Oral Pathology

Dr. Sook-Bin Woo is an Associate Professor in the Department of Oral Medicine, Infection, and Immunity. She is board certified in both oral pathology and oral medicine and has been a Professor at Harvard School of Dental Medicine and Harvard Medical School since 2008. She has published numerous scholarly papers, book chapters and an Atlas of Oral Pathology (now in its second edition) and is reviewer for many journals. She is a sought-after speaker at many national and international conferences. Dr. Woo has received the National Research Service Award from the National Institutes of Health and the American Cancer Society Career Development Award among other honours.

1. Introduction

Anatomy

Teeth

Diagnosis and Management

Some Basic Guidelines

2. Developmental and Congenital Conditions

DIFFUSE WHITE LESIONS

White Sponge Nevus (Canon White Sponge Nevus)

Hereditary Benign Intraepithelial Dyskeratosis

Darier Disease (Keratosis Follicularis) and Warty Dyskeratoma

NODULAR OR TUMOR-LIKE LESIONS

Fordyce Granules, Sebaceous Hyperplasia and Adenoma

Congenital Granular Cell Tumor (Congenital Granular Cell Epulis)

Osseous and Cartilaginous Choristomas

Gingival Fibromatosis

Gastrointestinal and Brain Heterotopias

Lymphangioma of the Alveolar Ridge in Neonates

Lingual Thyroid

Leiomyomatous Hamartoma

CYSTIC LESIONS

Oral Lymphoepithelial Cyst (Benign Lymphoepithelial Cyst)

Epidermoid (Epithelial Inclusion) and Dermoid Cysts

Palatal and Gingival Cysts of the Neonate

Cyst of the Incisive Papilla

Nasolabial Cyst (Naso-Alveolar Cyst)

3. Non-infectious Papillary Lesions

Inflammatory Papillary Hyperplasia of the Palate

Verruciform Xanthoma

Juvenile Localized Spongiotic Gingival Hyperplasia

4. Bacterial, Viral, Fungal and Other Infectious Conditions

Actinomycosis

Candidiasis (Candidosis)

Infectious Granulomatous Inflammation

Herpesvirus Infections

-Herpes Simplex Virus Infection

-Hairy Leukoplakia

-Cytomegalovirus Infection

Human Papilloma Virus-related Benign Lesions

Syphilis

5. Fibrous, Gingival, Lipocytic Nodules and Miscellaneous Tumors

FIBROUS LESIONS

Fibroma ("Bite" or "Irritation" Fibroma, Fibro-Epithelial or Fibro-Vascular Polyp) and Giant Cell Fibroma

GINGIVAL NODULES

Reactive/Inflammatory Gingival Nodules

Diffuse/Multifocal Gingival Hyperplasia

GINGIVAL CYST OF THE ADULT

PERIPHERAL (EXTRA-OSSEOUS) ODONTOGENIC NEOPLASMS

Peripheral Odontogenic Fibroma

Peripheral Ameloblastoma

Peripheral Calcifying Cystic Odontogenic Tumor

METASTASES TO THE GINGIVA

DENTURE-ASSOCIATED INFLAMMATORY FIBROUS HYPERPLASIA (EPULIS FISSURATUM)

LIPOCYTIC LESIONS

Lipoma

OTHER UNCOMMON TUMORS

Myofibroma

TUMORS OF UNCERTAIN HISTOGENESIS

Ectomesenchymal Chondromyxoid Tumor of the Tongue

Solitary Fibrous Tumor

Oral Focal Mucinosis

6. Vascular, Neural and Muscle Tumors

Vascular lesions

Pyogenic Granuloma

Varix (Venous Lake) and Venous Malformation (Venous Anomaly)

Caliber-Persistent Labial Artery

Kaposi Sarcoma

Lymphatic Malformation ("Lymphangioma Circumscriptum")

Neural tumors

Traumatic Neuroma

Neurofibroma

Schwannoma

Solitary Circumscribed Neuroma (Palisaded Encapsulated Neuroma)

Granular Cell Tumor

Subgemmal Neurogenous Plaque (Sub-Epithelial Nerve Plexus)

Muscle tumors

Leiomyoma and Angio-Leiomyoma (Vascular Leiomyoma)

Adult Rhabdomyoma

Embryonal Rhabdomyosarcoma

7. Ulcerative and Inflammatory Conditions

ULCERATIVE CONDITIONS

Recurrent Aphthous Ulcers and Traumatic Ulcers

Traumatic Ulcerative Granuloma with Stromal Eosinophils, Eosinophilic Ulcer of Tongue

NON-SPECIFIC INFLAMMATORY CONDITIONS

Non-specific Irritant Contact Stomatitis

Frictional Blisters

Chronic Gingivitis

Foreign Body Gingivitis

8. Immune-mediated, Autoimmune and Granulomatous Conditions

Granulomatous inflammation

Foreign Body Granulomas

Orofacial Granulomatosis and Crohn Disease

PYOSTOMATITIS VEGETANS

Immune-mediated conditions

Benign Migratory Glossitis (Migratory Stomatitis; Geographic Tongue, Erythema Areata Migrans)

Non-Specific Hypersensitivity Reactions

Erythema Multiforme

Plasma Cell Orificial Mucositis (Plasma Cell Stomatitis, Mucous Membrane Plasmacytosis)

Lichen Planus/Lichenoid Mucositis

Autoimmune conditions

Mucous Membrane Pemphigoid

Pemphigus Vulgaris

Paraneoplastic Pemphigus

Lupus Erythematosus

Wegener Granulomatosis

9. Pigmented Lesions

EXOGENOUS PIGMENTATION

Amalgam Tattoo

Graphite Tattoo

Medication Induced Pigmentation

MELANOCYTIC PIGMENTATION

Oral Melanotic Macule

Post-inflammatory Hypermelaninosis

Melanoacanthosis (Melanoacanthoma)

Oral Melanocytic Nevus

Dysplastic Melanocytic Nevus and Mucosal Melanoma

NEUROECTODERMAL PIGMENTATION

Melanotic Neuroectodermal Tumor of Infancy

10. Reactive Keratotic Lesions (Nonleukoplakias)

WHITE LESIONS

REACTIVE LESIONS

Leukoedema

Contact Desquamation

FRICTIONAL/FACTITIAL KERATOSES

Morsicatio Mucosa Oris (Morsicatio Buccarum, Morsicatio Linguarum, Morsicatio Labiarum, Pathominia Mucosa Oris)

Benign Alveolar Ridge (Frictional) Keratosis (Oral Lichen Simplex Chronicus)

Non-Specific Benign Reactive Keratoses

TOBACCO-RELATED LESIONS

Smokeless Tobacco Lesion

Nicotinic Stomatitis (Stomatitis Nicotina)

SUBMUCOUS FIBROSIS

11. Leukoplakia, Oral Dysplasia and Squamous Cell Carcinoma

Leukoplakia, Erythroplakia, and Dysplasia

Human Papillomavirus-Associated Apoptotic Dysplasia

Squamous Cell Carcinoma

-Conventional Infiltrating Squamous Cell Carcinoma

-Sarcomatoid Squamous Cell Carcinoma

-Basaloid Squamous Cell Carcinoma

-Human Papillomavirus-Associated Oropharyngeal Nonkeratinizing Squamous Cell Carcinoma

-Adenoid Squamous Cell Carcinoma

-Adenosquamous Cell Carcinoma

-Verrucous Carcinoma

-Papillary Squamous Cell Carcinoma

-Cuniculate Carcinoma (Carcinoma Cuniculatum)

12. Inflammatory Salivary Gland Lesions

Mucocele

Salivary Duct Cyst (Salivary Retention Cyst, Sialocyst)

Sialolith (Salivary Calculus)

Cheilitis Glandularis (Stomatitis Glandularis, Cheilitis Glandularis Apostematosa)

Necrotizing Sialometaplasia

Subacute Necrotizing Sialadenitis

Autoimmune Sialadenitis

Adenomatoid (Acinar) Hyperplasia

Sclerosing Polycystic Sialadenosis

13. Salivary Gland Neoplasms

BENIGN SALIVARY GLAND NEOPLASMS

Pleomorphic Adenoma and Myoepithelioma

Canalicular Adenoma

Cystadenoma, Papillary or Otherwise

Sialadenoma Papilliferum

Intraductal Papilloma

Inverted Ductal Papilloma

MALIGNANT SALIVARY GLAND NEOPLASMS

Mucoepidermoid Carcinoma

Adenoid Cystic Carcinoma

Polymorphous Low-Grade Adenocarcinoma

Acinic Cell Adenocarcinoma

Clear Cell Adenocarcinoma (Hyalinizing)

Adenocarcinoma, Not Otherwise Specified

14. Odontogenic Cysts

ODONTOGENIC CYSTS

INFLAMMATORY CYSTS

Apical and Lateral Radicular Cyst, and Periapical Granuloma

Mandibular Buccal Bifurcation Cyst

DEVELOPMENTAL CYSTS

Dentigerous Cyst (Follicular Cyst)

Lateral Periodontal Cyst

Orthokeratinized Odontogenic Cyst

Odontogenic Cyst in a Globulomaxillary Location

Primordial Cyst

Glandular Odontogenic Cyst

15. Odontogenic Tumors

EPITHELIAL TUMORS WITHOUT ECTOMESENCHYME

Keratocystic Odontogenic Tumor (Odontogenic Keratocyst)

Ameloblastoma

Calcifying Epithelial Odontogenic Tumor (Pindborg Tumor)

Adenomatoid Odontogenic Tumor

Squamous Odontogenic Tumor

Ameloblastic Carcinoma

Primary Intra-Osseous (Odontogenic) Carcinoma (Primary Intra-Osseous Squamous Cell Carcinoma)

Clear Cell Odontogenic Carcinoma

MIXED EPITHELIAL AND ECTOMESENCHYMAL TUMORS

Calcifying Cystic Odontogenic Tumor (Calcifying Odontogenic Cyst, Gorlin Cyst) and Dentinogenic Ghost Cell Tumor

Ameloblastic Fibroma

Ameloblastic Fibro-odontoma

Odontoma

MESENCHYMAL TUMORS

Central Odontogenic Fibroma

Odontogenic Myxoma

Granular Cell Odontogenic Tumor

Cementoblastoma

16. Nonodontogenic Intra-osseous Lesions

Tori and Exostoses

Fibro-Osseous Lesions

Paget Disease of Bone (Osteitis Deformans)

Central Giant Cell Granuloma (Aggressive and Non-Aggressive Giant Cell Lesion, Central Giant Cell Lesion, Central Giant Cell Reparative Granuloma)

Cherubism

Desmoplastic Fibroma

Osteosarcoma (Osteogenic Sarcoma)

Chondrosarcoma

Multiple Myeloma (Plasma Cell Myeloma)

Langerhans Cell Histiocytosis

Osteonecrosis and Osteomyelitis

Myospherulosis (Spherulocytosis, Spherulocystic Disease of Skin)

Hematopoietic Bone Marrow Defect (Osteoporotic Bone Marrow Defect)

NONODONTOGENIC CYSTS AND CYST-LIKE LESIONS

Nasopalatine Duct (Incisive Canal) Cyst

Surgical Ciliated Cyst (Post-Operative Maxillary Cyst)

Median Palatal (Palatine) Cyst

Aneurysmal Bone Cyst

Simple Bone Cyst (Traumatic Bone Cyst, Idiopathic Bone Cavity)

Stafne Bone Cavity (Lingual Salivary Gland Depression)