What feature is similar about Warthin's tumor, pleomorphic adenoma, and mucoepidermoid carcinoma?
all commonly localize to the parotid gland
papillary cystadenoma lymphomatosum and adenolymphoma other names for what? Why is it helpful to remember this?
Warthin's tumor - useful because cystic glandular benign tumor (cystadenoma) with lymph node-like stroma consisting of abundant lymphocytes and germinal centers (lymphomatosum ). Cystic spaces are surrounded by two uniform rows of cells with centrally placed pyknotic nuclei papillary - b/c epithelium surrounding cystic spaces exhibits "papillary infolding" adenolymphoma - useful to remember because neoplasm of glandular tissue (adenoma) with lymph-node like structures (lymphoma) *only type of salivary gland tumor more common in men than women, 15% of cases are bilateral
Rough whitish patch on the lateral tongue, usually arising in immunocompromised Pts, cannot be scraped off. What is it? What causes it? Is it cancerous?
Hairy leukoplakia Caused by EBV which induces squamous cell hyperplasia (not dysplasia!) not pre-malignant
Painful superficial ulceration of the oral mucosa that is characterized a greyish base surrounded by erythema What condition is this? What causes it?
Aphthous ulceration arises in relation to stress, spontaneously resolves
vesicles in the oral mucosa that rupture and result in shallow painful red ulcers. Usually seen in children. What is this? What causes it?
Primary HSV-1 infection Lesions heal but virus remains dormant in trigeminal nerve ganglion
Vesicles that rupture and result in shallow painful red ulcers - often occurring on the lips. What is it what causes it?
Reactivation of HSV-1 inefection that caused by stress or exposure to sunlight
How can you differentiate aphthous ulcers from primary HSV-1 infections?
primary HSV-1 doesn't have grey base of lesion and usually occurs in childhoord. HSV-1 reactivations don't have grey base and also occur on the lips
syndrome marked by recurrent aphthous ulcers, genital ulcers and uveitis What is it? What causes symptoms?
Bechet syndrome small vessel immune-complex vasculitis
easily scraped away white deposit on tongue seen in immunocompromised states
Oral candidiasis aka thrush
reddish plaque on tongue that cannot be scraped away . What is this? What is it a strong indicator of? Is it cancerous, pre-cancerous or benign?
Erythroplakia squamous cell dysplasia of the oral mucosa per-cancerous ==> can lead to squamous cell carcinoma Alcohol and tobacco are biggest risk factors
Protrusion of edematous, inflammed mucosa that usually arises secondary to repeated bouts of rhinitis but also occurs in cystic fibrosis and aspirin-intolerant asthma.
Protrusion of edematous, inflammed mucosa in a child should be checked for what? In adults?
cystic fibrosis Aspirin intolerant asthma
What is the most common cause of a malignant turmor of the nasopharyngeal epithelium? Who is most susceptible?
Nasopharyngeal carcinom - caused by EBV infection African CHILDREN or Chinese ADULTS
Pt. 16 YO male presents with recurrent epistaxis - what could be the cause?
Nasopharyngeal angioblastoma benign but locally aggressive vascular tumor that grows in the back of the nasal cavity (consists of large blood vessels and fibrous CT). Most commonly affects adolescent males. Usually presents with one-sided nasal obstruction and recurrent bleeding.
45 YO chinese pt. presents with swollen cervical lymph node, blood in saliva, bloody discharge from the nose, nasal congestion, hearing loss, frequent ear infections, headaches. What is a likely diagnosis? What might have caused this?
nasopharyngeal carcinoma secondary to EBV infection
biopsy of a nasopharyngeal carcinoma would likely show what two histological features?
pleomorphic keratin-positive (poorly differentiated) epithelial cells Background of lymphocytes
Most common cause of acute epiglottitis?
H influenza type B (especially among non-immunized)
inflamation of the epiglottis that results in high fever, sore throat, drooping with dysphagia, muffled voice, inspiratory stridow, and risk of airway obstruction
What is croup? What is the most common cause?
inflammation of the upper airway (aka laryngotracheaobronchitis) parainfluenza virus
Pt. is a singer who presents with hoarseness that resolves with resting of voice - what might they have?
vocal cord nodule - nodules on true vocal cords that develop from overuse, usually bilaterally, composed of degenerative(mixoid) CT. not a laryngeal papilloma (also has hoarseness) because resolves with non-use
what causes benign tumors on the vocal cords that present with hoarseness and does not get better with resting voice?
HPV 6 or 11 laryngeal papilloma
T/F layngeal papillomas are usually multiple in children and single in adults
T/F laryngeal papillomas are typically associated with epithelial dysplasia
False - not typically, only rarely pre-cancerous! But does occur - HPV 6 , 11 "Low risk" for cancer -- though can lead to laryngeal carcinoma in rare cases
Most common causes of epithelial dysplasia on true vocal cords that transisions to squamous cell carcinoma of the larynx (laryngeal carcinoma)?
Alcohol and tobacco
benign mobile painless and circumscribed mass in the parotid gland with high recurrence rate after surgical excision
in rare cases pleomorphic adenomas can become malignant resulting in parotid adenocarcinoma. What clinical symptom would be indicative of possible malignancy and why?
diffuse unilateral upper and lower facial pain -- facial nerve runs through parotid gland
Pt presents with bilaterally inflammed parotid glands, testicular pain, feeling of bloating after eating with diffuse left upper abdominal pain that radiates to the back, painful headache, fever, sensitivity to light, nausea and vomiting. Labs show high serum amylase. What do they have? What is the greatest risk of complications in teenagers?
Mumps virus infection with orchitis, pancreatitis and aseptic meningitis sterility
How are neural tube defects usually detected during pregnancy?
elevated AFP levels in amniotic fluid or maternal blood
Congenital failure of cerebellar vermis to develop resulting in massively dilated 4th ventricle very diminished or absent cerebellum; often accompanied by hydrocephalus.
Congenital downward displacement of cerebellar vermis and tonsils through the foramen magnum that can obstruct CSF flow and cause hydrocephalus - very commonly associated with meningomyelocele
Arnold-Chiari malformation Type II meningomyelocele is protrusion of meninges and spinal cord in spinal bifida