Background

The mouth or oral cavity is often affected by diseases of the skin, since it is in direct continuity with it.  In fact, it may be an important clue to systemic diseases. The nasopharynx is a common area with the oral cavity, nasal cavity, and the trachea leading to the lungs.  Risk factors for oral cancer such as smoking and alcohol abuse are often risk factors for cancer within the nasopharynx.  The advent of the flexible fiberoptiscope has greatly aided in the early diagnosis of diseases in this area.

A guide to the clinical appearance of diseases of the oral cavity are presented through the following links.

Oral Mucosal Lesions
Tounge Lesions

In addition to the soft tissue lesions, the temporomandibular joint is also the site of many disease process, with considerable overlap with other organ systems.

Actinic Cheilitis
Ameloblastoma
Aneurysmal bone cyst
Epidermal inclusion cyst
Ganglion
Hemangioma
Langerhans cell histiocytosis
Median Rhomboid Glossitis
Melkersson-Rosenthal Syndrome (Granulomatous Cheilitis)
Necrotizing Sialometaplasia
Non-Odontogenic Cysts
Nonossifying fibroma
Odontogenic Cysts
Odontogenic Fibroma
Odontogenic Myxoma
Oral Cancer
Oral Hairy Leukoplakia
Osteochondroma
Osteoma
Osteoblastoma
Pigmented villonodular synovitis
Plasma cell myeloma
Sarcoma
Simple bone cyst
Synovial cyst
Synovial chondromatosis

OUTLINE

Gross Appearance and Clinical Variants
Commonly Used Terms
Internet Links

DISEASE VARIANTS	CHARACTERIZATION
RIGA-FEDE DISEASE
Extensive Riga-Fede disease of the lip and tongue. Zaenglein AL, Chang MW, Meehan SA, Axelrod FB, Orlow SJ. Ronald O. Perelman Department of Dermatology, and the Department of Pediatrics, New York University School of Medicine.	J Am Acad Dermatol 2002 Sep;47(3):445-7 Abstract quote Riga-Fede disease presents in early infancy and is characterized by firm, verrucous plaques arising on the oral mucosal surfaces. These histologically benign lesions occur as a result of repetitive trauma of the oral mucosal surfaces by the teeth. Early recognition of this entity is important, because it may be the presenting sign of an underlying neurologic disorder. We report the case of a 10-month-old boy with extensive Riga-Fede disease involving the lip and tongue that prompted a diagnosis of congenital autonomic dysfunction with universal pain loss.

DIFFERENTIAL DIAGNOSIS

KEY DIFFERENTIATING FEATURES

Potential pitfalls in diagnostic oral pathology: a review for the general surgical pathologist. Massey D. From the Division of Anatomic Pathology, Virginia Commonwealth University School of Medicine, Richmond, VA.

Adv Anat Pathol. 2005 Nov;12(6):332-49. Abstract quote   Oral developmental, reactive, benign neoplastic and malignant neoplastic conditions, many odontogenic in origin, may not be seen routinely by the general surgical pathologist and therefore may present a diagnostic dilemma. This article describes odontogenic and nonodontogenic conditions with little or no destructive potential along with the more aggressive conditions that resemble them clinically and histologically. The importance of clinical and radiographic correlation as an adjunct to tissue diagnosis is highlighted. Additionally, a brief summary of odontogenesis is presented with attention given to odontogenic embryologic remnants and the developmental and pathologic processes that may arise from them.

Henry JB. Clinical Diagnosis and Management by Laboratory Methods. Twentieth Edition. WB Saunders. 2001.
Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lipincott Williams and Wilkins 2004.
Robbins Pathologic Basis of Disease. Seventh Edition. WB Saunders 2005.
DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
Fitzpatrick's Dermatology in General Medicine. 6th Edition. McGraw-Hill. 2003.
Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.

Erythroplakia-Literally means red plaque. It, like leukoplakia, is caused by numerous agents.  Histologically, however, there is a much higher association with squamous dysplasia and carcinoma than leukoplakia.

Leukoplakia-Literally means white plaque.   It is caused by a number of agents from tobacco, to ill fitting dentures, to lichen planus.  Thus, it is not specific and always requires further investigation.  It is a clinical term.  Histologically, there are no uniform changes and diseases ranging from benign keratoses to squamous cell carcinoma may present with leukoplakia.

Basic Principles of Disease
Learn the basic disease classifications of cancers, infections, and inflammation

Commonly Used Terms
This is a glossary of terms often found in a pathology report.

Diagnostic Process
Learn how a pathologist makes a diagnosis using a microscope

Surgical Pathology Report
Examine an actual biopsy report to understand what each section means

Special Stains
Understand the tools the pathologist utilizes to aid in the diagnosis

How Accurate is My Report?
Pathologists actively oversee every area of the laboratory to ensure your report is accurate

Got Path?
Recent teaching cases and lectures presented in conferences

Pathologists Who Make A Difference
Search for a Physician Specialist

Last Updated December 21, 2005

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