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Head and Neck > Head and Neck > Flashcards

Head and Neck Flashcards

1
Q

Oral Hairy Leukoplakia associated with and H and E findings?
Can it we wiped off?

A

EBV associated; Hyperkeratosis and hyperplasia with baloon cells in spinous layer, rare inflammation

No! vs. Thrush which can be (unless hyerplastic form)

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2
Q

Lichen planus clinical finding?

H and E?

IF?

A

Wickham striae (white on red)

Sawtooth rete, band like supepithelial chronic inflam.

Granular fibrinogen at basement

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3
Q

Pemphigus vulgaris H and E?
IF/target?

Bullous Pemphigoid H and E?
IF/target?

A

PV: Supra-basal/intra-epithelial blister

“Vulgar” Fishnet IgG, IgM, C3;Antidesmoglein 1/3

BP: Sub-basal;sub-epithelial blister

Basement membrane; linear IgG, C3

Anti-BP antigen (Anti-BP1/2)

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4
Q

Epulis found where on body and age group?
H and E?

Staining?

A

Alveolar ridge on kids

Granular cells without pseudoepitheliomatous hyperplasia

S100- (vs granular cell S100+)

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5
Q

HPV surrogate marker in Non-ker SCC; most common type?

Is there such thing as crypt dysplasia?

A

p16 upregulated by HPV E6/7; 16 (16; 31, 32 less common)

p16 is best in Oropharyngeal Carcinoma

No in NK-SCC it is invasion!!

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6
Q

What is nasopharyngeal carcinoma?

World location?

Associated with?

A

Non-keratonizing SCC mostly in Asia

Nitrosamine and EBV associated if Non-keratonizing; keratonizing not associated with HPV

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7
Q

Odontogenic keratocyst H and E?
Associated syndrome?

Why are OKC’s hard to eradicate?

Treatment?

A

Squamous layer (corregated cardboard) and palasading basal layer;

Gorlan: AD9 (PTCH and SHH pathway); OKC, BCC’s, meduloblasmoma, skeletal issues

Daughter cysts

Caustic treatment or marsupialization

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8
Q

Dentigerous cyst histology?

Ameloblastoma histology?

A

Proliferative squamous lining with inflammation

Central stellate reticulum; can be solid or cystic; reverse polarity

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9
Q

Who gets ameloblastic fibroams?

H and E?

Risk?

A

Kid seen as swelling of posterior mandible

Hypocellular stroma with compressed chrods of ameloblastic epithelium

Risk of ameloblastic fibrosarcoma

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10
Q

Fibrous displasia H and E?

Gene?

Poor or sharp demaracation?

A

Asian letters in fibrous stroma

GNAS

Poorly demarcated with Sharpey’s fibers

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11
Q

Cemento ossyfing fibroma H and E?
Gene?

Poor or sharp demarcation?

A

Variable cellular stroma, Osteoblastic rimming; some woven bone +/- cementum

HRPT2

Sharp!

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12
Q

Who gets Gnathic Osteosarcomas and location?

Is chemotherophy useful?

A

Mid 30s in Mandible>Maxilla

Most are chondroblastic vs osteoblastic

Not as much as in long bones: needs resection

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13
Q

Multiple giant cell lesions in jaw, think of?

Gene?

How to DDx from solid ABC?

A

Cherubism (SH3BP2); lobulated mononuclear cells and polygonal cells with osteoclastic giant cells

USP6+ in ABC

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14
Q

Respiratory Epithelial Adeonomatoid Hamartoma histology?

Who gets them?

A

Benign, see respirtaory glands and goblet cells, surface invaginations, stromal hylanization and thick basement menbranes

Adult men from olfactory clefts

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15
Q

Rhinoscleroma, organism and stain?

Rhiosporidiosis, organism?

A

K. Rhinoscleromastosis (bacteria), Wathin-Starry, Giema

Rhinosporidium seeberi (fungus), sporagnia in tissue (DDX Onocytic Schniderian papilloma)

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16
Q

What is myospherulosis?

A

RBC’s that pack together from petrolatum coated gause; GMS neg.

17
Q

Classic inverted Sinonasal Pap, location and gene?

Oncocytic location and gene?

Exophytic location and gene?

Carcinoma risk in each type?

A

Classic: Lateral nasal wall, EGFR mut >90% HPV LR>HR

Onco: Lateral nasal wall, KRAS ~100%

Exo: Septum; HPV LR

~20% in onco, and classic, rare in exo

18
Q

Sinonasal adeno intestinal type, assocation?

What gets nasopharyngeal angio fibromas?

Stains?

A

Wood/leather dust exposure; CK20+, CDX2+, CK2 +/-

Males with FAP

See slit like blood vessels and fibromas: Stroma AR+, Beta-catenin+

19
Q

SFT morphology, staining?

Hemangiopericytoma staining and gene?

A

Spindle cells with dilated blood vessels; Stat6+, SMA-, CD34+

HPC: SMA+, CD34-, Beta-catenin

HPC: Hylanized vessels!!!

20
Q

Biphenotypic sinonsal sarcoma, H and E?
Staining?

Translocation?

A

Monontonous infiltrative spindle cells, with proliferative respiratory glands

SMA+, S-100+

t(2;5) PAX3-MAML3

21
Q
A
22
Q

NUT Carcinoma H and E?

Genes?

Head and Neck prognosis based on?

A

Ugly primative cells with abrupt keratinization

NUT; BRD4 speckled

Stage; not grade

23
Q

Do chondroma’s occur in the larynx?

A

No most are chondrosarcoma’s; hypocellular grade I and hypercellular grade 2

24
Q

PA H and E?

Can it metastazie?

A

2 cell types; Flower like tyrosine cystals; sometimes chondroid matrix

Yes but rare; can transform to high grade carcinoma

25
Q

Muco-ep H and E?

2 growth patterns?

Adenoid cystic 2 cell types?

What is commonly seen?

A

3 types: Mucinous, intermediate (most common), Squamouid

Solid vs cystic growth patten

Epithelial and myoepithelial; Solid, cribiform, trabecular patterns

Perineural invasion!

26
Q

Polymorphous Adenocaricnoma H and E, common location?

IHC?

A

Palate, Single pale oval nuclei or various architectures; infiltrative with PNI

S100+, P40- (vs adenoid cystic and myo-ep)

27
Q

Acinic cell carcinoma histoloyg?
Good special stain?

Mammary analogue Secratory CA H and E staining, fusion?

A

Acinar cells in sheets without ducts or fat; granular cytoplasm

PAS-D for zymogen staining

Microcystic with some secretion; monotonous round oval nuclei cells

MASC: Mama+, S100+, ETV6-NTRK6

28
Q

Salivary duct carcinoma H and E?

Stains?

A

Looks like high grade DCIS, large cribiforming nests and possible necrosis

AR+, ER/PR-, Her2 amplicfication in some

29
Q

Epithelial myoepithelial carcinoma H and E?

Most common tumor of middle ear, and H and E?
IHC?

Gene to think of?

A

Bilayer tubules with water clear myoepithelial cells

Jugulotypanic paraganglioma, Zellballen type pattern

NE+, Keratin -, S100+ in sustentacular cells

SDHB loss needs genetic testing

30
Q

Papillary endolymphatic sac tumor associated wtih?

H and E?

A

VHL!

Papillary tumor in lymphatic areas!

Head and Neck (1 decks)

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