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S3B1 Pathology > Nasal Cavity & Ear II > Flashcards

Nasal Cavity & Ear II Flashcards

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1
Q

What aspect of the provided images indicate a diagnosis of squamous cell carcinoma

A

Left: keratin pearl

Right: Intercellular bridges

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2
Q

What are the major risk factors for squamous cell carcinoma of the head and neck?

A
  • Chronic smoking / alcohol use
  • Sunlight & pipe smoking
  • HPV 16 (oropharyngeal cancer)
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3
Q

What is the difference in prognosis for squamous cell carcinoma that is HPV (+) vs. HPV (-)?

A

HPV 16 (+) have greater long-term survival

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4
Q

What pathology is shown in the provided image?

What features of the photos indicate this diagnosis?

A

Squamous cell carcinoma

L: ulceration & induration of the oral mucosa

R: malignant keratinocytes invading underlying connective tissue stroma & skeletal muscle

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5
Q

What pathology is shown in the provided image?

A

Verrucous carcinoma

“wart-like” filiform appearance

don’t tend to metastasize but can cause problems where they are

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6
Q

What is a detigerous cyst?

Treatment?

A

Cyst originating around the crown of an unerupted tooth

Complete remoal of the lesion is curative

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7
Q

What pathology is shown in the provided image?

Describe how it was identified.

A

Unilocular lesion most often associated with impacted 3rd molar (wisdom) teeth

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8
Q

What is a periapical cyst?

Treatment?

A

Cyst inflammatory in origin found at the apex of the tooth

removal fo the offending material

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9
Q

What pathology is shown in the provided image?

A

periapical cyst

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10
Q

What is a keratocystic odontogenic tumor?

Most commonly affected demographic?

Treatment?

A

Radiographically present as well-defined unilocular/multilocular radiolucencies posterior to mandible most common

10-40, males

complete removal of the lesion

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11
Q

What pathology is shown in the provided image?

A

Keratocystic odontogenic tumor

locally aggressive

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12
Q

Multiple keratocystic odontogenic tumors is associated with what syndrome?

It is associated with what mutation?

A

Nevoid basal cell carcinoma

PTCH gene mutation

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13
Q

What is an odontoma composed of?

A

hamartoma

enamel, dentin, +/- cementum & varying number of tooth-like elements

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14
Q

What is shown in the provided image?

A

Odontoma

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15
Q

What are the features of an ameloblastoma?

A

benign, but locally aggressive with high recurrence rate

expansile, multiloculated “soap bubble” appearance

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16
Q

What patholgoy is shown in the provided images?

Describe the featues of each

A

Radiographically: “soap bubble”

Histologically : stellate reticulum, peripheral palisating (outside perpendicular to inside cells) with apical clear cytoplasm

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17
Q

What are the common causes of laryngitis?

A

allergic, viral, bacterial or chemical (tobacco smoke)

gastroesophageal reflux

systemic infections (tuberculosis & diptheria)

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18
Q

What is the cause of laryngotracheobronchitis?

Presentation?

A

“croup” in children - parainfluenzavirus

nonspecific respiratory symptoms & low grade fever

w/in 1-2 days hoarseness, barking cough & inspiratory stirdor

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19
Q

What are the common causes of laryngoepiglottis?

Presentation?

A

H. influenza, RSV, N. meningitidis, Strep

Medical Emergency in children

Cherry red epiglottis, drooling , tripod posture

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20
Q

What is reinke’s edema?

A

severe swelling of the vocal cords that occurs in heavy smokers

change in character of the voice & progressive hoarsness

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21
Q

What are singer’s nodules?

A

reactive nodules that occur in people who put great strain on their vocal cords

change in character of voice & progressive hoarsness

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22
Q

What can happen to individuals who put put great strain on their coval cords or have reflux irritation?

A

contact ulcers

change in character of the voice & progressive hoarsness

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23
Q

What pathology is shown in the provided image?

A

Singer’s nodule

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24
Q

What patholoyg is shown in the provided image?

A

Reinke’s edema

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25
What is often the cause of squamous papilloma & papillomatosis on the vocal cords? Describe their appearance.
HPV 6 & 11 soft, rasperry-like proliferations benign neoplasm
26
What pathology is shown in the provided image?
Squamous papilloma multiple slender, finger-like projections supported by central fibrovascula core covered in stratified squamous epithelium
27
What is the presentation of carcinoma of the larynx? Most commonly affected demographics? Treatment?
Persistent hoarseness, dysphgea & dysphonia men, chronic smokers, 6th decade, alcohol use Treatment: organ perservation early in disease (chemoradaition, w/ or w/o salvage laryngectomy later in disease)
28
What pathology is shown in the provided image?
Laryngeal squamous cell carcinoma check out keratin pearl on right side
29
What patholoyg is shown in the provided image?
squamous cell carcinoma keratin pearl
30
identify the different types of vocal cord nodules
31
What are the features of a branchial cyst? Most commonly affected demographics?
On lateral neck from remnants of second brachial arch 20-40 yr olds
32
What pathology is shown in the provided image?
Branchial cyst both inside & outside is smooth squamous-lined cysts
33
What are the features of a thyroglossal duct cyst?
midline cyst remnant of the developmental tract
34
What pathology is shown in the provided image?
Thyroglossal Duct Cyst Histology: respiratory or squamous lined; pink round structures are thyroid follicles
35
What is the name of paragangliomas in the head & neck? Most commonly affected demographics? Mutation?
Carotid Body Tumor painless masses 5th & 6th decade, men, high altitude living Loss of function mutation SDH gene
36
What tumor is histologically identical to the paraganglioma? Where does it arise?
Pheochromocytoma arises in adrenal medulla
37
What pathology is shown in the provided image?
Paraganglioma (carotid body tumor) not brachial cyst b/c imaging shows a solid mass rather than a cystic mass mass right at bifurcation of the carotids
38
What pathology is shown in the provided image?
Paraganglioma little nests of cells ("cell balling") with delicate connective tissue stroma surrounding them clusters separated by septa Right: dense-core secretory bodies (black dots) bottom: stain positive for chromogranin
39
What is xerostomia? Causes?
dry mouth old age, Sjogren syndrome, radiation therapy, lots of medications
40
What is Sjogren syndrome?
autoimmune disorder that causes dry mouth & is often accompanied by dry eyes due to lacrimal gland involement
41
Dry mouth can lead to what problems?
fissures, ulcers, dental carries, candidia infection ,dysphasia
42
What is sialadentitis & what are the 4 major causes?
Inflammation of the salivary gland 1. trauma 2. viral infection (mumps) 3. bacterial infection 4. autoimmune disease
43
What is sialolithiasis & what problem is it associated with?
Obstruction produced by a stone bacterial sialadentitis (infection of major salivary gland)
44
Bacterial sialadentitis is often secondary to what 3 conditions? Most common etiological causes?
1. Ductal obstruction produced by stones 2. Decreased secretory function 3. decreased salivary secretions due to dehydration ## Footnote *S. aureus & Streptococcus viridans*
45
What is the most common lesion of the salivary glands? What do they look like?
Mucocele flucuant blue hued nodole on lower lip
46
What is the cause of a salivary mucocele?
blockage or rupture of salivary gland duct w/ leakage of saliva in tissue
47
What is a ranula?
epithelial-lined cysts that arise when the duct of the sublingual gland has been damaged
48
What pathology is shown in the provided image? What features helped you to identify the structure?
mucocele Left: fluctuant fluid-filled lesion on the lower lip Right: cyst-like cavity filled with mucinous material & lined by histocytes adn organizing granular tissue
49
What pathology is shown in the provided image?
ranula
50
If you find a squamous cell carcinoma in the salivary gland, what should you do next?
look for primary in oral cavity, nasopharynx, skin etc. it is uncommon for primary squamous cell carcinoma to occur in the salivary glands
51
Where are the most common location of neoplasms of the salivary glands? What is the relationship between rate of malignancy & gland sise? Most commonly affected demographics?
* Location * Parotid (65-80%) * Submandubular (10%) * Sublingual & minor glands * rate of malignancy is inversely proportional to gland size * sublingual 70-90% * minor 50% * submandibular 40% * parodid 15-30% * Demographics * adults \>\> children * higher rater malignancy in childrren * females \>\> males
52
Primary neoplasms of the salivary glands are more common in females than males, except what kind?
Wharthin tumor
53
Most primary tumors of the salivary glands are bilateral, what are the exceptions?
Warthin tumor pleomorphic adenoma acinic cell carcinoma
54
What type of tumor is a pleomorphic adenoma? Where do they most likely occur? Presentation?
benign tumor - grossly well demarcated & encapsulated epithelial elements dispersed throughout in a matrix of myoid, hyaline, chondroid & osseous tissue usually occur in the parotid painless & slow growing
55
What pathology is shown in the provided image?
pleomorphic adenoma notice it is kind of a lateral neck mass, but it is higher up - will move but is firm
56
What pathology is shown in the provided image?
pleomorphic adenoma of the salivary gland left: well demarcated w/ adjacent normal salivary gland tissue right: (myo)epithelial cells within a chrondromyxoid matrix
57
Where are wharthin tumors located? Most commonly affected demographics?
* Location * parotid (restricted basically) * 10% multifocal * 10% bilateral * Demographics * smokers 8x more risk * males \> females * 5-7th decade
58
What pathology is shown in the provided image? Explain how you came to this conclusion.
Wharthin Tumor big cystic spaces w/ solid stuff poking into them (looking finger-like) w/ viscous black gook microscopically: well circumscribed neoplasm, centrally cystic, finger-like projections poking into the cyst
59
What pathology is shown in the provided image?
Wharthin tumor Left: Epithelial & lymphoid elements surroundign cystic space Right: doule layer of eosinophilic (due to mitochondria) epithelial cells w/ underlying lymphocytes
60
Where do mucoepdermoid carcinomas mosly often occur? What is the 5 yr survival rate of low grade? High grade?
60-70% in parotids low grade- 5 yrs= 90% high grade- 5 yrs= 50%
61
What is the most common form of primary malignant tumor of the salivary glands?
mucoepidermoid carcinoma
62
What pathology is shown in the provided image? How can you tell?
mucoepidermoid carcinoma nests of composed squamous cells, mucus secreting cells (eccentrically placed nuclei) & intermediate cells
63
Where do adenoic cystic carcinomas most commonly occur?
minor salivary glands (palatine) infiltrative
64
What pathology is shown in the provided image? How can you tell?
adenoid cystic carcinoma cribiform pattern enclosing secretions duct-like structures sharing epithelial walls
65
Where are acinic cell carcinomas most likely to occur? Unique characteristics?
parotid \> submandibular \>\>\>\>\> other second most common malignant salivary gland tumor in children may be bilateral
66
What pathology is shown in the provided image?
Acinic cell carcinoma individual cells have zymogen granules, no salivary gland structure
67
Where are salivary duct carcinomas most commonly found? Most commonly affected demographic? They often contain what type of receptors & contain what muation?
* Location * parotid \> submandibular * highly aggressive * look very similar to breast cancer * Demographic * elderly males * androgen receptors * HER/NEU positive
68
Where is polymorphous adenocarcinoma found? How common is it?
minor salivary glands, typically palate 2nd most common tumor of palate
69
What pathology is shown in the provided image?
polymorphous adenocarcinoma ulcerating lesion of the oral cavity histologically: looks like inocuous ducts (overrunning the tissue), but can be aggressive

S3B1 Pathology (7 decks)

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