Sandbox leucocytosis: Difference between revisions

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__NOTOC__
<div style="width: 70%;">
<small><small>
{| class="wikitable"
{| class="wikitable"
!Disease
|+
!Presentation
!Oral lesion
!Risk Factors
!Differentiating feature
!Diagnosis
!Symptoms
!Affected Organ Systems
!Location
!Important features
!Associated condition
!Picture
|-
! colspan="3" |Diseases predominantly affecting the oral cavity
!
!
!
!
|-
|-
|[[Oral candidiasis|Oral Candidiasis]]
|Benign migratory glossitis
|
|
* [[Dysphagia]] or [[odynophagia]]
* Red patches with white distinct border
* White patches on the mouth and tongue
* Map like appearance
| -
|Dorsal/Lateral surface of the tongue
|
|
*[[Newborn]] babies
*Denture users
*Poorly controlled [[diabetes]]
*As a side effect of medication, most commonly having taken [[antibiotic]]s. Inhaled [[corticosteroids]] for the treatment of lung conditions (e.g, [[asthma]] or [[COPD]]) may also result in oral candidiasis which may be reduced by regularly rinsing the mouth with water after taking the medication.
*People with poor [[nutrition]], specifically [[vitamin A]], [[Iron deficiency anemia|iron]] and [[Folate deficiency|folate deficiencies]].
*People with an [[immune deficiency]] (e.g. as a result of [[AIDS]]/[[HIV]] or [[chemotherapy]] treatment).
*Women undergoing hormonal changes, like [[pregnancy]] or those on [[birth control pills]].
*[[Organ transplantation]] patients
|
* Clinical diagnosis
* Confirmatory tests rarely needed
|'''Localized candidiasis'''
* [[Oral candidiasis|Oral]] and [[Esophageal candidiasis|esophageal candidasis]]
* [[Candida vulvovaginitis]]
* [[Chronic mucocutaneous candidiasis]]
'''Invasive candidasis'''
* [[Candidiasis|Candidaemia]]
* [[Endocarditis|Candida endocarditis]]
* [[Osteoarthritis|Candida osteoarticular disease]]
|
* [[Osteoarthritis|Oral candidiaisis is]] a benign self limiting disease unless accompanied by [[immunosuppression]].
|[[File:Human tongue infected with oral candidiasis--By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|thumb|Tongue infected with oral candidiasis - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg|400x400px]]
|-
|-
|[[Herpes simplex|Herpes simplex oral lesions]]
|Hairy tongue
|
|
* [[Fever]] 
* Elongated filiform lingual papillae
* [[Sore throat]]
* Carpet-like appearance
* Painful [[ulcer]]s
| -
|
|Dorsum of the tongue. '''25152586'''
* Stress
* Recent [[URTI]]
* Female sex
|
* Physical examination
* [[Viral culture]]
* [[Tzanck smear]]
|
* Orofacial Infection
* [[Herpes simplex anogenital infection|Anogenital Infection]]
* [[Herpes simplex ocular infection|Ocular Infection]]
* [[Herpes simplex encephalitis|Herpes Encephalitis]]
* [[Herpes simplex neonatorum|Neonatal Herpes]]
* [[Herpetic whitlow|Herpetic Whitlow]]
* [[Herpes gladiatorum|Herpes Gladiatorum]]
|
|
* The symptoms of primary [[HSV]] infection generally resolve within two weeks
|[[File:Herpesinfection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|thumb|Oral herpes simplex infection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg|400x400px]]
|-
|-
|[[Aphthous ulcer|Aphthous ulcers]]
|Leukoedema
|
* Painful, red spot or bump that develops into an open [[ulcer]]
|
* Being a female
* Between the ages of 10-40
* Family history of [[Aphthous ulcer|aphthous ulcers]]
|
|
* Physical examination
* White or whitish-gray edematous lesion
* Diagnosis of exclusion
* Diffuse or patchy
| -
|Buccal and labial oral mucosa'''7406518'''
|
|
* Oral cavity
|
* Self-limiting , [[Pain]] decreases in 7 to 10 days, with complete healing in 1 to 3 weeks
|[[File:Afta foto - By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358.jpg|thumb|Apthous ulcer on the under surface of the tongue|By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358|400x400px]]
|-
|-
|[[Squamous cell carcinoma]]
|White sponge nevus
|
|
*Non healing [[ulcer]], [[nodule]], indurated plaque or mass
* White patches of tissue (nevi)
*May involve [[skin]], [[lips]], inside the [[mouth]], [[throat]] or [[esophagus]]
* Thickened, velvety, sponge-like appearance
| -
|Toist lining of the oral mucosa buccal mucosa
|
|
* Chronic sun or [[Ultraviolet|UV exposure]]
|}
* Fair [[skin]]
__NOTOC__
* [[Elderly]] age (>45 yrs)
 
* [[Male sex]]
<div style="width: 70%;">
* [[Smoking]]
<small><small></small></small>
|
*[[Physical exam]]
*[[Biopsy]]
|
*[[Oral Cavity]]
**Floor of [[mouth]]
**Lateral [[tongue]]
*[[Throat]]
*[[Esophagus]]
|
*[[Malignant]]
*Can spread to [[TMJ]]
*Some times associated with [[leukoplakia]]
|[[File:PLoS oral cancer.png|thumb|400x400px|Squamous cell carcinoma - By Luca Pastore, Maria Luisa Fiorella, Raffaele Fiorella, Lorenzo Lo Muzio - http://www.plosmedicine.org/article/showImageLarge.action?uri=info%3Adoi%2F10.1371%2Fjournal.pmed.0050212.g001, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=15252632]]
|-
|[[Leukoplakia]]
|
*White leathery spots on the [[mucous membranes]] of the [[tongue]] and inside of the [[mouth]]
*Lateral borders of [[tongue]]
|
*Atypical [[Tobacco]] use
*Chronic [[irritation]]
*[[Immunodeficiency]]
*[[Bloodroot]] ([[Sanguinarine|sanguinaria]])
|
*[[Physical exam]]
*Diagnosis of exclusion
*[[Biopsy]]
|
*[[Vulva|Vulvar]] lesions occur independent of oral lesions
|
*Associated with [[HIV]]
*Persistant white spots
*[[Benign]] but can progress to [[carcinoma]] after almost 10 years
*Oral proliferative [[Leukoplakia|verrucous leukoplakia]] is an aggressive sub type with multiple lesions and higher conversion to [[warts]] or [[carcinoma]]
|[[File:Oral hairy leukoplakia (EBV, in HIV)a.jpg|thumb|400x300px|Leukoplakia - By Aitor III - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=9873087]]
|-
|[[Melanoma]]
|
*A lesion with [[ABCD]]
**[[Asymmetry]]
**Border irregularity
**Color variation
**[[Diamete]]r changes
*[[Bleeding]] from the lesion
|
*[[Ultraviolet|UV radiations]]
*[[Genetic predisposition]]
*[[Old age]]
*[[Male gender]]
*Family or personal history of [[melanoma]]
*Multiple benign or atypical [[Nevus|nevi]]
|
*[[ABCD]] characteristics
*[[Bleeding]] or [[ulceration]] may show [[malignancy]]
*Serum [[LDH]] may be elevated in case of [[malignancy]]
*[[Biopsy]]
|
*Can [[metastasize]]
*All [[UV radiation]] or sun exposed areas can be effected independently
*1-2 to hundreds of [[granules]]
|
*[[Neural crest cell]] derivative
*Development begins with disruption of [[nevus]] growth control
*Progression involves [[MAPK/ERK pathway]]
*[[RAS|N-RAS]] or [[BRAF]] [[oncogene]] also involved
|[[File:Palate malign melanoma 01.jpg|thumb|400x400px|Oral melanoma - By Emmanouil K Symvoulakis, Dionysios E Kyrmizakis, Emmanouil I Drivas, Anastassios V Koutsopoulos, Stylianos G Malandrakis, Charalambos E Skoulakis and John G Bizakis - Symvoulakis et al. Head & Face Medicine 2006 2:7 doi:10.1186/1746-160X-2-7 (Open Access), [1], CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=9839811]]
|-
|[[Fordyce spots]]
|
*Rice-like [[granules]] or [[spots]]
*Small, [[painless]], [[raised]], [[pale]], red or white
*1 to 3 mm in [[diameter]]
|
*Greasy skin types
*Some [[Rheumatic|rheumatic disorders]]
*[[Hereditary nonpolyposis colorectal cancer]]
**Lower [[gingiva]] (gums)
**[[Vestibular system|Vestibular mucosa]]
|
*[[Physical exam]]
*Small [[keratin]]-filled [[pseudocysts]]
*May be seen on [[incidental]] [[mucosal]] [[biopsy]]
**[[Biopsy]] not done for them primarily
|
*[[Oral cavity]]
**[[Vermillion border|Vermilion border]] of the lips
**[[Oral mucosa]] of the upper lip
*[[Buccal mucosa]] in the commissural region often bilaterally
*[[Genitals]]
|
*[[Benign neoplasms]] with [[sebaceous]] features
*Visible [[sebaceous glands]]
*No surrounding [[mucosal]] change
*Several adjacent [[glands]] may coalesce into a larger cauliflower-like cluster
|[[File:Fospot.jpg|thumb|400x400px|Fordyce spots - Por Perene - Obra do próprio, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19772899]]
|-
|[[Burning mouth syndrome]]
|
*Burning or [[tingling]] on the [[lips]], [[tongue]], or entire [[mouth]]
|
*[[Nutritional deficiencies]]
*Chronic [[anxiety]] or [[depression]]
*[[Diabetes type 2]]
*[[Menopause]]
*[[Oral thrush]] or [[dry mouth]], or damaged [[nerves]] transmitting taste
*[[Female gender ]]
*[[Menopause]]
|
*[[Presentation]]
*[[Physical exam]]
|
*[[Oral cavity]]
|
*Pain typically is low in the morning and builds up over the day
*Low dosages of [[benzodiazepines]], [[tricyclic antidepressants]] or [[anticonvulsants]] may be effective
|
|-
|[[Torus palatinus]]
|
*Bony growth on midline of the [[hard palate]]
*[[Nodular]] mass covered with normal [[mucosa]]
|
*[[Genetic predisposition]]
**[[Autosomal dominant]]
|
*[[Physical exam]]
*Types
**[[Torus palatinus|Flat tori]]
**[[Torus palatinus|Spindle tori]]
**[[Torus palatinus|Nodular tori]]
**[[Torus palatinus|Lobular tori]]
|
*[[Hard palate]]
|
*More common in [[Asian]] and Inuit populations
*Twice more common in [[females]]
*Repeated [[trauma]] can cause [[bleeding]]
*[[Surgery]] may be required in symptomatic
|[[File:06-06-06palataltoria.jpg|thumb|Torus palatinus|400x400px|Torus palatinus - By Photo taken by dozenist, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=846591]]
|-
| colspan="4" |'''Diseases involving oral cavity and other organ systems'''
|
|
|
|-
|[[Behçet's disease|Behcet's disease]]
|
*Painful [[mouth sores]]
*[[Acne]] like skin lesions
*Headache, [[fever]], poor [[balance]], [[disorientation]]
*[[Abdominal pain]], [[diarrhea]] or [[bleeding]]
*[[Uveitis]]
*Joint [[swelling]] and joint [[pain]]
*Genital [[sores]] wit [[pain]] and [[scaring]]
*[[Aneurysms]]
|
*Over active [[immune system]]
|
*[[Physical examination]]
|
*[[Mouth]]
*[[Genitals]]
*[[GIT]]
*[[Eye]]
*[[Joints]]
*[[Skin]]
*[[Vascular system]]
*[[Brain]]
|
*[[Outbreaks]] of exaggerated [[inflammation]]
*Affects smaller [[blood vessels]]
|[[File:Behcets disease.jpg|thumb|400x400px|Behcet's disease - By Ahmet Altiner MD, Rajni Mandal MD - http://dermatology.cdlib.org/1611/articles/18_2009-10-20/2.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17863021]]
|-
|[[Crohn's disease]]
|
*Chronic, episodic [[diarrhea]] or [[constipation]]
*[[Abdominal pain]]
*[[Vomiting]]
*[[Weight loss]] or [[weight gain]]
|
*[[Smoking]]
*[[Whites]] and [[European]] [[Jews]]
*[[Hormonal contraception]]
*Diets high in microparticles, sweet, fatty or refined foods
*Industrialized country
|
*Typical [[history]] and [[symptoms]]
*[[Skip lesions]] on [[biopsy]]
*[[Anti saccharomyces cerevisiae antibodies|Anti-Saccharomyces cerevisiae antibodies (ASCA)]]
*[[Anti-neutrophil cytoplasmic antibodies]] ([[ANCA]])
|
*[[Eyes]]
*[[Joints]]
*[[Skin]]
|
*May lead to
**[[Obstruction]]s
**[[Abscess]]es
**Free [[perforation]]
**[[Hemorrhage]]
|
|-
|[[Agranulocytosis]]
|
*[[Fever]] or [[chills]]
*Frequent [[infections]]
*Unusual [[redness]], [[pain]], or [[swelling]] around a wound
*Mouth [[ulcers]]
*[[Abdominal pain]]
*[[Burning sensation when urinating]]
*[[Sore throat]]
|
*[[Medications]]
*[[List of chemotherapeutic agents#Cytotoxic Chemotherapy|Cytotoxic chemotherapy]]
*[[Hematological malignancy|Hematologic malignancies]]
*[[Autoimmune disorders]]
|
*[[Neutropenia]] <100 cells per micro litre
*[[Eosinopenia]]
*[[Basopenia]]
|
*[[Oral cavity]]
*[[Skin]]
*[[GIT]]
*[[Urinary system]]
*[[Conjunctiva]]
|
*[[Immunocompromised|Immunocompromization]]
*Types
**[[Drug-induced]]
**[[Malignant]]
**[[Autoimmune]]
|
|-
|[[Syphilis]]
|
*[[Chancre]]
*Regional [[lymphadenopathy]]
|
*[[Multiple sexual partners]]
*Illicit [[drug use]]
*[[Unprotected sex]]
*[[Homosexual men|Men who have sex with men]]
*Residence in highly prevalent areas
*[[Human Immunodeficiency Virus (HIV)|HIV]] infection
*Presence of other [[STI]]s
*Previous history of [[Sexually transmitted disease|STIs]]
*[[Intravenous drug use]]
|
*[[Darkfield microscope|Darkfield microscopy]]
*Non [[Treponema|treponemal]] tests like [[VDRL]] and [[RPR test]])
*[[Treponema|Treponemal]] tests[[FTA-ABS|FTA-ABS tests]], (TP-PA) assay, [[Enzyme linked immunosorbent assay (ELISA)|enzyme immunoassays]], and [[Chemiluminescence|chemiluminescence immunoassays]])
|
*[[Oral cavity]]
*[[Penis]]
*[[Cervix]]
*[[Labia]]
*[[Anal canal]]
*[[Rectum ]]
*[[CNS]]
*[[Cardiovascular|CVS]]
|
*[[Primary syphilis]]
**[[Chancre]]
*[[Secondary syphilis]]
**[[Condyloma latum|Condylomata lata]]
*[[Latent syphilis]]
**[[Asymptomatic]]
*[[Tertiary syphilis]]
**[[Gumma|Gummas]]
**[[Neurosyphilis]]
|[[File:Hutchinson teeth congenital syphilis PHIL 2385.rsh.jpg|thumb|400x400px|oral syphilis - By CDC/Susan Lindsley - http://phil.cdc.gov/phil_images/20021114/34/PHIL_2385_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134349]]
|-
|[[Coxsackie virus]]
|
*[[Fever]]
*[[Sores]] in the [[mouth]]
*[[Rash]] with [[blisters]]
*[[Aches]]
|
*[[Pregnancy]]
*[[immunodeficiency]]
|
*[[History]] and [[Physical exam]]
*[[Swabbing|Throat swabs]]
*Swabs from the lesion
*[[Tzanck test]]
|
*[[Oral cavity]]
*[[Skin]]
|
*Symptomatic treatment
|[[File:Hand foot mouth disease 07a.jpg|thumb|400x400px|Hand-foot-and-mouth disease - adapted from atlasdermatologico.com]]
|-
|[[Chickenpox|Chicken pox]]
|
*[[Conjunctival]] symptoms
*[[Catarrhal]] symptoms
*Characteristic [[spots]] on the trunk appearing in two or three waves
*[[Itching]]
|
*[[Pregnancy]]
*[[Premature infants]] born to susceptible mothers
*All [[infants]] born at less than 28 weeks [[gestation]] or who weigh =1000 grams
*[[Immunocompromised]]
|
*[[History]] and [[physical exam]]
*[[PCR]] to detect [[VZV]] in [[skin lesions]] ([[vesicles]], [[scabs]], [[Maculopapular|maculopapular lesions]])
|
*[[Oral cavity]]
*[[Skin]]
|
*[[Sodium bicarbonate]] in baths or [[antihistamines]] for [[itching]]
*[[Paracetamol]] ([[acetaminophen]]) for [[fever]]
*[[Prednisolone]] is [[contraindicated]]
|[[File:Herpangina2016.jpg|thumb|400x400px|Chickenpox - By James Heilman, MD - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=52872565]]
|-
|[[Measles]]
|
*[[Fever]]
*[[Rash]]
*[[Cough]]
*[[Coryza]] (runny nose)
*[[Conjunctivitis]] (pink eye)
*[[Malaise]]
*[[Koplick spots]] in mouth
|
*Unvaccinated individuals
*Crowded and/or unsanitary conditions
*Traveling to less developed and developing countries
*Immunocompromized
*Winter and [[spring]] seasons
*Born after 1956 and never fully vaccinated
*Health care workers
|
*[[History]] and [[examination]]
*[[PCR]] for [[Measles]]-specific [[IgM|IgM antibody]]
*[[PCR]] for [[Measles]] [[RNA]]
|
*[[Oral cavity]]
*[[Skin]]
*[[Respiratory tract]]
*[[Eyes]]
*[[Throat]]
|
*Caused by [[Morbillivirus]]
*Primary site of infection is the [[respiratory epithelium]] of the [[nasopharynx]]
*Transmitted in [[respiratory secretions]], via [[aerosol droplets]] containing [[Virus|virus particles]]
|[[File:Koplik spots, measles 6111 lores.jpg|thumb|400x400px|Koplick spots (Measles) - By CDC - http://phil.cdc.gov/PHIL_Images/20040908/4f54ee8f0e5f49f58aaa30c1bc6413ba/6111_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=824483]]
|}</small></small>
{|
{|
|-
|-
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! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated conditions
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated conditions
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Image
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Image
|-
! colspan="9" |White lesions
|-
|-
| rowspan="16" style="background: #DCDCDC; padding: 5px; text-align: left;" |
| rowspan="16" style="background: #DCDCDC; padding: 5px; text-align: left;" |
Line 495: Line 84:
* Carpet-like appearance  
* Carpet-like appearance  
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
| colspan="2" style="background: #F5F5F5; padding: 5px;" |
* Dorsum of the tongue.
* Dorsum of the tongue. 25152586
|-
|-
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: left;" |
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: left;" |
Line 760: Line 349:
| style="background: #F5F5F5; padding: 5px;" |  
| style="background: #F5F5F5; padding: 5px;" |  
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| colspan="8" |Vesicular/Ulcerative/Erythematous
!
|-
|-
| rowspan="18" style="background: #DCDCDC; padding: 5px; text-align: left;" |
| rowspan="18" style="background: #DCDCDC; padding: 5px; text-align: left;" |
* Vesicular/Ulcerative/Erythematous
*  
| style="background: #DCDCDC; padding: 5px; text-align: left;" |
| style="background: #DCDCDC; padding: 5px; text-align: left;" |
* Hereditary
* Hereditary

Revision as of 21:03, 24 January 2019

Oral lesion Differentiating feature Symptoms Location Associated condition
Benign migratory glossitis
  • Red patches with white distinct border
  • Map like appearance
- Dorsal/Lateral surface of the tongue
Hairy tongue
  • Elongated filiform lingual papillae
  • Carpet-like appearance
- Dorsum of the tongue. 25152586
Leukoedema
  • White or whitish-gray edematous lesion
  • Diffuse or patchy
- Buccal and labial oral mucosa7406518
White sponge nevus
  • White patches of tissue (nevi)
  • Thickened, velvety, sponge-like appearance
- Toist lining of the oral mucosa buccal mucosa


Surface Lesions of Oral Mucosa Description Location Associated conditions Image
White lesions
  • White
  • Epithelial
  • Geographic tongue/Benign migratory glossitis
  • Unknown etiology
  • Mostly asymptomatic but rarely burning sensation
  • Decreased papillae
  • Red patches with white distinct border giving it a map like appearance
  • Diagnosis is clinical but a biopsy may be indicated
  • No treatment for asymptomatic cnditions
  • Anesthetics/antihistamines/Steroids for pain
  • Dorsal/Lateral surface of the tongue
  • Psoriasis
  • Diabetes
  • Reiter's syndrome
  • Down's syndrome
  • Pregnancy
  • Medicine such as Oral contraceptive pills, lithium carbonate
  • Asthma
  • Hairy tongue
  • Elongated filiform lingual papillae
  • Carpet-like appearance
  • Dorsum of the tongue. 25152586
  • Leukoedema
  • White sponge nevus
  • Hairy leukoplakia
  • Lichen planus
  • Nicotinic stomatitis
  • Hyperkeratosis
  • Epithelial dysplasia
  • Carcinoma in-situ
  • Squamous cell carcinoma
  • Surface debris
  • Candidiosis
  • Burn
  • Subepithelial
  • Congenital keratotic cyst
  • Scar
  • Fordyce granules
  • Pigmented
  • Localized
  • Intravascular
  • Hemangioma
  • Varix
  • Kaposi sarcoma
  • Extravasated blood
  • Hematoma
  • Ecchymosis
  • Petechiae
  • Melanocytic
  • Oral melanocytic macule
  • Nevus
  • Melanoma
  • Ephelis
  • Tattoo
  • Diffuse
  • Hereditary
  • Addison's disease
  • Heavy metal ingestion
  • Peutz-Jeghers syndrome
  • Neurofibromatosis
  • Polyostotic fibrous dysplasia
  • Pregnancy
  • Medication
  • Smoker's melanosis
Vesicular/Ulcerative/Erythematous
  • Hereditary
  • Epidermolysis bullosa
  • Viral
  • Herpes simplex
  • Herpangina
  • Hand foot and mouth disease
  • Herpes zoster
  • Infectious mononucleosis
  • Varicella
  • Autoimmune
  • Erosive lichen planus
  • Mucous memrane pemphigoid
  • Pemphigous vulgaris
  • Bullous pemphigoid
  • Lupus erythmatosus
  • Idiopathic
  • Aphthous ulcer
  • Erythema multiforme
  • Erythroplakia
  • Medication induced mucositis
  • Contact stomatitis
  • Mycotic
  • Candidiosis
Soft Tissue Lesion Description Location Asssociated conditions Treatment Image
  • Tumor/Neoplasms
  • Benign
  • Epithelial
  • Papilloma
  • Verruca vulgaris
  • Condyloma acuminatum
  • Mesenchymal
  • Fibroma
  • Peripheral ossifying fibroma
  • Leiomyoma
  • Rhabdomyoma
  • Peripheral giant cell granuloma
  • Hemangioma
  • Lymphangioma
  • Pyogenic granuloma
  • Lipoma
  • Neuroma
  • Neurofibroma
  • Schwannoma
  • Granular cell tumor
  • Congenital epulis
  • Salivary gland
  • Pleomorphic adenoma
  • Papillary cystadenoma lymphomatosum
  • Adenoid cystic carcinoma
  • Acinic cell adenocarcinoma
  • Mucoepidermoid carcinoma low grade
  • Polymorphous low grade adenocarcinoma
  • Acinic cell adenocarcinoma
  • Cyst
  • Gingival cyst of adult
  • Lymphoepithelial cyst
  • Epidermoid/dermoid cyst
  • Thyroglossal tract cyst
  • Malignant
  • Squamous cell carcinoma
  • Verrucous carcinoma
  • Lymphoma
  • Melanoma
  • Sarcoma
  • Salivary gland adenocarcinoma
  • Adenoid cystic carcinoma
  • Mucoepidermoid carcinoma
  • Polymorphous low grade adenocarcinoma
  • Acinic cell adenocarcinoma
  • Metastatic carcinoma
  • Reactive
  • Sinus track
  • Periodontal abscess
  • Mucocele
  • Fibrous hyperplasia
  • Inflammatory papillary hyperplasia
  • Necrotizing sialometaplasia
Type of cancer Subtype Epidemiology Localization Clinical features Diagnostic procedures
Squamous cell carcinoma
  • Basaloid squamous cell carcinoma
  • Papillary squamous cell carcinoma
  • Spindle cell carcinoma
  • Acantholytic squamous cell carcinoma
  • Adenosquamous carcinoma
Verrucous carcinoma
  • Older males
  • 5th and 6th decades of life
  • Males are affected more often than females
  • Hard palate
  • Anterior two-thirds of the tongue, including dorsal, ventral and lateral surfaces, and the floor of mouth
  • Often asymptomatic or may present with vague symptoms and minimal physical finding
Biopsy shows:

Thickened club-shaped

papillae and blunt stromal invaginations

of well-differentiated squamous epithelium with marked keratinization

Lymphoepithelial carcinoma 0.8-2% of all oral or oropharyngeal cancers
  • Some tumors can be bilateral
Biopsy chows:
Epithelial precursor lesions --- --- Seen in the entire digestive tract Biopsy shows:
Proliferative verrucous leukoplakia and precancerous conditions ---
  • Average age at diagnosis is 62 years
  • Women are more commonly afflicted (ratio, 4:1)
An aggressive form of oral leukoplakia with considerable morbidity and

strong predilection to malignant transformation

Biopsy shows:
Papillomas Squamous cell papilloma and

verruca vulgaris

  • Common in children and in adults in the 3rd to 5th decades
  • Almost equal sex incidence with a slight male predominance
Any oral site may be affected mostly: Soft, pedunculated lesions formed by a cluster of finger-like fronds or a sessile, dome-shaped lesion with a nodular, papillary or verrucous surface Biopsy shows:
Condyloma acuminatum 2nd and 5th decade with a peak in teenagers and young adults
  • 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 then usually clustered
Biopsy shows:

Several sessile, cauliflower-like swellings forming a cluster

Focal epithelial hyperplasia Disease of children, adolescents and young adults
  • Soft rounded or flat plaque-like sessile swelling.
  • Usually pink or white in color
  • 2-10mm in diameter
Biopsy shows:
  • Rounded sessile swelling formed by a sharply demarcated zone of epithelial acanthosis
  • Koilocytes similar to those of squamous papilloma are usually present
Granular cell tumor ---
  • Arise in all age groups, with a peak between 40 and 60 years
  • Females are affected more often than males with an M/F ratio of 2:1
  • The overlying epithelium is of normal color or may be slightly pale
Biopsy shows:
Keratoacanthoma ---
  • Occurs more often in

whites

  • Twice as frequent in

men as in women

Biopsy shows:
Papillary hyperplasia --- Affects all age groups Palate Asymptomatic nodular or papillary mucosal lesion Biopsy shows:
  • Parakeratinisation or less frequently orthokeratinisation
Median rhomboid glossitis --- --- Dorsum of the tongue at the junction of the anterior two thirds

and posterior third

Forms a patch of papillary atrophy in the region of the

embryological foramen caecum

Biopsy shows:
Salivary gland tumors Acinic cell carcinoma
  • 2-6.5% of all intraoral salivary gland tumors
  • Age range from 11-77 years, with a mean of 45 years
  • Male to female ratio of 1.5:1
Tumors usually

form non-descript swellings

Biopsy shows:
  • Solid sheets of epithelium with secretory material
  • Ductal differentiation in tumors
Mucoepidermoid carcinoma
  • 9.5-23% of all minor gland tumors
Low power microscopy shows low-grade tumor with both cystic and solid areas and an inflamed, fibrous stroma
Adenoid cystic carcinoma
  • 42.5% of minor gland tumors
Predominantly solid variant shows peri- and intraneural invasion
Epithelial-myoepithelial

carcinoma

--- --- --- ---
Clear cell carcinoma,

NOS

--- --- ---
Basal cell

adenocarcinoma

Rare in minor glands Asymptomatic, smooth or lobulated sub-mucosal masses Microscopically similar to basal

cell adenocarcinomas of the major gland

Cystadenocarcinoma 32% developed in the minor glands Slow growing and painless but

some palatal tumors may erode the

underlying bone causing sinonasal complex

---
Salivary duct carcinoma
  • Rare in minor salivary glands
  • Age range was 23-80 years (mean 56 years)
Tumors formed painless swellings but many in the palate can be painful and ulcerated or fungated with metastases to regional lymph nodes The range of

microscopical appearances is similar

to that seen in the major glands

Salivary gland adenomas Pleomorphic adenoma 40-70% of minor gland tumors Painless, slow growing, submucosal masses, but when

traumatized may bleed or ulcerate

Biopsy shows cellular, and hyaline or plasmacytoid cell
Myoepithelioma 42% of minor gland tumors --- ---
Basal cell adenoma 20% of minor gland tumors --- They are histologically

similar to those in major glands.

Cystadenoma 7% of benign minor gland tumors --- ---
Kaposi sarcoma --- Biopsy of all 4 types show:
Lymphangioma ---
  • Appear mostly in the head and neck area but may be found in any other part of the body
Tongue
  • Circumscribed painless swelling
  • Soft and fluctuant on palpation
  • Irregular nodularity of the dorsum of the tongue
Biopsy shows:
Ectomesenchymal chondromyxoid

tumour of the anterior tongue

---
  • Age range varies from 9-78 years
  • No distinct sex predilection.
--- Asymptomatic, slow growing solitary nodule in the anterior dorsal tongue Biopsy shows:
Focal oral mucinosis (FOM) ---
  • The lesion affects all ages
  • Rare in children
  • There is no distinct sex predilection.
Asymptomatic fibrous or cystic-like lesion Histopathology is characterized by:
  • Mucinous material shows alcianophilia at pH 2.5
Congenital granular cell epuli ---
  • Affects newborns
  • Females are affected ten times more often than males
Solitary, somewhat pedunculated fibroma-like lesion attached to the alveolar

ridge near the midline

Hematolymphoid tumors Non-Hodgkin lymphoma Second most common cancer of the oral cavity NHL of the lip presents with: Biopsy shows:
  • Large cells with predominantly round nuclei and membrane-bound nucleoli, consistent with centroblastic morphology.
  • Predominantly medium-sized cells with abundant pale cytoplasm.
  • Large cells with round or multilobated nuclei
Langerhans cell histiocytosis ---
  • Jaw bone
  • Intraoral soft tissues
  • Gingiva

and

Common oral symptoms

include:

Biopsy shows ovoid Langerhans cells

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

Hodgkin lymphoma --- Most patients present with localized disease (stage I/II), with ---
Extramedullary myeloid

sarcoma

--- Isolated tumor-forming intraoral mass Biopsy shows an Indian-file pattern of infiltration
Follicular dendritic cell

sarcoma / tumour

  • Tumor of adulthood
  • Affects wide age range
The patients usually

present with a painless mass

Biopsy usually exhibits

borders and comprises:

  • Storiform arrays or
  • Diffuse sheets of spindly to ovoid tumor cells sprinkled with small lymphocytes
Mucosal malignant melanoma ---
  • 0.5% of oral malignancies
  • Incidence 0.02 per 100,000
80% arise:

Others:

  • Floor of mouth
  • Biopsy:
  • S100 positive
  • Negative for cytokeratins
  • More specific markers include:
  • HMB45,
  • Melan-A or anti-tyrosinase