Head and Neck

Question 1

what is a papilloma

Answer 1

benign, HPV associated papillary wart often caused by types 6 and 11

Question 2

what is leukoplakia

Answer 2

pre-malignant, white plaque like lesions

Question 3

where is squamous cell carcinoma most commonly located in the mouth

Answer 3

floor of mouth
lateral/ventral surfaces of tongue

Question 4

where is mucosal melanoma most commonly located

Answer 4

hard palate/gingiva

Question 5

what is most important when staging the oral cavity/tongue

Answer 5

tumor size and depth of invasion

Question 6

a tumor of which size differentiates a T1 and T2 lip and oral cavity tumor

Answer 6

<2 cm = T1
>2 cm = T2 and beyond

Question 7

what is the normal weight of a thyroid gland

Answer 7

18-25 g

Question 8

what is the gross appearance of Hashimoto thyroiditis

Answer 8

enlarged, pale yellow-tan with a firm, nodular cut surface

Question 9

how much will a thyroid with a multinodular goiter weigh

Answer 9

over 2000 g

Question 10

what is the gross appearance of a follicular adenoma

Answer 10

spherical and encapsulated

Question 11

what is the most common type of malignant thyroid lesion

Answer 11

papillary carcinoma

Question 12

what is a hurthle cell adenoma

Answer 12

follicular adenoma with oxyphilia

Question 13

how can one tell the difference between a follicular adenoma and a follicular carcinoma

Answer 13

follicular carcinomas will have capsular invasion

Question 14

which thyroid malignancy is of neuroendocrine origin

Answer 14

medullary carcinoma

Question 15

how should you section a thyroid specimen

Answer 15

lobes will be sectioned superior to inferior
isthmus will be sections from medial to lateral

Question 16

what’s an important section to submit for a hemi-thyroid specimen

Answer 16

isthmus margin

Question 17

what should you submit for a papillary thyroid lesion

Answer 17

1 section/cm

Question 18

what should you submit for a follicular thyroid lesion

Answer 18

representative sections of lesions and entire capsule

Question 19

what should you submit for a goiter

Answer 19

representative sections per nodule (up to 5)
also submit anything odd like hemorrhage or calcifications

Question 20

what is the most important thing for staging thyroid

Answer 20

tumor size and confinement within thyroid

Question 21

which thyroid carcinoma is staged independent of the rest

Answer 21

medullary because it is a neuroendocrine tumor

Question 22

how should you measure a thyroid

Answer 22

each lobe and the isthmus should be measured separately

Question 23

what is the most common type of parathyroid lesion

Answer 23

adenoma (80%)

Question 24

what is the most important feature of a parathyroid specimen

Answer 24

weight

Question 25

what is the normal weight of a parathyroid gland

Answer 25

20-40 mg/gland

Question 26

what is the supraglottis

Answer 26

area from tip of epiglottis to apex of ventricle

Question 27

what is the glottis

Answer 27

area from ventricle to 1 cm below the free level of the true vocal cord

Question 28

what is the subglottis

Answer 28

area from 1 cm below the level of the true vocal cord to the inferior rim of the cricoid cartilage

Question 29

what is the order of the vocal cords and ventricle from superior to inferior

Answer 29

false vocal cords ventricle true vocal cords

Question 30

from which direction, anterior or posterior, is a larengectomy specimen opened

Answer 30

posteriorly through midline - then use a cotton swab to prop open and fix

Question 31

what is a type of benign laryngeal lesion

Answer 31

squamous papilloma

Question 32

95% of laryngeal carcinomas are what

Answer 32

squamous cell carcinoma

Question 33

where do malignant laryngeal lesions most commonly arise

Answer 33

vocal cords

Question 34

which sections should you submit for a laryngectomy specimen

Answer 34

inferior tracheal margin superior mucosal margin anterior/posterior soft tissue margins tumor with three anatomic subsites both sides of cords, ventricle, and paraglottic space aryepiglottic fold, pyriform sinus, and anterior commessure

Question 35

what is the most important aspect of larynx staging

Answer 35

tumor site/anatomical subsite is critical to staging

Question 36

why is a subsite important for a laryngectomy case

Answer 36

used to identify where lesion is within the supraglottis, glottis, and epiglottis

Question 37

what does a standard radical lymph node dissection include

Answer 37

cervical nodes sternocleidomastoid muscle internal jugular vein spinal accessory nerve submandibular gland

Question 38

what does a modified radical lymph node dissection include

Answer 38

cervical nodes and submandibular gland

Question 39

what does an extended radical lymph node dissection include

Answer 39

cervical nodes sternocleidomastoid muscle internal jugular vein spinal accessory nerve submandibular gland retropharyngeal nodes paratracheal nodes parotid suboccipital nodes mediastinal nodes

Question 40

what does a regional radical lymph node dissection include

Answer 40

nodes of first metastatic station

Question 41

how many lymph nodes typically come in a radcial lymph node dissection

Answer 41

30-40 nodes

Question 42

what's something important to note for a lymph node dissection

Answer 42

if there are enmeshed/matted lymph nodes

Question 43

what is the CPT code for a mucosal biopsy

Answer 43

88305

Question 44

what is the CPT code for a parathyroid gland

Answer 44

88305

Question 45

what is the CPT code for a thyroid

Answer 45

88307

Question 46

what is the CPT code for a larynx without regional lymph nodes

Answer 46

88307

Question 47

what is the CPT code for lymph nodes

Answer 47

88307

Question 48

what is the CPT code for a tongue resection for tumor

Answer 48

88309

Question 49

what is the CPT code for a larynx with regional lymph nodes

Answer 49

88309