Immune-mediated and Mesenchymal disorders Tutorials **A/Prof Omar Kujan** **Case 1** A 47-year-old female complained of soreness affecting her oral mucosa bilaterally and gave a history of oral mucosa irritation associated with consuming food and toothpaste. Her symptoms come and go. Her medical history is significant for hypertension and hepatitis C. She is a non-smoker and denied alcohol use. **Activity:** • Identify the pathosis and describe the clinical, and histopathological features • What is the differential diagnosis? • What are the relevant clinical investigations? • What is the diagnosis? **Fig. 1. (A) Oral lichen planus involving the left buccal mucosa. (B) Oral lichen planus involving the lateral border of the tongue.** ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_3/fig_0.jpeg) ![fig1](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_3/fig_1.jpeg) **600um** ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_4/fig_0.jpeg) **200µm** ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_5/fig_0.jpeg) **200um** ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_6/fig_0.jpeg) Identify the pathosis and describe the clinical and histopathological features • Clinically Identify the pathosis and describe the clinical and histopathological features • Microscopically Differential diagnosis **Relevant clinical investigations?** What is the diagnosis? **Case 2** **Case description:** A 34-year-old male sought an opinion regarding lower lip swelling, which he noted a few months ago. It increases and decreases in size but does not disappear and has not changed. It remains asymptomatic. He is a non- smoker and drinks socially. His medical history is non-contributory. **Activity:** • Identify the pathosis and describe the clinical and histopathological features • What is the differential diagnosis? • What are the relevant clinical investigations? • What is the diagnosis? No text detected in the image. ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_13/fig_0.jpeg) Histological image of tissue with inflammatory infiltration. ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_14/fig_0.jpeg) Histological image with dense inflammatory infiltrate and vascular congestion. ![fig0](file:///C:/Users/ayham/Documents/Synced Documents/School/D2S2/DENT4217/Oral Pathology/W5 Case Discussion_figures/page_15/fig_0.jpeg) Identify the pathosis and describe the radiological and histopathological features • Clinically Identify the pathosis and describe the radiological and histopathological features • Microscopically What is the differential diagnosis? What are the relevant clinical investigations? What is the diagnosis?