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OS 212 ORL > Patho/Radio > Flashcards

Patho/Radio Flashcards

(94 cards)

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1
Q

reactive lesions (benign fibroepithelial lesions)

etiology

A

chronic irritation

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2
Q

pyogenic granuloma vs peripheral fibroma vs irritation fibroma

A

both gingival

pyogenic - more vascular
peripheral fibroma - more fibrous
irritation fibroma - buccal, more fibrous

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3
Q

denture-induced proliferations

A

epulis fissuratum, gravidarum

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4
Q

leukoplakia (white plaque)

etiology

A

cannot be ascribed to any identifiable etiology

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5
Q

leukoplakia (white plaque)

histology

A

sq hyperplasia w hyperkeratosis (white bc of keratin)

parakeratosis - w nuclei

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6
Q

acanthosis

A

elongation of rete ridges

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7
Q

most important determinant of premalignant potential

A

dysplastic features (pleiomorphism, nucleoli, inc mitosis, hyperchromasia)

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8
Q

most common presentation of EARLY ORAL CANCERS

A

erythroplakia (red plaque)

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9
Q

erythroplakia (red plaque)

histology

A

thin, atropic epithelium, without keratin

LP with engorged capillaries

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10
Q

erythroplakia (red plaque)

grading

A

2/3 sq epith replaced by atypical cells = SEVERE

1/3 replaced = mild

full thickness = carcinoma in situ (intact BM/no invasion)

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11
Q

major oral cavity cancer

A

SCCA

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12
Q

non-keratinizing oral cavity cancer etiology

A

HPV 16, 18

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13
Q

oral cancer histology

A

keratin pearls, intercellular bridges (well differentiated)

poorly differentiated if hardly any (more aggressive)

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14
Q

oral cancer treatment (3)

A

surgery
radiotherapy/chemo
targeted molecular therapy/EGFR targeted drugs

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15
Q

oral cancer prognosis (best and worst)

A

best - lip

worst - floor of the mouth, base of tongue

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16
Q

most common ODONTOGENIC TUMOR

A

ameloblastoma

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17
Q

ameloblastoma presentation (lesions)

A

lytic cysts (soap bubble lesions) - multi-locular radioluscencies (with scalloped margins)

*slow-growing, painless, benign but locally invasive and recurrent

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18
Q

ameloblastoma microscopic landmarks/pathologic hallmarks (3)

A

peripheral palisading cells

reverse nuclear polarization (nuclei at inner edge)

central stellate reticulum

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19
Q

ameloblastoma treatment (2)

A

hemimandelectomy

total mandiblectomy

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20
Q

fibrous dysplasia affects

A

pediatric age group, stops growing near skeletal maturation

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21
Q

ossifying fibroma; osteosarcoma

affects?

A

OF - middle age

osteosarcoma - late teens/ early 20’s

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22
Q

inflammatory nasal polyps etiology

A

chronic inflammation (systemic allergies, asthma)

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23
Q

inflammatory nasal polyps histology

A

PCCE

stroma w edematous inflammatory cells (glistening polyp)

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24
Q

inflammatory nasal polyps treatment (2)

A

polypectomy

treat underlying cause

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25
inflammatory nasal polyps radio
thinned out skull bones (due to pressure, chronic sneezing?)
26
tonsilitis etiology (2)
viral | bacterial (b-hemolytic strep most common -> rheumatic fever, rh heart disease)
27
tonsilitis treatment
medical treatment | tonsillectomy if obstructing airflow (kissing tonsils)
28
necrotizing lesions ("lethal midline granuloma") (3)
fungal (mucor - invasive, aspergillus - non-invasive) auto-immune (wegener's granulomatosis) t/nk lymphoma
29
most neoplasms in nasopharynx are
scca
30
nasopharyngeal angiofibroma (juvenile angiofibroma) histology
branching thin-walled bv in fibrous stroma *unilateral
31
nasopharyngeal angiofibroma treatment
surgery (but complications may arise e.g. hemorrhage)
32
most common benign nasopharyngeal mass
nasopharyngeal (juvenile) angiofibroma
33
nasopharyngeal angiofibroma imaging (2)
angiography with contrast | ct/mri: like sinusitis/polyp; bony structures intact
34
tonsillitis vs asymmetrical tonsils
ddx by persistence of asymmetry
35
sinonasal (schneiderian) papilloma etiology
hpv 6, 11
36
sinonasal (schneiderian) papilloma histology
inverting type papilloma: sq invaginates into stroma
37
sinonasal (schneiderian) papilloma treatment
excision (but formidable; high recurrence)
38
olfactory neuroblastoma (esthesioneuroblastoma) - how to ddx from other nasopharyngeal neoplasms? *malignant; roof of nasal cavity; glabellar protrusions
anosmiaaa
39
olfactory neuroblastoma histology
small round dark blue cells (ddx lymphoma) | homer-wright pseudorosettes!
40
olfactory neuroblastoma treatment
surgery, chemo
41
nasopharyngeal carcinoma affects?
bimodal - young adults, 30-60 y/o endemic in africa & asia
42
nasopharyngeal carcinoma etiology
EBV
43
nasopharyngeal carcinoma presentation (4)
lateral neck mass (late sign of cervical LN metastasis) - most common hot potato voice nasal obstruction unilateral HL & otalgia
44
nasopharyngeal carcinoma histo
small blue round cells ulit undifferentiated - no keratin pearls/intercellular bridges ddx: IHC (detect cytokeratin, present in carcinoma)
45
nasopharyngeal carcinoma treatment
radiotherapy (primary modality) - very effective | difficult surgical access. "swing-out method"
46
nasopharyngeal carcinoma imaging
mass at nasopharynx can extend in all directions bone invasion (characteristic of CA; ddx from angiofibroma)
47
laryngeal cancer treatment
total or partial laryngectomy
48
branchial cleft cyst presentation, etiology
anterior end of scm does not move with swallowing! remnants of branchial arches
49
thyroglossal duct cyst presentation, etiology
anterior midline moves with swallowing! or protrusion of tongue remnants of thyroid cell left behind during migration (recall: from foramen cecum/floor of mouth migrate downward to throat)
50
thyroglossal duct cyst | imaging
beaking of infrahyoid strap muscles over cyst
51
thyroglossal duct cyst histo
sse (above hyoid) pcce (below hyoid) with (functional) thyroid tissue underneath (hyperplastic or resemble follicular/papillary CA)
52
thyroglossal duct cyst treatment
complete excision (cis-trunk). may necessitate removal of hyoid *recurrence; malignant transformation
53
otitis imaging *mastoiditis
chronic irritation can lead to mastoiditis and cholesteatoma in mastoiditis: no honeycombing and air cells due to sclerosis
54
otitis treatment
ab for infections, surgery if severe
55
cholesteatoma etiology
(congenital or acquired) severe otitis media w tm rupture, ingress of sse from external to middle ear (pcce)
56
very common cause of PREVENTABLE DEAFNESS (in child?); conduction deafness
cholesteatoma
57
cholesteatoma histo
sse with keratin debris
58
cholesteatoma treatment
surgical excision
59
tumors pinna pinna & canal child middle ear
pinna - bcc pinna and canal - scc child middle ear - embryonal rhabdomyosarcoma *ceruminous gland tumors
60
sialadenitis etiology (2)
viral - viral parotitis/mumps | bacterial - s. aureus; strep viridans
61
sialadenitis risk factors
dehydration -> viscous fluid -> obstruction (sialolithiasis may be seen in imaging) --> stasis --> infection
62
sialadenitis histo
neutrophilic infiltrates in duct & between acini - BACTERIAL
63
sialadenitis treatment
rarely surgical unless may stone
64
most common salivary gland TUMOR
benign mixed tumors/pleomorphic adenoma
65
benign mixed tumors/pleomorphic adenoma histo
pleomorphic; epithelial (ducts) mesenchymal (chondromyxoid stroma/loose cartilage-like)
66
benign mixed tumors/pleomorphic adenoma treatment
complete excision (mary recur/transform if not complete)
67
SECOND most common salivary gland TUMOR
warthin's tumor (oncocytic papillary cystadenoma lymphomatosum)
68
most common BILATERAL salivary gland tumor
warthin's tumor *synchronous or metachronous (even decades)
69
warthin's tumor location
exclusively in PAROTID
70
warthin's tumor histo
papillary lined by ONCOCYTES (tall columnar eosinophilic) abundance of LYMPHOCYTES
71
most common salivary gland MALIGNANCY, most common salivary gland malignancy in CHILDREN
mucoepidermoid carcinoma
72
mucoepidermoid carcinoma histo
epidermal - squamous cells | mucoid - mucus-secreting cells
73
mucoepidermoid carcinoma grading
``` low-grade = more mucin, more cystic high-grade = more squamous, more solid ```
74
mucoepidermoid carcinoma parameters
anaplasia, necrosis, solid component
75
mucoepidermoid carcinoma treatment
high-grade = total removal (facial nerve sacrifice) low-grade = superficial parotidectomy
76
most common malignancy of MINOR salivary glands; oral cavity (also affects lacrimal)
adenoid cystic carcinoma
77
adenoid cystic carcinoma presentation
oral cavity ulcer (ddx oral cavity scc?) pain due to perineural invasion
78
adenoid cystic carcinoma histology
cribriform (swiss cheese) + hyaline in the lumina
79
adenoid cystic carcinoma prognosis
can recur 10-15 yrs after surg so do long-term follow-up
80
2nd most common BILTERAL salivary gland MALIGNANCY in CHILDREN
acinic cell carcinoma
81
acinic cell carcinoma presentation
pre-auricular masses (well circumscribed and movable, usually in parotid)
82
acinic cell carcinoma histo
dark blue neoplastic acinar cells acini look normal but no adipocytes and ductal system
83
acinic cell carcinoma treatment
complete excision
84
common in the elderly (6th-7th)
carcinoma ex-pleomorphic adenoma (from bmt) *most commonly poorly differentiated
85
carcinoma ex-pleomorphic adenoma histo
residual cartilage (indicates lesions was benign dati)
86
carcinoma ex-pleomorphic adenoma treatment
practically hopeless :(
87
most common lacrimal gland tumor...?
adenoid cystic ca *lacrimal is a specialized salivary gland so salivary gland-type tumor
88
most common MALIGNANT eye tumor of CHILDHOOD
retinoblastoma
89
retinoblastoma presentation
leukocoria | loss of ror --> cat's eye (eye can still be salvaged)
90
retinoblastoma histo
blue small round cell flexner-wintersteiner true rosettes (embryonic rods and cones; with central lumen!)
91
small blue round cell (4)
olfactory neuroblastoma nasopharyngeal ca lymphoma retinoblastoma
92
retinoblastoma treatment
enucleation | laser/cryotherapy + chemotherapy (aggressive but chemoreactive)
93
retinoblastoma imaging
intraocular calcification
94
acute and chronic sinusitis imaging
air fluid levels seen with gravity thickened mucosal swelling & periosteum (pressure)

OS 212 ORL (7 decks)

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