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Answer : Pleomorphic adenoma The most common salivary gland tumour 2-3.5 cases / 100,000 Occurs in all ages Most common 3-6 th decades Female : Male = 2 : 1 Parotid >Palate>Submandibular Usually solitary but synchronous or metachronus lesions may occus Major glands – encapsulated Minor glands – non encapsulated Histopathology Main diagnostic Duct like structures and + mucin casts Epithelial component Stroma Ductal epithelial cells – 2 layered inner squamous and outer cuboidal Duct like Strands Islands Myxoid Mucoid Myoepithelial cells- produce stroma Spindle Plasmacytoid Ovoid Epitheliod Chondroid – similar to hyaline cartilage Osseous Squamous metaplasia and keratin pearls may not be unusual Mutation – PLAG1 Hyalinization and very dense collagenation – Very high chance of malignancy Types of malignancy arising from PA Ca. Ex – pleomorphic adenoma (Adeno ca, duct ca, myoepithelial ca) Carcino sarcoma Metastasizing PA – Histologically ...

Oral Pathology Shot case 10 - 35 Year Male - Whitish lesion in the buccal mucosa

Answer : Oral lichen planus Varying degrees of orthokeratosis and parakeratosis may be present on the surface of the epithelium The thickness of the spinous layer can also vary. The rete ridges may be absent or hyperplastic, but they classically have a pointed or “saw-toothed” shape Destruction of the basal cell layer of the epithelium (hydropic degeneration) is also evident. This is accompanied by an intense, bandlike infiltrate of predominantly T lymphocytes immediately subjacent to the epithelium Degenerating keratinocytes may be seen in the area of the epithelium and connective tissue interface and have been termed colloid, cytoid, hyaline, or Civatte bodies. Download the Oral Pathology Short cases clicking the following link Click Here

Oral Pathology Short Case 6 - 60 Years old Male - Lump in the parotid

Answer : Warthin tumour Second most common tumour of salivary gland 5-15% of all cases 6 th and 7 th decades Male > Female Linked to cigarette smoking Table 6 Histopathology Papillary projections lined by epithelium Lymphoid stroma Papillary cystic structures lined by epithelium Epithelium Inner – Columnar Outher - Cuboidal With germinal centers After FNAC – necrosis confused with malignancy Granulomatous reaction with langerhan type giant cells may seen Oncocytes – epithelial cells characterized by excessive number of mitochondria When present in a lower pole metastatic node is a suspicion May associate with HIV (P 27 positivity in HIV) Technetium 99 may appear as hot lesion Complete surgical excision with adequate margin Parotid resection nomenclature Anatomical Functional Extracapsular dissection Partical parotidectomy Superficial parotidectomy Deep parotidectomy Conservative Semi conservative Radical Eg : Conservative superficial parotidectomy D...

Oral Pathology Short case 9 - Lump on the buccal mucosa

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Dr R M Sumudu Himesha B Medawela BDS(Pera), MD(Col)

SL OMFX

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Oral Pathology Shot case 10 - 35 Year Male - Whitish lesion in the buccal mucosa

Oral Pathology Short case 9 - Lump on the buccal mucosa

Oral Pathology Short Case 8 - Swelling of the lip and rough buccal mucosa in a 25 Year old Male

Oral Pathology Short Case 7 - Non healing ulcer on lateral tongue for 2 weeks duration

Oral Pathology Short Case 6 - 60 Years old Male - Lump in the parotid

Oral Pathology Short Case 5 - 15-year old Female - Lesion present in anterior maxilla. A mixed radiodense lesion

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Oral Pathology Short case 9 - Lump on the buccal mucosa