Author, Donkey, Bureaucrats, Administrators
53,803
edits
Changes
Jump to navigation
Jump to search
Category:Oral Cavity and Gingiva - Pathology (view source)
Revision as of 13:50, 24 May 2010
, 13:50, 24 May 2010Created page with '{{review}} ==Introduction== *Stomatitis - generalised inflammation throughout mouth. *Glossitis - inflammation of tongue. *Pha…'
{{review}}
==Introduction==
*Stomatitis - generalised inflammation throughout mouth.
*Glossitis - inflammation of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]].
*Pharyngitis - pharynx inflammation.
==[[:Category:Oral Cavity - Developmental Pathology]]==
===[[Cleft Palate]]===
==Erosive & Ulcerative Pathology==
*"True ulcer" occurs when connective tissue under epithelium is exposed i.e. stratum germinativum is breached and then lesion takes much longer to heal.
===[[Bovine Virus Diarrhoea Virus]]===
*'''Mucosal Disease''': erosive condition produces small multiple, cleanly punched out lesion in mouth
*[[Neutrophils - WikiBlood|Neutrophils]] invade the ulcer and if bacterial colonisation occurs, further excavation follows. Either:
::#This lesion develops a granular base and becomes diphtheritic.
::#If bacterial colonisation does not take place, healing occurs within fourteen days.
*Seen in most parts of mouth (or maybe on muzzle) e.g. dental pad, [[Cheeks - Anatomy & Physiology|cheeks]], sides of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]]
*Lesions extend throughout gut with particularly big ulcers in small intestine over [[Peyer's Patches - Anatomy & Physiology|Peyers patches]]. Necrosis occurs in lymph nodes and [[Spleen - Anatomy & Physiology|spleen]]
====<span id="BVDHistology">Histology</span>====
*No vesicular stage, prickle cells die off from surface resulting in layer of necrotic debris over epithelial layer
*Infection penetrates inward through stratum germinativum.
*Epithelium does not recover as animal does not recover
===[[Malignant Catarrhal Fever Virus]]===
==Vesicular Pathology==
===Pathology===
*Damage to [[prickle cell]]s ([[stratum spinosum]]).
*Appears as accumulation of fluid within epithelium, quickly erodes leaving hyperaemic [[stratum germinativum]].
*Heals by proliferation of new cells, so long as infection does not continue.
===Pathogenesis===
May be caused by:
#Ingestion of hot food (corrosive liquids)
#Systemic viral diseases. e.g:
##[[picornaviridae#Foot and Mouth Disease Virus|Foot and Mouth disease]] - ruminants and pigs
##[[Vesicular stomatitis]] - horse, pigs, cattle
##[[Vesicular exanthema]] - pigs
N.B. All are indistinguishable from FMD clinically.
===[[Foot and Mouth Disease (FMDV)]]===
====Pathology====
=====Gross=====
#Initially - hyperaemia of mucosa (e.g. catarrhal inflammation) then within 12 hours produces fluid filled vesicles on dorsum of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]], may be other places
#Small vesicle coalesce to produce big ones -i.e. Bullae
#Very quickly rupture; epithelium appears dirty grey in colour because of necrosis - sloughed skin, very good for diagnosis
#Leave painful, hyperaemic epithelium
#Looks like "ulcer "with ragged edge but not a true ulcer as stratum germinativum retained and will rapidly heal completely in about 2 weeks unless becomes secondarily infected
=====Microscopic lesions=====
*Degeneration of prickle cells
*Cells "balloon" as fill with fluid and then die to produce vesicle containing straw coloured or clear fluid
===[[Swine Vesicular Disease]]===
*May produce vesicles in mouth that are indistinguishable from foot and mouth disease
*Swine vesicular disease produces sporadic large outbreaks
**Approximately 5% have lesions in mouth, foot lesions much more common
===Vesicles in dogs===
*Vesicles in mouth are often caused by hot food - especially in dogs.
*Can produce quite big vesicles, but will heal.
*No major problems associated with vesicles on [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] in dogs (except if due to drinking battery acid, but this also produces vomiting).
==Catarrhal Stomatitis==
*Non-specific, general stomatitis
===Pathology===
*Starts as hyperaemia and oedema of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] or pharynx with mucoid exudate on surface.
*Lymphoid follicles on [[Soft Palate - Anatomy & Physiology|soft palate]] may enlarge and proliferate.
*Often see white spots due to epithelial hyperplasia and increased mucous secretion.
**(can be scraped off to leave ordinary mucosa underneath).
*May produce bad smell.
*Resolves normally if not secondarily infected.
===Pathogenesis===
*May be caused by:
**Low grade [[:Category:Streptococcus species|streptococcal]] infection
**Ingestion of toxins
**Result of other more systemic diseases
==Granulomatous and pyogranulomatous Inflammation==
==Eosinophilic Inflammation==
===Eosinophilic granuloma===
This is a complex of diseases affecting skin and [[Oral Cavity Overview - Anatomy & Physiology|oral cavity]] mainly of cat, which include:
#Oral eosinophilic granuloma
#[[Linear granuloma]] of skin
#[[Eosinophilic plaque]] of skin
====Clinical====
*Any age, but usually young adults.
*Mainly affects [[Lips - Anatomy & Physiology|lips]], may also occasionally affect '''frenulum of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]]'''.
*Sometimes called "rodent ulcer "
*Not neoplastic - it is an inflammatory disease but is '''progressive and destructive'''.
*May see small plaque or becomes very '''infiltrative'''.
*In worst cases may erode away whole nose.
====Pathogenesis====
*Histologically lots of eosinophils, polymorphs.
*Exaggerated eosinophilic response.
==Necrotizing Inflammation==
==Lymphocytic and plasmacytic Inflammation==
==Immune Mediated Pathology==
===Autoimmune===
*Occasionally see vesicles on the oral mucosa. associated with autoimmune diseases such as [[pemphigus]] vulgaris.
===Hypersensitivity===
==Proliferative Pathology==
===Hyperplastic===
====Polychlorinated Napthalene Poisoning====
*Polychlorinated biphenyl's (PCB's).
*Used in all sorts of things.
*Do not break down in environment and very toxic.
*Poisoning was classically seen as proliferative stomatitis when PCB used to lubricate feed pellet making machine.
*Vitamin A antagonist produces hyperkeratosis of mouth (like Vitamin A deficiency).
===Papular===
====Orf====
*[[Poxviridae|Pox]] infection
*Quite a common '''zoonotic''' disease
=====Clinical=====
*In sheep produces a proliferative nodule/papular mass on [[Lips - Anatomy & Physiology|lips]]
*In flocks in which it is endemic it is seen in lamb
*If flock is non-immune seen in ewes too but much worse in lambs (may spread to inside of mouth)
*Can spread to udder of ewe
=====Pathology=====
*Poxvirus infections produce local infection of [[prickle cells]] in epithelium with proliferation of cells and formation of papule followed by ulceration / necrosis and covered by necrotic epithelium
*Eventually scabs form and crust drops off
*Scabs - very infectious ( N.B.if touch -> catch it)
====Bovine Papular stomatitis====
[[Image:BPS.gif|right|thumb|125px|<small><center>Ring Zone Lesions of BPS - Calf (Courtesy of Alun Williams (RVC))</center></small>]]
*Parapox virus
*Very similar disease to orf but seen in cattle and generally milder condition.
*'''Must be differentiated from [[#Foot and Mouth disease|Foot and Mouth Disease]] and [[#Bovine Viral Diarrhoea / Mucosal disease|Mucosal Disease.]]'''
*Sporadic, in cattle, less than 1 year old.
*Develop papules on the muzzle, external nares and in the [[Oral Cavity Overview - Anatomy & Physiology|oral cavity]]; the [[Oesophagus - Anatomy & Physiology|oesophagus]] and [[Stomach and Abomasum - Anatomy & Physiology|forestomachs]] may also be affected.
*Usually heals spontaneously.
=====Pathogenesis=====
*The early lesions are round areas of intense congestion up to 1.5 cm in diameter.
*The centre becomes necrotic and slightly depressed.
*Slow peripheral extension of this lesion gives a classical ring zone formation with concentric rings of
**yellow (necrosis),
**grey (epithelial hyperplasia)
**red (congestion).
=====Histology=====
*There are focal areas of hydropic degeneration in the stratum spinosum
*Large eosinophilic intracytoplasmic inclusion
*Epidermis is markedly thickened.
*The superficial layers of the epithelium become necrotic and slough.
*''Vesicle formation is not a feature of this disease.''
====Papilloma====
===Neoplastic===
====Squamous cell carcinoma====
[[Image:oral squamous cell carcinoma.jpg|right|thumb|125px|<small><center>'''Oral squamous cell carcinoma'''. Courtesy of T. Scase</center></small>]]
==Degenerative Pathology==
==Metabolic Pathology==
===Uraemia===
[[Image:uraemia.gif|right|thumb|125px|<small><center>Lesions due to uraemia associated with pyelonephritis/chronic renal failure (Courtesy of Alun Williams (RVC))</center></small>]]
*In terminal renal failure animal may present with painful ulcers in mouth, which become secondarily infected with Fusiformis.
**High concentrations of toxic materials in the blood results in degeneration of small arterioles.
*In the mouth, this damage to the blood supply can cause epithelial necrosis.
*Usually seen as erosions along the ventrolateral borders of the [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] and on the [[Cheeks - Anatomy & Physiology|cheeks]], especially opposite the [[Oral Cavity - Teeth & Gingiva - Anatomy & Physiology|teeth]].
*In some cases there may be more extensive necrosis which may involve subepithelial tissue
**for example, the tip of the [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] may slough.
*Most commonly seen in dog sometimes in cat.
==Nutritional Pathology==
===Nicotinic Acid Deficiency===
*May also cause epithelial necrosis and sloughing.
==Traumatic Pathology==
===Ulcers Following Trauma===
*Any animal that is exposed to coarse feed or sharp things in food can suffer from ulcers in mouth.
*They often become secondarily infected with production of metastatic infection that may result in large abscess on point of jaw.
**i.e. trauma on [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] may lead to secondary infection that may lead to abscess in drainage lymph node.
*Deep ulcers may occur as a result of trauma in any species.
*These readily become secondarily infected by [[Fusiformis]].
*Produces a fibrin-covered ulcer.
*Responds to antibiotics, but may leave a defect or scar in mucosa.
==Vascular Pathology==
==Learning Tools==
::[[Alimentary Flashcards - Pathology#Cavity and Gingiva Flashcards|Cavity and Gingiva Flashcards]]
==Introduction==
*Stomatitis - generalised inflammation throughout mouth.
*Glossitis - inflammation of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]].
*Pharyngitis - pharynx inflammation.
==[[:Category:Oral Cavity - Developmental Pathology]]==
===[[Cleft Palate]]===
==Erosive & Ulcerative Pathology==
*"True ulcer" occurs when connective tissue under epithelium is exposed i.e. stratum germinativum is breached and then lesion takes much longer to heal.
===[[Bovine Virus Diarrhoea Virus]]===
*'''Mucosal Disease''': erosive condition produces small multiple, cleanly punched out lesion in mouth
*[[Neutrophils - WikiBlood|Neutrophils]] invade the ulcer and if bacterial colonisation occurs, further excavation follows. Either:
::#This lesion develops a granular base and becomes diphtheritic.
::#If bacterial colonisation does not take place, healing occurs within fourteen days.
*Seen in most parts of mouth (or maybe on muzzle) e.g. dental pad, [[Cheeks - Anatomy & Physiology|cheeks]], sides of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]]
*Lesions extend throughout gut with particularly big ulcers in small intestine over [[Peyer's Patches - Anatomy & Physiology|Peyers patches]]. Necrosis occurs in lymph nodes and [[Spleen - Anatomy & Physiology|spleen]]
====<span id="BVDHistology">Histology</span>====
*No vesicular stage, prickle cells die off from surface resulting in layer of necrotic debris over epithelial layer
*Infection penetrates inward through stratum germinativum.
*Epithelium does not recover as animal does not recover
===[[Malignant Catarrhal Fever Virus]]===
==Vesicular Pathology==
===Pathology===
*Damage to [[prickle cell]]s ([[stratum spinosum]]).
*Appears as accumulation of fluid within epithelium, quickly erodes leaving hyperaemic [[stratum germinativum]].
*Heals by proliferation of new cells, so long as infection does not continue.
===Pathogenesis===
May be caused by:
#Ingestion of hot food (corrosive liquids)
#Systemic viral diseases. e.g:
##[[picornaviridae#Foot and Mouth Disease Virus|Foot and Mouth disease]] - ruminants and pigs
##[[Vesicular stomatitis]] - horse, pigs, cattle
##[[Vesicular exanthema]] - pigs
N.B. All are indistinguishable from FMD clinically.
===[[Foot and Mouth Disease (FMDV)]]===
====Pathology====
=====Gross=====
#Initially - hyperaemia of mucosa (e.g. catarrhal inflammation) then within 12 hours produces fluid filled vesicles on dorsum of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]], may be other places
#Small vesicle coalesce to produce big ones -i.e. Bullae
#Very quickly rupture; epithelium appears dirty grey in colour because of necrosis - sloughed skin, very good for diagnosis
#Leave painful, hyperaemic epithelium
#Looks like "ulcer "with ragged edge but not a true ulcer as stratum germinativum retained and will rapidly heal completely in about 2 weeks unless becomes secondarily infected
=====Microscopic lesions=====
*Degeneration of prickle cells
*Cells "balloon" as fill with fluid and then die to produce vesicle containing straw coloured or clear fluid
===[[Swine Vesicular Disease]]===
*May produce vesicles in mouth that are indistinguishable from foot and mouth disease
*Swine vesicular disease produces sporadic large outbreaks
**Approximately 5% have lesions in mouth, foot lesions much more common
===Vesicles in dogs===
*Vesicles in mouth are often caused by hot food - especially in dogs.
*Can produce quite big vesicles, but will heal.
*No major problems associated with vesicles on [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] in dogs (except if due to drinking battery acid, but this also produces vomiting).
==Catarrhal Stomatitis==
*Non-specific, general stomatitis
===Pathology===
*Starts as hyperaemia and oedema of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] or pharynx with mucoid exudate on surface.
*Lymphoid follicles on [[Soft Palate - Anatomy & Physiology|soft palate]] may enlarge and proliferate.
*Often see white spots due to epithelial hyperplasia and increased mucous secretion.
**(can be scraped off to leave ordinary mucosa underneath).
*May produce bad smell.
*Resolves normally if not secondarily infected.
===Pathogenesis===
*May be caused by:
**Low grade [[:Category:Streptococcus species|streptococcal]] infection
**Ingestion of toxins
**Result of other more systemic diseases
==Granulomatous and pyogranulomatous Inflammation==
==Eosinophilic Inflammation==
===Eosinophilic granuloma===
This is a complex of diseases affecting skin and [[Oral Cavity Overview - Anatomy & Physiology|oral cavity]] mainly of cat, which include:
#Oral eosinophilic granuloma
#[[Linear granuloma]] of skin
#[[Eosinophilic plaque]] of skin
====Clinical====
*Any age, but usually young adults.
*Mainly affects [[Lips - Anatomy & Physiology|lips]], may also occasionally affect '''frenulum of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]]'''.
*Sometimes called "rodent ulcer "
*Not neoplastic - it is an inflammatory disease but is '''progressive and destructive'''.
*May see small plaque or becomes very '''infiltrative'''.
*In worst cases may erode away whole nose.
====Pathogenesis====
*Histologically lots of eosinophils, polymorphs.
*Exaggerated eosinophilic response.
==Necrotizing Inflammation==
==Lymphocytic and plasmacytic Inflammation==
==Immune Mediated Pathology==
===Autoimmune===
*Occasionally see vesicles on the oral mucosa. associated with autoimmune diseases such as [[pemphigus]] vulgaris.
===Hypersensitivity===
==Proliferative Pathology==
===Hyperplastic===
====Polychlorinated Napthalene Poisoning====
*Polychlorinated biphenyl's (PCB's).
*Used in all sorts of things.
*Do not break down in environment and very toxic.
*Poisoning was classically seen as proliferative stomatitis when PCB used to lubricate feed pellet making machine.
*Vitamin A antagonist produces hyperkeratosis of mouth (like Vitamin A deficiency).
===Papular===
====Orf====
*[[Poxviridae|Pox]] infection
*Quite a common '''zoonotic''' disease
=====Clinical=====
*In sheep produces a proliferative nodule/papular mass on [[Lips - Anatomy & Physiology|lips]]
*In flocks in which it is endemic it is seen in lamb
*If flock is non-immune seen in ewes too but much worse in lambs (may spread to inside of mouth)
*Can spread to udder of ewe
=====Pathology=====
*Poxvirus infections produce local infection of [[prickle cells]] in epithelium with proliferation of cells and formation of papule followed by ulceration / necrosis and covered by necrotic epithelium
*Eventually scabs form and crust drops off
*Scabs - very infectious ( N.B.if touch -> catch it)
====Bovine Papular stomatitis====
[[Image:BPS.gif|right|thumb|125px|<small><center>Ring Zone Lesions of BPS - Calf (Courtesy of Alun Williams (RVC))</center></small>]]
*Parapox virus
*Very similar disease to orf but seen in cattle and generally milder condition.
*'''Must be differentiated from [[#Foot and Mouth disease|Foot and Mouth Disease]] and [[#Bovine Viral Diarrhoea / Mucosal disease|Mucosal Disease.]]'''
*Sporadic, in cattle, less than 1 year old.
*Develop papules on the muzzle, external nares and in the [[Oral Cavity Overview - Anatomy & Physiology|oral cavity]]; the [[Oesophagus - Anatomy & Physiology|oesophagus]] and [[Stomach and Abomasum - Anatomy & Physiology|forestomachs]] may also be affected.
*Usually heals spontaneously.
=====Pathogenesis=====
*The early lesions are round areas of intense congestion up to 1.5 cm in diameter.
*The centre becomes necrotic and slightly depressed.
*Slow peripheral extension of this lesion gives a classical ring zone formation with concentric rings of
**yellow (necrosis),
**grey (epithelial hyperplasia)
**red (congestion).
=====Histology=====
*There are focal areas of hydropic degeneration in the stratum spinosum
*Large eosinophilic intracytoplasmic inclusion
*Epidermis is markedly thickened.
*The superficial layers of the epithelium become necrotic and slough.
*''Vesicle formation is not a feature of this disease.''
====Papilloma====
===Neoplastic===
====Squamous cell carcinoma====
[[Image:oral squamous cell carcinoma.jpg|right|thumb|125px|<small><center>'''Oral squamous cell carcinoma'''. Courtesy of T. Scase</center></small>]]
==Degenerative Pathology==
==Metabolic Pathology==
===Uraemia===
[[Image:uraemia.gif|right|thumb|125px|<small><center>Lesions due to uraemia associated with pyelonephritis/chronic renal failure (Courtesy of Alun Williams (RVC))</center></small>]]
*In terminal renal failure animal may present with painful ulcers in mouth, which become secondarily infected with Fusiformis.
**High concentrations of toxic materials in the blood results in degeneration of small arterioles.
*In the mouth, this damage to the blood supply can cause epithelial necrosis.
*Usually seen as erosions along the ventrolateral borders of the [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] and on the [[Cheeks - Anatomy & Physiology|cheeks]], especially opposite the [[Oral Cavity - Teeth & Gingiva - Anatomy & Physiology|teeth]].
*In some cases there may be more extensive necrosis which may involve subepithelial tissue
**for example, the tip of the [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] may slough.
*Most commonly seen in dog sometimes in cat.
==Nutritional Pathology==
===Nicotinic Acid Deficiency===
*May also cause epithelial necrosis and sloughing.
==Traumatic Pathology==
===Ulcers Following Trauma===
*Any animal that is exposed to coarse feed or sharp things in food can suffer from ulcers in mouth.
*They often become secondarily infected with production of metastatic infection that may result in large abscess on point of jaw.
**i.e. trauma on [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]] may lead to secondary infection that may lead to abscess in drainage lymph node.
*Deep ulcers may occur as a result of trauma in any species.
*These readily become secondarily infected by [[Fusiformis]].
*Produces a fibrin-covered ulcer.
*Responds to antibiotics, but may leave a defect or scar in mucosa.
==Vascular Pathology==
==Learning Tools==
::[[Alimentary Flashcards - Pathology#Cavity and Gingiva Flashcards|Cavity and Gingiva Flashcards]]