Oral Path Chapter 7

Which of the following choices is the most common salivary gland neoplasm? a. Adenoid cystic carcinoma b. Mucoepidermoid carcinoma c. Pleomorphic adenoma d. Monomorphic adenoma

C. pleomorphic adenoma

The diagnosis of oral osteosarcoma is dependent on: a. clinical examination. b. palpation. c. radiographic interpretation. d. patient symptoms.

C. radiographic interpretation.

Patients who have undergone radiation therapy for malignant tumors of the head and neck often experience severe xerostomia as a result of radiation damage to _____ tissue. a. oral mucosa b. striated muscle c. salivary gland d. tooth

C. salivary gland

An intraoral mucosal lesion that shows a mixture of red and white areas is generally called: a. erythroplakia. b. speckled erythroplakia. c. speckled leukoplakia. d. leukoplakia.

C. speckled leukoplakia

An ameloblastoma may appear as a _____ on radiographs. a. unilocular radiolucency b. multilocular opacity c. unilocular or multilocular radiolucency d. unilocular or multilocular radiopacity

C. unilocular or multilocular radiolucency

Idiopathic leukoplakia: a. is a malignant lesion of the oral mucosa. b. can be rubbed off with gauze squares. c. is caused by direct irritation, as in tobacco pouch keratosis. d. does not have a specific known cause.

D. does not have a specific known cause.

Hyperchromatic

Microscopic staining that is more intense than normal

Cells closely resemble their cells of origin.

a. Benign

Recurrence of the tumor is not common.

a. Benign

The majority of these neoplasms are encapsulated.

a. Benign

Ghost cells are characteristic of which of the following lesions? a. Calcifying odontogenic cyst b. Adenomatoid odontogenic tumor c. Calcifying epithelial odontogenic tumor d. Ameloblastoma

a. Calcifying odontogenic cyst

Squamous cell carcinoma may appear anywhere in the oral cavity; where is the most common site? a. Floor of the mouth b. Gingiva c. Retromolar pad d. Midline of the hard palate

a. Floor of the mouth

The papilloma will appear whiter clinically because of additional amounts of what substance? a. Keratin b. Exudate c. Granulation tissue d. Macrophages

a. Keratin

Where is the most common intraoral location for the development of minor salivary gland tumors? a. Tongue b. Junction of the hard and soft palate c. Interdental papilla d. Floor of the mouth

b. Junction of the hard and soft palate

Cells are poorly differentiated.

b. Malignant

Growth expands by invasion and replaces normal tissue.

b. Malignant

In naming the neoplasm, the word sarcoma or carcinoma is used.

b. Malignant

Mitosis is uncontrolled with rapid division.

b. Malignant

Which is the most significant factor for the development of squamous cell carcinoma? a. Sun exposure b. Tobacco use c. Age d. Chronic irritant

b. Tobacco use

The ameloblastic fibroma: a. occurs most often in adults over 50. b. occurs more commonly in males than females. c. is most commonly located in the mandibular anterior region. d. is most commonly located in the maxillary anterior region.

b. occurs more commonly in males than females

A central mucoepidermoid carcinoma is derived from either salivary gland tissue trapped within bone or: a. a periapical abscess surrounding the apex of a nonvital tooth. b. the transformed epithelial lining of a dentigerous cyst. c. a lateral periodontal cyst. d. an incisive canal cyst.

b. the transformed epithelial lining of a dentigerous cyst.

What is the treatment for a benign cementoblastoma? a. No treatment needed b. Surgical excision and drainage c. Enucleation of tumor and tooth extraction d. Surgery and radiation therapy follow-up

c. Enucleation of tumor and tooth extraction

Which intraoral lesion appears as a smooth red patch or a granular red and velvety patch? a. Sarcoma b. Papilloma c. Erythroplakia d. Leukoplakia

c. Erythroplakia

Clinical signs and symptoms of a pleomorphic adenoma include the following except one. Which is the exception? a. Nonulcerated lesion b. Painless c. Quickly enlarging d. Dome-shaped mass

c. Quickly enlarging

A benign tumor of salivary gland origin is called a(n): a. leiomyoma. b. lipoma. c. adenoma. d. papilloma.

c. adenoma

Which of the following tumors occurs most frequently in the anterior part of the jaws? a. Ameloblastoma b. Calcifying epithelial odontogenic tumor c. Adenomatoid odontogenic tumor d. Odontogenic myxoma

c. adenomatoid odontogenic tumor

Which is the false statement about basal cell carcinoma? a. It often occurs in white adults with fair complexions. b. It appears as a non healing ulcer with rolled borders. c. It is usually seen on the skin of the face. d. It occurs intraorally.

d. It occurs intraorally.

All of the following carcinomas are malignant tumors that originate from squamous epithelium except one. Which one is the exception? a. Adenoid cystic b. Basal cell c. Verrucous d. Squamous cell

A. Adenoid cystic

Epithelial dysplasia is a microscopy-based diagnosis; it indicates disordered growth and is considered a premalignant condition. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true

A. Both statements are true.

Which of the following is a common characteristic of benign neoplasms? a. Inability to spread to distant sites b. Nonencapsulated c. Undifferentiated and pleomorphic d. No resemblance to surrounding cells

A. Inability to spread to distant sites

Kaposi sarcoma is: a. caused by a human herpesvirus. b. seen only in association with HIV infection. c. most often seen intraorally on the tongue. d. a malignant striated muscle tumor.

A. caused by a human herpesvirus.

Acute leukemia is characterized by a proliferation of _____ cells. a. immature white blood b. mature white blood c. immature plasma d. mature plasma

A. immature white blood

The granular cell tumor: a. most often occurs on the tongue followed by the buccal mucosa. b. appears as a painful, ulcerated nodule. c. occurs most commonly in children. d. occurs most often in men.

A. most often occurs on the tongue followed by the buccal mucosa.

A benign tumor of bone is called a(n): a. osteoma. b. osteogenic sarcoma. c. chondroma. d. carcinoma.

A. osteoma.

"Keratin pearls" are a characteristic feature of: a. squamous cell carcinoma. b. basal cell carcinoma. c. pleomorphic adenoma. d. monomorphic adenoma.

A. squamous cell carcinoma.

A common location of the oral neurofibroma is the: a. tongue. b. palate. c. gingiva. d. buccal mucosa.

A. tongue

As a general rule, a patient should be referred to an oral and maxillofacial surgeon or dermatologist to have a biopsy performed on any nonhealing ulcer of the skin or lips that has been present for more than: a. twenty-four hours. b. ten days. c. three months. d. one year.

B. 10 days

According to the TNM staging system for oral squamous carcinoma, T2, N1, M0 would mean tumor _____ cm in diameter, _____ palpable nodes, and _____ metastasis. a. less than 2; ipsilateral; no distant b. 2 to 4; ipsilateral; no distant c. 2 to 4; contralateral; no distant d. 2 to 4; contralateral; distant

B. 2 to 4; ipsilateral; no distant

Only about _____% of patients with chondrosarcoma involving the jaws survive 5 years after the diagnosis. a. 10 b. 30 c. 50 d. 70

B. 30

Approximately _____% of leukoplakias examined microscopically demonstrate epithelial dysplasia. a. 1 to 2 b. 5 to 25 c. 50 to 60 d. 90

B. 5% to 25%

All of the following are common warning signs of malignant neoplasms except one. Which one is the exception? a. Leukoplakia b. Bleeding c. Erythroplakia d. Pigmentation

B. Bleeding

How does an adenomatoid odontogenic tumor differ from a dentigerous cyst on radiographs? a. It will not be associated with an impacted tooth. b. It extends beyond the cementoenamel junction and can involve 50% to 60% of the root. c. It will not form calcifications within the tumor, as does a dentigerous cyst. d. It will not form a well-circumscribed radiolucency.

B. It extends beyond the cementoenamel junction and can involve 50% to 60% of the root.

_____ means new growth. a. Metastasis b. Neoplasia c. Hypertrophy d. Hyperplasia

B. Neoplasia

Which of the following statements about epithelial dysplasia is true? a. It is considered a malignant condition. b. Unlike squamous cell carcinoma, cellular changes in epithelial dysplasia may revert to normal if the stimulus, such as tobacco smoking, is removed. c. It presents clinically as an erythematous lesion and not a white lesion (leukoplakia). d. Lesions often arise on the hard and soft palate.

B. Unlike squamous cell carcinoma, cellular changes in epithelial dysplasia may revert to normal if the stimulus, such as tobacco smoking, is removed.

Osteosarcoma occurs more often in the _____ and more often in _____. a. maxilla; males b. maxilla; females c. mandible; males d. mandible; females

C. mandible; males

Which of the following choices represents characteristics of malignant tumors? a. Encapsulated b. Ability to spread to distant sites c. Benign d. Cells resemble normal cells

B. ability to spread to distant sites.

A lipoma: a. is a tumor of peripheral nerve tissue. b. appears clinically as a yellowish mass surfaced by a thin layer of epithelium. c. is found most commonly intraorally on the tongue. d. occurs most often in men over 60.

B. appears clinically as a yellowish mass surfaced by a thin layer of epithelium.

Intraoral minor salivary gland tumors are most commonly located: a. on the labial and buccal mucosa. b. at the junction of the hard and soft palate. c. on the retromolar area. d. on the floor of the mouth.

B. at the junction of the hard and soft palate.

A(n) _____ is composed of islands and sheets of polyhedral epithelial cells with deposits of amyloid-like material that is thought to represent a form of abnormal enamel protein. a. adenomatoid odontogenic tumor b. calcifying epithelial odontogenic tumor c. ameloblastoma d. mucoepidermoid carcinoma

B. calcifying epithelial odontogenic tumor

A _____ is a benign proliferation of capillaries. a. hematoma b. hemangioma c. hamartoma d. lymphangioma

B. hemangioma

Squamous cell carcinoma of the oral epithelium usually metastasizes first to the lymph nodes of the neck. Common distant sites include: a. kidneys and spleen. b. lungs and liver. c. breast and lungs. d. liver and spleen.

B. lungs and liver.

A _____ both invades and destroys surrounding tissue and has the ability to spread throughout the body. a. benign tumor b. malignant tumor c. hypertrophy d. hyperplasia

B. malignant tumor

Which of the following choices is the most common malignant salivary gland tumor in children? a. Adenoid cystic carcinoma b. Mucoepidermoid carcinoma c. Monomorphic adenoma d. Pleomorphic adenoma

B. mucoepidermoid carcinoma

Which of the following tumors is an unencapsulated, infiltrating tumor composed of a combination of mucous cells interspersed with squamous-like epithelial cells? a. Adenoid cystic carcinoma b. Mucoepidermoid carcinoma c. Monomorphic adenoma d. Pleomorphic adenoma

B. mucoepidermoid carcinoma

Multiple myeloma is a systemic, malignant proliferation of: a. red blood cells. b. plasma cells. c. eosinophils. d. basophils.

B. plasma cells

Malignant melanoma usually presents as a(n): a. slowly enlarging white mass. b. rapidly enlarging blue-to-black mass. c. slowly enlarging papule. d. exophytic, wartlike lesion.

B. rapidly enlarging blue-to-black mass.

A basal cell carcinoma will _____ metastasize. a. never b. rarely c. often d. always

B. rarely

The most frequent intraoral site for metastatic tumors of the jaws is the: a. nares. b. maxilla. c. mandible. d. zygoma.

C. mandible.

Which of the following statements about erythroplakia is true? a. Most cases of erythroplakia occur on the buccal mucosa and vestibule. b. Erythroplakia is more common than leukoplakia. c. When examined microscopically, 90% of cases of erythroplakia demonstrate epithelial dysplasia or squamous cell carcinoma. d. Erythroplakia is considered a less serious clinical finding than leukoplakia.

C. When examined microscopically, 90% of cases of erythroplakia demonstrate epithelial dysplasia or squamous cell carcinoma

Which of the following salivary gland tumors has a "Swiss cheese" appearance under the microscope? a. Pleomorphic adenoma b. Monomorphic adenoma c. Adenoid cystic carcinoma d. Mucoepidermoid carcinoma

C. adenoid cystic carcinoma

Which of the following tumors will most closely resemble an ameloblastoma with ameloblast-like epithelial cells surrounding areas that resemble stellate reticulum? a. Calcifying epithelial odontogenic tumor b. Adenomatoid odontogenic tumor c. Calcifying odontogenic cyst d. Odontogenic myxoma

C. calcifying odontogenic cyst

Severe epithelial dysplasia involving the full thickness of the epithelium is called: a. anaplasia. b. squamous cell carcinoma. c. carcinoma in situ. d. metastasis.

C. carcinoma in situ.

The majority of adenomatoid odontogenic tumors occur in _____ years of age. a. females over 40 b. males over 40 c. females under 20 d. males under 20

C. females under 20 years of age.

Adenoid cystic carcinoma is commonly seen in which demographic group? a. more common in men than in women. b. most common in women of childbearing age. c. fifth and sixth decades of life. d. children.

C. fifth and sixth decades of life.

According to the TNM staging system for oral squamous carcinoma, T3, N0, M0 would mean tumor _____ cm in diameter, _____ palpable nodes, and _____ metastasis. a. less than ; ipsilateral; no distant b. is 2 to 4; ipsilateral; no distant c. greater than 4; no; no distant d. greater than 4; contralateral; distant

C. greater than 4; no; no distant

This benign tumor of fat cells that clinically appears as a yellowish mass surfaced by a thin layer of epithelium is referred to as a: a. chondroma. b. rhabdomyosarcoma. c. lipoma. d. lymphoma.

C. lipoma

Most cases of verrucous carcinoma occur in the _____ years old. a. posterior lateral border of the tongue of women over 40 b. floor of the mouth of women over 70 c. vestibule and buccal mucosa of men over 55 d. bone of the mandible of men over 20

C. vestibule and buccal mucosa of men over 55 years old.

Enucleation

Complete surgical removal without cutting into the lesion

In situ

Confined to the site of origin without an invasion of neighboring tissues

The name of this benign tumor that is slow growing but locally aggressive and derived in association with an impacted tooth and dentigerous cyst is: a. calcifying odontogenic cyst. b. odontogenic myxoma. c. compound odontoma. d. ameloblastoma.

D. Ameloblastoma

Sarcomas are _____ common than carcinomas. a. ten times more b. three times more c. three times less d. ten times less

D. Ten times less

The multiple myeloma is a benign proliferation of plasma cells that produce large amounts of immunoglobulin. Patients usually experience bone pain and swelling. a. Both statements are true. b. Both statements are false. c. The first statement is true; the second is false. d. The first statement is false; the second is true.

D. The first statement is false; the second is true.

Squamous cell carcinomas on the vermilion border of the lips and skin of the face are: a. associated with lack of exposure to the sun and vitamin D deficiency. b. more common in individuals with dark skin. c. associated with a poorer prognosis than that for squamous cell carcinoma of the oral mucosa. d. associated with color changes of the vermilion border from dark pink and uniform to mottled grayish pink.

D. associated with color changes of the vermilion border from dark pink and uniform to mottled grayish pink.

The distinction between dangerous and innocuous leukoplakia is best determined by the: a. clinical appearance of the lesion. b. identification of predisposing factors. c. patient's previous experience. d. biopsy of the lesion.

D. biopsy of the lesion.

Which of the following choices is not regarded as an initiating factor in the development of oral cancer? a. Cigar, pipe, and cigarette smoking b. Snuff dipping and tobacco chewing c. Consumption of alcohol d. Chronic irritation

D. chronic irritation

Anaplastic means the tumor: a. is composed of cells that vary in size and shape. b. has cells with darker nuclei than those of normal cells. c. has cells that exhibit an increased nuclear-to-cytoplasmic ratio. d. does not resemble the tissue from which it was derived.

D. does not resemble the tissue from which it was derived.

Squamous cell carcinoma of the oral epithelium usually metastasizes first to the: a. spleen. b. lungs. c. liver. d. lymph nodes.

D. lymph nodes

A rhabdomyosarcoma is a _____ tumor of _____ muscle. a. benign; smooth b. malignant; smooth c. benign; striated d. malignant; striated

D. malignant; striated

When a mucoepidermoid carcinoma arises within bone, it will usually be in the _____ region. a. maxillary anterior b. maxillary posterior c. mandibular anterior d. mandibular posterior

D. mandibular posterior

The ameloblastoma: a. occurs exclusively in the mandible. b. is a benign, encapsulated tumor. c. is commonly known as a Pindborg tumor. d. may cause expansion of bone.

D. may cause expansion of bone.

A benign cementoblastoma has all of the following radiographic characteristics except one. Which one is the exception? a. Well circumscribed b. Radiopaque c. Attached to root d. Multilocular

D. multilocular

Bence Jones proteins are associated with: a. osteosarcoma. b. leukemia. c. lymphoma. d. multiple myeloma.

D. multiple myeloma.

The _____ is a unique type of monomorphic adenoma. a. verrucous carcinoma b. mucoepidermoid carcinoma c. cylindroma d. papillary cystadenoma lymphomatosum

D. papillary cystadenoma lymphomatosum

Most ameloblastomas are located in the: a. anterior maxilla. b. posterior maxilla. c. anterior mandible. d. posterior mandible.

D. posterior mandible

Aberrant

Deviating from the usual or natural type

Pleomorphic

Occurring in various forms

Central

Occurring within bone

Odontogenic

Tooth forming

What is the classic radiographic appearance of the ameloblastoma? a. Multilocular, soap-bubble radiolucency b. Associated with the crown of an unerupted tooth c. Unilocular or multilocular radiolucency with radiopaque areas within d. Multilocular lesions with poorly defined borders, causing tooth displacement

a. Multilocular, soap-bubble radiolucency

What is the term to describe a malignant tumor in bone? a. Osteosarcoma b. Osteoma c. Lipoma d. Carcinoma

a. Osteosarcoma

Because the origin of these tumors is glandular epithelium, benign tumors of salivary gland origin are termed a. adenomas b. nevi c. chondromas d. lipomas

a. adenomas

Verrucous carcinoma: a. has a better prognosis than other forms of squamous cell carcinomas. b. appears clinically as a quick-growing exophytic tumor with a pebbly white surface. c. is characterized by poorly differentiated epithelium with atypical cells. d. shows invasion of tumor cells through the basement membrane.

a. has a better prognosis than other forms of squamous cell carcinomas

All terms are associated with malignancy except one. Which is the exception? a. Invasive b. Encapsulated c. Cancer d. Metastasis

b. Encapsulated

Leukoplakia cannot be diagnosed clinically as a specific disease; therefore, it must often be examined in a laboratory setting. When examined microscopically, leukoplakia may reveal the following except one. Which is the exception? a. Squamous cell carcinoma b. Hemangioma c. Epithelial dysplasia d. Premalignant condition

b. Hemangioma

A compound odontoma: a. consists of a mass of enamel, dentin, cementum, and pulp that does not resemble a normal tooth. b. usually occurs in the posterior mandible. c. appears on radiographs as a cluster of miniature teeth surrounded by a radiolucent halo. d. appears as a radiolucent mass surrounded by a thin radiopaque halo.

c. appears on radiographs as a cluster of miniature teeth surrounded by a radiolucent halo

The adenomatoid odontogenic tumor features ductlike structures that: a. resemble those found in major salivary glands. b. resemble those found in minor salivary glands. c. are actually ameloblast-like cells that resemble ducts because of their circular arrangement. d. are actually odontoblast-like cells that resemble ducts because of their circular arrangement.

c. are actually ameloblast-like cells that resemble ducts because of their circular arrangement

A papilloma is a _____ tumor derived from _____ epithelium. a. benign; salivary gland b. malignant; squamous c. benign; squamous d. malignant; odontogenic

c. benign; squamous

A benign tumor of cartilage is called a(n): a. osteoma. b. lipoma. c. chondroma. d. carcinoma.

c. chondroma

The adenoid cystic carcinoma is: a. a benign tumor of salivary gland origin. b. well encapsulated and does not infiltrate surrounding tissue. c. most commonly seen intraorally on the palate. d. painless.

c. most commonly seen intraorally on the palate

A "sunburst" pattern is associated with: a. Kaposi sarcoma. b. osteoma. c. osteosarcoma. d. multiple myeloma.

c. osteosarcoma

The most common intraoral location for the pleomorphic adenoma is the: a. parotid gland. b. submandibular gland. c. palate. d. floor of the mouth.

c. palate

Which of the following statements about malignant melanoma is true? a. It has a benign counterpart known as the benign melanoma. b. Most malignant melanomas arise on the skin as a result of prolonged exposure to chemicals such as benzene. c. Primary malignant melanoma of the oral cavity is rare. d. The most common intraoral location is the tongue.

c. primary malignant melanoma of the oral cavity is rare

Most cases of papilloma occur on the: a. hard palate. b. buccal mucosa. c. soft palate or tongue. d. retromolar area.

c. soft palate or tongue

Which of the following statements is true of the odontogenic myxoma? a. It occurs most often in people over 50. b. It exhibits a unilocular radiolucency with well-defined margins. c. The tumor may become quite large and cause displacement of teeth. d. Most cases arise in the posterior maxilla.

c. the tumor may become quite large and cause displacement of teeth

The most common intraoral location for a neurofibroma is the: a. floor of the mouth. b. vestibule. c. tongue. d. tonsillar pillar.

c. tongue

The most common location for an intraoral lymphoma is the: a. floor of the mouth. b. posterior lateral border of the tongue. c. tonsillar area. d. vestibule.

c. tonsillar area

Which lesion most closely resembles a papilloma? a. Benign mixed tumor b. Leukoplakia c. Epithelial dysplasia d. Verruca vulgaris

d. Verruca vulgaris

The pleomorphic adenoma: a. is a malignant tumor. b. appears clinically as a painful dome-shaped mass. c. occurs most often in children. d. appears as a slowly enlarging, nonulcerated, painless, dome-shaped mass.

d. appears as a slowly enlarging, nonulcerated, painless, dome-shaped mass

The peripheral ossifying fibroma is most likely derived from: a. ameloblasts. b. odontoblasts. c. osteoblasts. d. cells of the periodontal ligament.

d. cells of the periodontal ligament

The Warthin tumor: a. is a unique type of pleomorphic adenoma. b. presents as a painless, soft mass, usually in the sublingual gland. c. often develops bilaterally in adult women. d. contains sheets of lymphocytes that surround the cystic structures.

d. contains sheets of lymphocytes that surround the cystic structures.

The benign oral pathologic lesion that occurs frequently in the head and neck area and is classified as capillary or cavernous is referred to as a(n): a. hematoma. b. lipoma. c. adenoma. d. hemangioma.

d. hemangioma

Basal cell carcinoma is a _____ tumor that _____ in the oral cavity. a. benign; occurs b. malignant; occurs c. benign; does not occur d. malignant; does not occur

d. malignant; does not occur

Surgery, chemotherapy, radiation therapy, or a combination of all three may be used to treat which lesion? a. Papilloma b. Fibroma c. Adenoma d. rhabdomyosarcoma

d. rhabdomyosarcoma

Which of the following statements about hemangiomas is true? a. The gingiva is the most common intraoral location. b. They are more common in boys than in girls. c. They appear as variably sized, deep red or blue lesions that do not blanch when pressure is applied. d. They may occur in adults as a response to trauma and represent an abnormal proliferation of blood vessels during the healing process.

d. they may occur in adults as a response to trauma and represent an abnormal proliferation of blood vessels during the healing process