Lingual Choristoma — NDEB AFK MCQ

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HardOral PathologyLingual ChoristomaNDEB AFK

A patient presents with a painless swelling on the dorsum of the tongue. Biopsy shows striated skeletal muscle fibres, adipose tissue, and minor salivary glands with no atypia. What is the most likely diagnosis?

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Correct answer: C — Choristoma (lingual thyroid if contains thyroid tissue; otherwise developmental choristoma)

A choristoma is a mass of histologically normal tissue in an abnormal location (a developmental heterotopia). On the tongue, choristomas can contain cartilage (cartilaginous choristoma), bone (osseous choristoma/osteoma), thyroid tissue (lingual thyroid), gastrointestinal mucosa, or glial tissue. The finding of striated muscle, fat, and salivary gland tissue in a developmental mass on the tongue without atypia is consistent with a choristoma. Treatment is conservative excision. Lingual thyroid should be investigated with thyroid function tests before excision to ensure it is not the patient's only functioning thyroid tissue.

Reference: Neville – Oral and Maxillofacial Pathology, 4th ed., 2016