mouth







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  • Normal

    • stratified squamous epithelium
    • basement membrane
    • lamina propria

  • Non-neoplastic

  • WHO neoplasms

    • malignant epithelial
    • epithelial precursor lesions
      • squamous cell hyperplasia
      • dysplasia
        • mild
        • moderate
        • severe
      • carcinoma in situ
    • benign epithelial
      • papillomas
      • granular cell tumor
      • keratoacanthoma
    • salivary gland tumors
      • see salivary gland section
    • soft tissue
      • Kaposi sarcoma
      • lymphangioma
      • ectomesenchymal chondromyxoid tumor
      • focal oral mucinosis
      • congenital granular cell epulis
      • fibroma
      • lobular capillary hemangioma
      • peripheral ossifying fibroma
      • peripheral giant cell granuloma
    • hematolymphoid
      • lymphoma
        • DLBCL
        • MCL
        • follicular lymphoma
        • MZL
        • Burkitt lymphoma
        • T-cell lymphoma
      • plasmacytoma
      • Langerhans cell histiocytosis
      • myeloid sarcoma
      • follicular dendritic cell sarcoma
    • melanoma
    • metastasis

  • TNM (useful for grossing)

    • T
      • T1: <= 2cm
      • T2: 2-4cm
      • T3: > 4cm
      • T4a
        • lip: involves cortical bone, inferior alveolar nerve, floor of mouth, or skin
        • oral cavity: involves cortical bone, deep/extrinsic tongue muscle, maxillary sinus, skin
        • oropharynx: involves larynx, deep/extrinsic tongue muscle, medial pterygoid, hard palate, mandible
      • T4b
        • lip and oral cavity: involves masticator space, pterygoid plate, skull base, or encases carotid artery
        • oropharynx: involves lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, skull base, or encases carotid artery
      • notes
        • bone involvement can't be just superficial erosion
        • deep/extrinsic tongue muscles: genioglossus, hyoglossus, palatoglossus, styloglossus
    • N (cervical nodes)
      • N1: single ipsilateral node, <= 3cm
      • N2a: single ipsilateral node, 3-6cm
      • N2b: multiple ipsilateral nodes, <= 6cm
      • N2c: contralateral or bilateral nodes, <= 6cm
      • N3: > 6cm

  • Staging

    • 0: Tis
    • I: T1
    • II: T2
    • III: T3 or N1
    • IVA: T4a or N2
    • IVB: T4b or N3
    • IVC: M1
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