Oral S

[Anaphylactic]

What I mean is Oral Squamous cell carcinoma.

Goljan RR path says that the lower lip is the most common site. But BRS path and Robbins indicate that the tongue is the most common site. Anyone has any insight?

Also, BRS path says that polyarteritis nodosa is associated with P-ANCA. But 1st Aid and Robbins say that it is not. Who is correct?

Thanks.

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[docmd2010]

Hello, i believe that when goljan he was just trying to make an easy way to remember what cancer is on a particular part of the body,

goljan says that from the lower lip and down, if u see a skin neoplasm it's probably going to be SCC and if it's upper lip and up, it's probly going to be a basal cell ca.
that is he isn't saying that the lower lip is the most common site for oral squamous carcinoma.
tongue SCC is the most common cancer in the oral region, i think BRS is correct hrere.

 

[Mediculous]

I think I can help with the P-ANCA part because this confused me during the year. There are, as of right now, only 3 relevant things associated with an ANCA. Furthermore, there are only 2 relevant ANCA's known right now,
P-ANCA(anti-MPO antibody) and C-ANCA(anti-proteinase 3 antibody).
The associations are:
P-ANCA
microscopic polyangiitis
Churg-Strauss syndrome

C-ANCA
wegener's granulomatosis

The reason why PAN is sometimes associated with P-ANCA is because some sources(NOT Robbins) classify microscopic polyangiitis as a variant of PAN. Microscopic polyangiitis effects small vessels, while PAN effects medium-size vessels.

 

[Mediculous]

According to Johns Hopkins' site, microscopic polyangiitis was officially separated from PAN in 1994.
http://vasculitis.med.jhu.edu/typesof/polyangiitis.html

14 years later, and here I am trying to convince my professor and path TA that that happened...
I don't want to come off as the argumentative douche, but I was taught that the buck stops with Robbins, and when there was a discrepancy between my school's path notes and BRS path with Robbins, I went with Robbins. Everyone else frankly didn't care, but whatever, stuff changes and we're supposed to keep up with it.

 

[mercaptovizadeh]

What I mean is Oral Squamous cell carcinoma.

Goljan RR path says that the lower lip is the most common site. But BRS path and Robbins indicate that the tongue is the most common site. Anyone has any insight?

Also, BRS path says that polyarteritis nodosa is associated with P-ANCA. But 1st Aid and Robbins say that it is not. Who is correct?

Thanks.

There is a classic form of polyarteritis nodosa and one form affecting just the small blood vessels called microscopic polyangiitis, which is a leukocytoclastic vasculitis. I think the latter is p-ANCA positive whereas polyarteritis nodosa per se would be a small and medium vessel vasculitis and p-ANCA negative.

Perhaps its a question of semantics. The outer part of the lip might be considered by some to be just a sort of border zone between facial skin and oral mucosa, so BRS path would treat it as non-oral and then the tongue is the most common site of oral scc.

 

[Anaphylactic]

Thanks guys. I think for purpose of step 1, I'l just assume that polyarteritis nodosa is not associated with ANCA.

Docmd: on pg. 331 of Goljan RR path, the margin note indicates that the most common site for SCC is the lower lip. I remember what you said from his audiotape as well so I am not sure about this one.