Oral pathology: cysts and odontogenic tumours: Langerhans cell histiocytosis: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral pathology: cysts and odontogenic tumours: Langerhans cell histiocytosis

Sample item

A 3-year-old child has loose teeth that seem to float, gingival ulceration and punched-out radiolucencies of the alveolar bone. Biopsy shows cells with Birbeck granules on electron microscopy. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Langerhans cell histiocytosis

Langerhans cell histiocytosis is a clonal proliferation of CD1a-positive cells with Birbeck granules. Jaw involvement gives punched-out lesions and floating teeth, and multisystem disease can add skull lesions, diabetes insipidus and exophthalmos. Management depends on the extent.

Option by option

  • A. Hypophosphatasia

    Hypophosphatasia causes early shedding with intact roots but no bone lesions or Birbeck granules.

  • B. Cherubism

    Cherubism shows bilateral multilocular jaw expansion with a family pattern.

  • C. Langerhans cell histiocytosis (correct)

    Correct. Birbeck granules with floating teeth and punched-out bone lesions define it.

  • D. Burkitt lymphoma

    Burkitt lymphoma produces a rapidly growing jaw mass in a different age group with starry-sky histology.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is C, Langerhans cell histiocytosis. Langerhans cell histiocytosis is a clonal proliferation of CD1a-positive cells with Birbeck granules.

Why is "Hypophosphatasia" not the answer?

Hypophosphatasia causes early shedding with intact roots but no bone lesions or Birbeck granules.

Why is "Cherubism" not the answer?

Cherubism shows bilateral multilocular jaw expansion with a family pattern.

Why is "Burkitt lymphoma" not the answer?

Burkitt lymphoma produces a rapidly growing jaw mass in a different age group with starry-sky histology.

What concept does this question test?

It tests Oral pathology: cysts and odontogenic tumours: Langerhans cell histiocytosis in Dentistry. Jaw involvement gives punched-out lesions and floating teeth, and multisystem disease can add skull lesions, diabetes insipidus and exophthalmos. Management depends on the extent.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral pathology: cysts and odontogenic tumours: Langerhans cell histiocytosis?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.