Deck 7: Connective Tissue Lesions

Question 1

Pain is often a characteristic clinical feature of which of the following lesions?

A) Squamous papilloma
B) Pyogenic granuloma
C) Palatal papillomatosis
D) Traumatic fibroma
E) Traumatic neuroma

Answer 1

Traumatic neuroma

Question 2

A 16-year-old patient complained of a 1 * 1 cm nontender mass in his upper lip. The lesion was nonulcerated and was composed of a dilated duct containing a sialolith. This would be which of the following?

A) Focal fibrous hyperplasia
B) Traumatic neuroma
C) Fibromatosis
D) Mucous extravasation phenomenon
E) None of the above

Answer 2

None of the above

Question 3

Oral reactive hyperplasias:

A) Represent premalignant processes
B) Are caused by overgrowth of oral bacterial flora
C) Represent preneoplastic processes
D) Are relatively common in dental patients
E) All the above

Answer 3

Are relatively common in dental patients

Question 4

Peripheral fibromas are seen exclusively in which of the following intraoral sites?

A) Lip
B) Buccal mucosa
C) Palate
D) Tongue
E) Gingiva

Question 5

A firm asymptomatic lump measuring 1 * 1 cm was discovered in the mandibular gingiva of a 32-year-old woman. The mass was well defined, firm, and the same color as the surrounding tissue. Which of the following would be most likely?

A) Granular cell tumor
B) Peripheral fibroma
C) Necrotizing sialometaplasia
D) Salivary gland tumor
E) Pyogenic granuloma

Question 6

A 54-year-old woman developed an asymptomatic 1 *1 cm nodule in her buccal mucosa. An excisional biopsy was done and was described microscopically as a circumscribed mass of dense collagen and fibroblasts. This would be a:

A) Pyogenic granuloma
B) Peripheral fibroma
C) Focal fibrous hyperplasia
D) Neurofibroma
E) Papilloma

Question 7

Acute leukemias, especially monocytic leukemias, may cause oral manifestations of bleeding and:

A) Generalized gingival hyperplasia
B) Mucous extravasation
C) Focal lymphoid hyperplasia
D) Melanosis
E) All the above

Question 8

An oral biopsy was taken from the tongue of a 36-year-old woman and was interpreted as a leiomyoma. This is a:

A) Benign neoplasm of smooth muscle
B) Malignant neoplasm of skeletal muscle
C) Reactive hyperplasia
D) Benign tumor of salivary gland origin
E) Congenital lesion of lymphatic vessels

Question 9

Mucosal plexiform neuromas, pheochromocytomas, and thyroid medullary carcinomas are components of which of the following syndromes?

A) Peutz-Jeghers syndrome
B) MEN III
C) Addison's disease
D) von Recklinghausen's disease of skin
E) Sjögren's syndrome

Question 10

Which of the following is known to behave in a clinically aggressive fashion and have a significant recurrence rate?

A) Schwannoma
B) Granular cell tumor
C) Neurofibroma
D) Fibromatosis
E) Monomorphic adenoma

Question 11

Pseudoepitheliomatous hyperplasia is a microscopic phenomenon that mimics squamous cell carcinoma microscopically and is frequently associated with which of the following?

A) Peripheral giant cell granuloma
B) Peripheral fibroma
C) Congenital epulis of the newborn
D) Pyogenic granuloma
E) Granular cell tumor

Question 12

Pseudoepitheliomatous hyperplasia is a frequent microscopic finding of a neural-derived benign tumor in which granular cells expand submucosa. This lesion is known as:

A) Traumatic neuroma
B) Neurofibroma
C) Neurilemmoma
D) Leiomyoma
E) None of the above

Question 13

Cells found in the congenital epulis of the newborn are identical or nearly identical to cells making up which of the following tumors?

A) Neurilemmoma
B) Peripheral giant cell granuloma
C) Mixed tumor
D) Granular cell tumor
E) None of the above

Question 14

A 16-year-old girl had an asymptomatic 2 *3 cm crepitant mass in her tongue. It was slightly lighter in color than the surrounding tissue. Biopsy showed numerous endothelial-lined channels. This is a:

A) Granular cell tumor
B) Ranula
C) Mucocele
D) Lymphangioma
E) Lymphoma

Question 15

A 1 * 1 cm pedunculated lesion of the gingiva of a 3-month-old girl was described microscopically as being composed of granular cells covered by thin epithelium. This describes which of the following?

A) Peripheral fibroma
B) Dysplastic oral wart
C) Gingival cyst
D) Neuroectodermal tumor of infancy
E) Congenital granular cell tumor

Question 16

The condition in which a patient may develop café-au-lait macule patches on skin and mucocutaneous neurofibromas is known as:

A) Gorlin's syndrome
B) MEN III
C) Neurofibromatosis
D) Melanoma
E) None of the above

Question 17

Trauma or irritation is believed to be the cause of all the following except:

A) Papillary hyperplasia
B) Mucous extravasation phenomenon
C) Peripheral fibroma
D) Pyogenic granuloma
E) Neurofibroma

Question 18

Nifedipine-induced gingival hyperplasia may be confused clinically with all the following except:

A) Dilantin-induced hyperplasia
B) MEN III
C) Idiopathic gingival hyperplasia
D) Leukemic infiltrates of gingiva
E) Generalized gingival hyperplasia associated with "local factors"

Question 19

Reactive hyperplasias:

A) Are relatively rare in dental patients
B) Are etiologically associated with immunodeficiency
C) Represent an overexuberant repair process
D) Are caused by Candida albicans
E) All the above

Question 20

A significant risk of malignant transformation is associated with which of the following?

A) Papillary hyperplasia
B) Peripheral ossifying fibroma
C) Squamous papilloma
D) Focal epithelial hyperplasia (Heck's disease)
E) None of the above

Question 21

All the following could be classified as oral reactive fibrous hyperplasia except:

A) Traumatic fibroma
B) Peripheral fibroma
C) Fibromatosis
D) Generalized gingival hyperplasia
E) Denture-induced hyperplasia

Question 22

Peripheral ossifying fibromas are lesions that occur exclusively in which of the following sites?

A) Ramus of the mandible
B) Lips
C) Tongue
D) Palate
E) None of the above

Question 23

Surgical excision is the treatment of choice for which of the following?

A) Traumatic fibroma
B) Traumatic neuroma
C) Granular cell tumor
D) Neurofibroma
E) All the above

Question 24

Risk of malignant transformation is associated with which of the following, when occurring as multiple lesions, in conjunction with pigmented patches of the skin?

A) Lipoma
B) Neurofibroma
C) Granular cell tumor
D) Traumatic fibroma
E) Traumatic neuroma

Question 25

All the following represent connective tissue reactions to injury except:

A) Pyogenic granuloma
B) Traumatic neuroma
C) Peripheral ossifying fibroma
D) Lymphangioma
E) Peripheral fibroma

Question 26

The granular cell tumor is often surfaced by epithelium showing:

A) Pseudoepitheliomatous hyperplasia
B) Atrophy
C) Acantholysis
D) Ulceration
E) None of the above

Question 27

A 24-year-old man presented with the second recurrence of a buccal mucosa mass. The lesion was composed of fibrous connective tissue and was cytologically benign. However, it was nonencapsulated and freely infiltrated surrounding soft tissue. This lesion suggests which of the following?

A) Fibromatosis
B) Traumatic fibroma
C) Reactive hyperplasia
D) Pyogenic granuloma
E) Hyperplastic scar

Question 28

The Schwann cell is the cell of origin for which of the following tumors?

A) Leiomyoma
B) Rhabdomyoma
C) Neurilemmoma
D) Mixed tumor
E) None of the above

Question 29

A 20-year-old patient, who has been taking sodium dilantin for seizure control, develops a marked increase in the bulk of his attached gingiva. If the change is, in fact, drug related, which of the following features would dominate the microscopic picture?

A) Epithelial hyperplasia
B) Generalized gingival hyperplasia
C) Malignant leukocytes
D) Abundant nerve tissue
E) Sebaceous hyperplasia

Question 30

Generalized gingival hyperplasia may be associated with ingestion of which of the following drugs?

A) Ibuprofen
B) Aspirin
C) Nifedipine
D) Penicillin
E) Tetracycline

Question 31

All the following occur predominantly in the gingiva except:

A) Peripheral giant cell granuloma
B) Peripheral fibroma
C) Congenital epulis of the newborn
D) Pyogenic granuloma
E) Neurofibroma

Question 32

A biopsy of a painful nodule from the soft tissue adjacent to the mental foramen showed the presence of mixture of both hyperplastic nerve tissue and scar. This is indicative of:

A) Nodular fasciitis
B) Traumatic neuroma
C) Peripheral fibroma
D) Granular cell tumor
E) Neurofibroma

Question 33

Granular cell tumors of the adult have a predilection for which of the following sites?

A) Gingiva
B) Upper lip
C) Lower lip
D) Tongue
E) Buccal mucosa

Question 34

Denture-induced fibrous hyperplasia that is associated with the flanges of poorly fitting dentures is characteristically seen in what location?

A) Retromolar pad
B) Buccal mucosa
C) Lateral border of the tongue
D) Anterior vestibular mucosa
E) Hard palate

Question 35

Which of the following disorders places the patient at risk for the appearance or development of a malignancy?

A) Primary Sjögren's syndrome
B) Proliferative verrucous leukoplakia
C) Neurofibromatosis
D) MEN III
E) All the above

Question 36

Conservative surgical excision would be appropriate treatment, and probably curative, for which of the following?

A) Nodular fasciitis
B) Fibromatosis
C) Fibrosarcoma
D) Rhabdomyosarcoma
E) Adenoid cystic carcinoma