|
|
| (15 intermediate revisions by the same user not shown) |
| Line 1: |
Line 1: |
| − | {{review}} | + | {{frontpage |
| | + | |pagetitle =Oral Cavity and Gingiva - Pathology |
| | + | |pagebody = Stomatitis - generalised inflammation throughout mouth. Glossitis - inflammation of [[Tongue - Anatomy & Physiology|tongue]]. Pharyngitis - pharynx inflammation. |
| | + | |contenttitle =Content |
| | + | |contentbody =<big><b> |
| | + | <br><br> |
| | + | <categorytree mode=pages>Oral Cavity and Gingiva - Pathology</categorytree> |
| | | | |
| | + | </b></big> |
| | + | |logo =path-logo.png |
| | + | }} |
| | | | |
| − | ==Introduction==
| |
| − | *Stomatitis - generalised inflammation throughout mouth.
| |
| | | | |
| − | *Glossitis - inflammation of [[Oral Cavity - Tongue - Anatomy & Physiology|tongue]].
| + | [[Category:Alimentary_System_-_Pathology|A]] |
| − | | + | [[Category:Oral Cavity]] |
| − | *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]]
| |
