the adjacent bone Intraoally:
Langerhan cell histiocytosis[93][94][95]

Associated with:

Biopsy shows ovoid langerhans cells

with deeply grooved nuclei, thin nuclear membrane and abundant eosinophilic cytoplasm

Extramedullary myeloid sarcoma[96][97][98] Isolated tumor-forming intraoral mass History of acute myeloid leukemia,

predominantly in the monocyticor myelomonocytic subtypes

Tumors of uncertain histiogenesis Congenital granular cell epulis[99][100]
  • Congenital
  • Spontaneously regresses over first 8 months of life
Ectomesenchymal chondromyxoid tumor[101][102]
  • Tongue, mainly on its anterior side
Cysts Oral Lymphoepithelial cyst (Branchial cleft cyst)[103][104]
  • Painless
  • White to yellow
  • Soft to firm submucosal nodule
  • Less than 1 cm
  • Floor of the mouth
  • Laterla margin of the tongue
Cystic cavity lined with:
Oral Epidermoid cyst[105][106][107]
  • A slow growing nonfluctuating mass
  • Soft and painless

Histopathologically:

Lingual thyroglossal tract cyst[108][109]
  • Painless or minimally painful
  • Well defined, smooth and cystic mass
  • Airway obstruction in infants
  • Base of the tongue
  • Cystic mass lined with non-keratinized stratified squamous epithelium with underlying stroma consisting of mucus glands, muscle fibres and inflammatory infiltrate
Nasolabial cyst ( Klestadt cyst)[110][111][112]

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