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A 24-year-old man, on routine examination is found to have nonpainful, sessile masses in the posterior lateral tongue bilaterally. Further inspection shows them to be soft and pink. He is recovering from a recent upper respiratory infection. What is the most likely histological finding when biopsying this tissue?

A. Invasive islands and cords of malignant squamous-epithelial cells

B. Thick layer of parakeratin with underlying koilocytes

C. Normal lymphoid tissue

D. Dense irregular connective tissue

C. A nonpainful, soft, semitranslucent bilateral lesion on the posterior lateral tongue in an otherwise healthy young man with history of pharyngitis should lead one to suspect hyperplastic lingual tonsil. It is due to chronic enlargement of normal lymphoid tissues of the lingual tonsils from repeated pharyngitis or “flue.” The histology is that of normal lymphoid tissue. Choice A corresponds to squamous cell carcinoma. Choice B corresponds to lymphoma. Choice D corresponds to irritation fibroma.

An otherwise healthy 42-year-old man presents with a 5-year history of intermittent tongue pain. The pain is worse when eating and he describes the latest exacerbation after eating at an Indian restaurant. Examination shows a single, irregular deep fissure running down the mid dorsum of the tongue that is moderately tender to palpation. What therapy might be of help with his symptoms?

A. Nystatin lozenges

B. Partial glossectomy

C. Antibiotics

D. Chlorhexidine mouth wash

A. This patient has fissured tongue. The condition can develop pain in later years. Pain can be attributed to spicy foods and secondary candidal infection. Antifungal medication may be of some help to this patient. Also, you can advise avoiding spicy foods.

A concerned mother brings her 6-year-old daughter to your clinic for evaluation of a lingual frenum. Her daughter has met all her milestones and does very well in school. She is wondering if her daughter will require surgical correction of this developmental defect. Oral examination shows a ventral tongue fused to the floor of the mouth with very minimal extension of the frenum to the lingual gingival. What is the best advice to give her?

A. Treatment is recommended as this condition usually progresses to causes speech problems later in life.

B. Treatment is necessary as swallowing and chewing will be affected once she begins her growth spurt

C. Usually no treatment is needed


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