Leukaemia Oral Manifestations — MFDS Part 1 MCQ

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ModerateHuman DiseaseLeukaemia Oral ManifestationsMFDS Part 1

Which oral presentation, when unexplained by local plaque-related disease or medication, should most strongly raise suspicion of acute leukaemia, particularly acute myeloid leukaemia?

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Correct answer: B — Diffuse gingival enlargement with spontaneous gingival bleeding

Explanation lettering: C = shown as A · A = shown as B · B = shown as C

A is correct. Acute leukaemia, particularly myelomonocytic or monocytic forms of acute myeloid leukaemia, may cause diffuse gingival enlargement through leukaemic infiltration. Concurrent thrombocytopenia can produce spontaneous gingival bleeding, petechiae and ecchymoses. Rapid or disproportionate gingival enlargement without an adequate local or medication-related explanation is therefore an important diagnostic warning sign and may precede the haematological diagnosis. Bilateral parotid enlargement suggests salivary-gland disease; white reticular buccal striae are typical of oral lichen planus. Dental caries is common and multifactorial rather than a characteristic presenting manifestation of acute leukaemia. Isolated xerostomia is similarly non-specific.

Reference: Sharan J, Mohapatra S, Chhabra G, et al. Gingival hyperplasia: An initial oral manifestation of acute myeloid leukemia. Journal of Indian Society of Periodontology. 2023;27(2):201-206. https://pubmed.ncbi.nlm.nih.gov/37152465/