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Mucocoele Histology — ORE Part 1 MCQ

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ModerateOral PathologyMucocoele HistologyORE Part 1

A patient presents with a smooth, dome-shaped, blue-tinged swelling on the inner aspect of the lower lip. It is approximately 10 mm in diameter, painless, and has been present for 2 months. It has ruptured and reformed twice. What histological feature would you expect on excision biopsy?

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Correct answer: E — Extravasated mucin surrounded by granulation tissue without an epithelial lining

The correct answer is E. A recurrent, bluish, fluctuant swelling on the lower lip is characteristic of an extravasation mucocele. Trauma to a minor salivary-gland duct permits mucin to escape into connective tissue. Histologically, the mucin pool is surrounded by granulation tissue, commonly containing inflammatory cells and muciphages, but lacks an epithelial lining; it is therefore a pseudocyst. Option B describes a true epithelial-lined retention cyst, which results from duct obstruction rather than mucus escape. Option C suggests granulomatous infection or a foreign-body reaction rather than the characteristic mucin pseudocyst. Option D describes a lipoma, and option A indicates a salivary-gland neoplasm; neither fits the recurrent lower-lip lesion or its expected pathology.

Reference: Stojadinovic M, et al. Oral retention and extravasation mucoceles of the minor salivary glands - more common than you might think! 2023. https://pubmed.ncbi.nlm.nih.gov/37272605/