Pathology #13 - Odontogenic And Non-Odontogenic Cysts

Front 1

What are the two primary classifications of cysts?

Back 1

Odontogenic and Non-odontogenic

Front 2

What are the two main classes of ODONTOGENIC CYSTS?

Back 2

Developmental
Inflammatory

Front 3

Define PALATAL CYST OF NEWBORN:

Back 3

common, small developmental cyst on the palate of newborn infants

Front 4

What are the two types of PALATAL CYST OF NEWBORN?

Back 4

- epstein's pearls
- Bohn's nodules

Front 5

Describe the similarities/differences between EPSTEIN'S PEARLS and BOHN's NODULES:

Back 5

BOTH- 1-3mm white/yellowish papules, probably arising from epithelium

EPSTEIN - located along median palatal raphe
BOHN - scattered over hard palate, often near soft palate junction

Front 6

What is the most common NON-ODONTOGENIC CYST OF THE ORAL CAVITY?

Back 6

NASOPALATINE DUCT CYST

Front 7

Where does the NASOPALATINE DUCT CYST arise from?

Back 7

Remnants of the nasopalatine duct (embryologic structure connecting oral and nasal cavities)

Front 8

What are the three most common presenting signs of NASOPALATINE DUCT CYST?

Back 8

- swelling of anterior palate
- drainage
- pain
- some cases may be asymptomatic and only discovered on routine radiography

Front 9

Define "CYSTS OF INCISIVE PAPILLA"

Back 9

Nasopalatine duct cysts that develop entirely within the soft tissue of the incisive papilla

Front 10

What is the treatment of nASOPALATINE DUCT CYST?

Back 10

- Surgical enucleation

Front 11

Define "MEDIAN PALATAL CYST":

Back 11

- rare fissural cyst

Front 12

How does the MEDIAN PALATAL CYST arise?

Back 12

Theoretically, from epithelium trapped along embryonic line of fusion of the lateral palatal shelves of the maxilla

Front 13

How does a MEDIAN PALATAL CYST present?

Back 13

firm or fluctuant swelling of the midline hard palate posterior to the palatine papilla

Front 14

WHat is the treatment of MEDIAN PALATAL CYST?

Back 14

Surgical removal

Front 15

Define NASOLABIAL CYST:

Back 15

a rare developmental cyst that occurs in the upper lip lateral to the midline

Front 16

What are the two theories of pathogenesis of NASOLABIAL CYST?

Back 16

- arise from epithelial remnants entrapped along line of fusion of max, medial nasal, and lateral nasal processes
- arise from misplaced epithelium of nasolacrimal duct

Front 17

What is the clinical presentation of NASOLABIAL CYST?

Back 17

soft tissue swelling of the upper lip lateral to the midline (over canine area), resulting in elevation of ala of the nose.

Front 18

What is the treatment of NASOLABIAL CYST?

Back 18

surgical enucleation

Front 19

Which ODONTOGENIC CYSTS probably arise from dental lamina?

Back 19

- odontogenic keratocyst
- lateral periodontal cyst
- gingival cyst of adult
- dental lamina cyst of newborn
- glandular odontogenic cyst

Front 20

Which ODONTOGENIC CYSTS probably arise from reduced enamel epithelium?

Back 20

- dentigerous cyst
- eruption cyst

Front 21

Which ODONTOGENIC CYSTS probably arise from rest of Malassez?

Back 21

- periapical cyst
- residual cyst

Front 22

Which cysts are associated with the crown of an unerupted tooth?

Back 22

- DENTIGEROUS CYST
- OKC
- ORTHOKERATINIZED ODONTOGENIC CYST
- CALCIFYING ODONTOGENIC CYST

Front 23

What is the most common type of developmental odontogenic cyst?

Back 23

Dentigerous cyst

Front 24

What are possible complications of DENTIGEROUS CYST?

Back 24

- extensive bone destruction with growth
- resorption of adjacent tooth roots
- displacement of teeth
- several epithelial neoplasms may including ameloblastoma, mucoepidermoid carcinoma and squamous cell carcinoma may arise in the lining of a dentigerous cyst

Front 25

Define CERVICAL LYMPHOEPITHELIAL CYST (Branchial Cleft cyst):

Back 25

Unusual developmental cyst of the lateral neck

Front 26

Define ORAL LYMPHOEPITHELIAL CYST:

Back 26

Uncommon lesion that develops within oral lymphoid tissue

Front 27

What is the treatment of CERVICAL LYMPHOEPITHELIAL CYST?

Back 27

Surgical removal

Front 28

What is the treatment of ORAL LYMPHOEPITHELIAL CYST?

Back 28

Surgical excision

Front 29

Define THYROGLOSSAL DUCT CYST:

Back 29

arise from epithelial remnants of thyroid gland development, occur in the midline of neck - anywhere between thyroid embryonic origin (foramen caecum of tongue) and thyroid gland. Most occur below hyoid bone.

Front 30

What are the clinical features of THYROGLOSSAL DUCT CYST?

Back 30

- painless
- fluctuant swelling
- slow enlarging
- moveable swelling
- primarily children/ young adults

Front 31

Define "SISTRUNK PROCEDURE":

Back 31

- thyroglossal duct cyst is removed in addition to the midline segment of the hyoid bone and a generous portion of muscular tissue along the entire thyroid tract
- less than 10% recurrence

Front 32

Define FOLLICULAR CYST OF THE SKIN (EPIDERMOID CYST):

Back 32

A common keratin filled lesion that arises from one or more portions of the hair follicle.
Often arise after localized inflammation of the hair follicle or after traumatic implantation.

Front 33

EPIDERMOID CYST may be associated with what condition?

Back 33

Gardner's syndrome

Front 34

What is the treatment of EPIDERMOID CYST?

Back 34

Surgical excision

Front 35

What areas does EPIDERMOID CYST most commonly occur in?

Back 35

- acne-prone areas of head, neck and back

Front 36

Define DERMOID CYST:

Back 36

Uncommon, developmental cystic malformation

Front 37

What is the most common site of DERMOID CYST?

Back 37

- midline of FOM
- if ABOVE geniohyoid muslce it produces sunlingual swelling
- if BELOW geniohyoid muscle it produces submental swelling with double chin appearance

Front 38

What is the treatment of DERMOID CYST?

Back 38

surgical removal

Front 39

What is the etiology of DENTIGEROUS CYST?

Back 39

fluid accumulation between the reduced enamel epithelium and the enamel surface, resulting in a cyst

Front 40

What is the most common type of ODONTOGENIC CYST?

Back 40

Dentigerous cyst

Front 41

DENTIGEROUS CYST occurs mainly in which teeth?

Back 41

MANDIBULAR THIRD MOLARS > max canines > max third molar > mand. second premolars

Front 42

WHat are the clinical features of DENTIGEROUS CYST?

Back 42

- radiographically, unilocular, well-defined radiolucency associated with the crown of an unerupted tooth, usually with sclerotic borders.
- if infected may show ill-defined borders

Front 43

Describe the features of a NORMAL follicular space:

Back 43

PANORAMIC: 3mm
INTRAORAL: 2.5mm

Front 44

What is the treatment of DENTIGEROUS CYST?

Back 44

- removal of the tooth
- enucleation of the cyst

Front 45

Define ERUPTION CYST:

Back 45

- a dentigerous cyst that forms in the soft tissue overlying the crown of an erupting tooth

Front 46

What is the treatment for an ERUPTION CYST?

Back 46

- usually ruptures spontaneously, permitting tooth eruption.
- if this does not occur, excision of the root of the cyst will aid eruption

Front 47

An OKC, radiographically, may simulate what other lesions?

Back 47

- dentigerous cyst
- radicular cyst
- residual cyst
- lateral periodontal cyst
- nasopalatine duct cyst

Front 48

Which has the highest recurrence rate of all cysts?

Back 48

OKC - 30% within the first 5 post-op years

Front 49

What is the treatment of OKC?

Back 49

Surgical enucleation and curettage. Long term clinical and radiographic follow-up is necessary.

Front 50

What is the peak incidence of OKC?

Back 50

3rd decade of life

Front 51

Define "de novo"

Back 51

- from new
- fresh

Front 52

Patients with multiple OKC's should be evaluated for what other condition?

Back 52

Gorlin syndrome

Front 53

What are the clinical features of GORLIN SYNDROME?

Back 53

SKIN: basal cell carcinomas in non-sun exposed skin. Palmar and plantar pits, epidermal cysts of the skin , and milia
SKELETAL: bifid ribs, vertebral anomalies, lamellar calcifications of the falx cerebri, multiple jaw OKC's
CNS: meduloblastoma, meningioma

Front 54

Define "GINGIVAL CYST OF THE ADULT:

Back 54

uncommon, developmental odontogenic cyst of gingiva soft tissue - basically soft tissue counterpart of lateral periodontal cyst

Front 55

Define "LATERAL PERIODONTAL CYST:"

Back 55

Uncommon developmental odontogenic cyst that typically occurs along the lateral root surface of a tooth

Front 56

Define "BOTRYOID ODONTOGENIC CYST:"

Back 56

Lateral periodontal cyst that can be multicystic and has "grape-like" clusters of small cysts

Front 57

What is the treatment of LATERAL PERIODONTAL CYST?

Back 57

Surgical enucleation

Front 58

Define CALCIFYING ODONTOGENIC CYST:

Back 58

uncommon lesion that demonstrates considerable histopathologic diversity and variable clinical beahviours.

Front 59

CALCIFYING ODONTOGENIC CYST may be associated most commonly with what:

Back 59

- odontoma
- unerupted tooth (most often canine)
- other tumours (adenomatoid odontogenic tumour)
- ameloblastoma

Front 60

What is the treatment of CALCIFYING ODONTOGENIC CYST:

Back 60

enucleation/curettage

CYSTIC TYPE: good prognosis
NEOPLASTIC: prognosis less certain because of its rarity

Front 61

Name two INFLAMMATORY ODONTOGENIC CYSTS:

Back 61

- periapical cyst
- residual cyst

Front 62

What are the three things ODONTOGENIC CARCINOMA may arise from?

Back 62

- ameloblastoma
- de novo
- epithelial lining of odontogenic cysts

Front 63

What is the treatment for ODONTOGENIC CARCINOMA:

Back 63

- Partial resection to total resection - with/without radiation or adjunctive chemotherapy
- 50% five-year survival rate after treatment

Front 64

What is the most common type of cyst associated with carcinoma transformation?

Back 64

RESIDUAL CYST > dentigerous > apical and lateral periodontal

Front 65

What is the finding?

Back 65

Epstein's Pearl

Front 66

What is the finding?

Back 66

Epstein's Pearl

Front 67

What is the finding?

Back 67

Epstein's Pearl

Front 68

What is the finding?

Back 68

Bohn's nodule

Front 69

What is the finding?

Back 69

Bohn's nodule

Front 70

What is the finding?

Back 70

Nasopalatine Duct Cyst

Front 71

What is the finding?

Back 71

Nasopalatine Duct Cyst

Front 72

What is the finding?

Back 72

Nasopalatine Duct Cyst

Front 73

What is the finding?

Back 73

Nasopalatine Duct Cyst

Front 74

What is the finding?

Back 74

Nasopalatine Duct Cyst

Front 75

What is the finding?

Back 75

Nasopalatine Duct Cyst

Front 76

What is the finding?

Back 76

Median palatal cyst

Front 77

What is the finding?

Back 77

Nasolabial cyst

Front 78

What is the finding?

Back 78

Nasolabial cyst

Front 79

What is the finding?

Back 79

Nasolabial cyst

Front 80

What is the finding?

Back 80

Epidermoid cyst

Front 81

What is the finding?

Back 81

Epidermoid cyst

Front 82

What is the finding?

Back 82

Epidermoid cyst

Front 83

What is the finding?

Back 83

Epidermoid cyst

Front 84

What is the finding?

Back 84

Eruption cyst

Front 85

What is the finding?

Back 85

Eruption cyst

Front 86

What is the finding?

Back 86

Eruption cyst

Front 87

What is the finding?

Back 87

Eruption cyst

Front 88

What is the finding?

Back 88

Eruption cyst

Front 89

What is the finding?

Back 89

Eruption cyst