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CPR 2 Pulm Section > Respiratory Pathology Pt. 6 > Flashcards

Respiratory Pathology Pt. 6 Flashcards

1
Q

What are viral causes of infectious rhinitis/sinusitis?

A
  • rhinovirus
  • coronavirus
  • adenovirus
  • echovirus
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2
Q

What are bacterial causes of infectious rhinitis/sinusitis?

A
  • Strep pneumo

- Haemophilus influenzae

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3
Q

What do the nasal secretions look like in viral rhinitis/sinusitis vs. bacterial?

A

viral: clear
bacterial: thick, purulent

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4
Q

What causes inflammatory sinonasal polyps?

A

chronic rhinitis/sinusitis

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5
Q

What would you see on histology of inflammatory sinonasal polyps?

A
  • edema in the stroma

- eosinophilic infiltrate

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6
Q

To what sinus cavity would a tooth infxn spread?

A

maxillary

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7
Q

What sinus cavity is most likely to have complications such as orbital cellulitis and orbital abscess?

A

ethmoid

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8
Q

What sinus cavity is most likely to have complications such as meningitis and brain abscess?

A

frontal

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9
Q

What would be seen on histology of allergic fungal sinusitis?

A
  • allergic mucin
  • Charcot Leyden crystals
  • eosinophils
  • fungal hyphae
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10
Q

What is a mycetoma?

A
  • “fungal ball”

- possibly seen in fungal sinusitis

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11
Q

What population of patients is most at-risk for the acute invasive sinusitis form of fungal sinusitis?

A

diabetics or immunocompromised

often Mucor

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12
Q

What are possible complications of acute invasive sinusitis d/t fungal sinusitis and what is the Tx?

A
  • infxn spread to brain
  • sepsis

-emergent situation requiring IV antifungal therapy

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13
Q

What age is typical for onset of Granulomatosis w/ Polyangiitis?

A

middle-aged adults

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14
Q

How does Granulomatosis w/ Polyangiitis affect the nasal passages and sinuses?

A
  • ulceration
  • necrosis
  • perforated septum
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15
Q

What will you seen on histology of Granulomatosis w/ Polyangiitis?

A
  • granulomatous inflammation/vasculitis

- “necrobiotic” necrosis (blue)

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16
Q

What are two benign tumors of the nose/sinus/nasopharynx?

A
  • nasopharyngeal angiofibroma

- sinonasal (Schneiderian) papilloma

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17
Q

What are some malignant tumors of the nose/sinus/nasopharynx?

A
  • olfactory neuroblastoma
  • NUT (Nuclear Protein of the Testis) midline carcinoma
  • EBV malignancies (ex: nasopharyngeal carcinoma, extranodal NK/T cell lymphoma)
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18
Q

What is the typical patient population for nasopharyngeal angiofibroma?

A

-young men

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19
Q

What is seen on histology of nasopharyngeal angiofibroma?

A
  • vascular fibrous core lined by benign epithelium
  • spindle cell proliferation
  • looks exactly like penile erectile tissue
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20
Q

What genetic condition is associated with nasopharyngeal angiofibromas?

A

-Familial Adenomatous Polyposis (FAP), which is caused by a mutation in the APC gene

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21
Q

True or False: after removal, nasopharyngeal angiofibromas can recur

A

True.

they also bleed b/c of high vascularity

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22
Q

What population demographic is typical for Sinonasal (Schneiderian) Papilloma?

A

–middle-aged men (more-so than women)

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23
Q

What two patterns of growth could a Sinonasal (Schneiderian) Papilloma exhibit?

A
  • exophytic

- endophytic

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24
Q

What are the characteristics of an endophytic Sinonasal (Schneiderian) Papilloma?

A
  • high rate of recurrence
  • may progress to malignancy (10%)
  • difficult to resect
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25
Q

What is seen on histology of an Olfactory Neuroblastoma?

A
  • “small round blue cell tumor”

- rosettes

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26
Q

From what type of tissue does an Olfactory Neuroblastoma arise?

A

neuroectoderm

it’s a neuroendocrine tumor

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27
Q

True or False: olfactory neuroblastomas have a bimodal age distribution

A
  • adolescence

- middle age

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28
Q

In what shape does an olfactory neuroblastoma grow and why?

A

“dumb-bell” tumor because it runs out of room growing downward, so then it penetrates the cribriform plate and grows upward

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29
Q

What type of cancer is nasopharyngeal carcinoma?

A

squamous cell carcinoma

  • keratinizing (or non-keratinizing)
  • basophilic w/ lymphoid tissue
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30
Q

Where do the majority of cases of nasopharyngeal carcinoma present?

A

-in the neck d/t lymph node metastasis

31
Q

What virus is a risk factor for nasopharyngeal carcinoma?

A

EBV

especially in young African children; this type has a better prognosis

32
Q

What subset of adults has an increased risk of nasopharyngeal carcinoma and why?

A

Chinese and Southeast Asians d/t ingestion of smoked fish w/nitrosamines

(also EBV-related)

33
Q

What virus is a risk factor for Extranodal NK/T cell lymphoma?

A

EBV

34
Q

What demographic has a higher incidence of Extranodal NK/T cell lymphoma?

A
  • occurs at any age, but peaks in middle age

- higher incidence in Asia and Latin America

35
Q

What effects does Extranodal NK/T cell lymphoma have on the sinuses?

A

-necrotic destruction of the paranasal sinuses (necrosis occurs b/c these tumors are so aggressive)

36
Q

What are systemic symptoms of lymphoma?

A
  • fever
  • night sweats
  • weight loss
37
Q

What are vocal cord nodules (aka “singer’s nodules”)?

A
  • reactive process (not infxn, not dysplastic or neoplastic)

- an expansion of the soft tissue underlying the vocal fold in Rienke’s space)

38
Q

What do vocal cord nodules look like on gross appearance?

A
  • soft

- translucent

39
Q

What do vocal cord nodules look like on histology?

A
  • edema

- loose stroma underlying benign squamous epithelium

40
Q

Are laryngeal squamous papillomas a neoplasm?

A

Yes, benign w/ a papillary appearance.

41
Q

With what virus are laryngeal squamous papillomas associated?

A

HPV 6 and 11

42
Q

What do laryngeal squamous papillomas look like on gross appearance?

A

friable papillary masses

43
Q

What do laryngeal squamous papillomas look like on histology?

A

benign or mildly atypical squamous epithelium w/ multiple papillae

44
Q

What condition is associated with multiple laryngeal squamous papillomas?

A

recurrent respiratory papillomatosis

45
Q

What age demographic is most typical for recurrent respiratory papillomatosis?

A

-children and adolescents

46
Q

With what virus is recurrent respiratory papillomatosis associated?

A

HPV 6 and 11

47
Q

What are risk factors of recurrent respiratory papillomatosis?

A
  • -mothers < 20yrs old
  • -vaginal delivery
  • -first-born
48
Q

How does recurrent respiratory papillomatosis affect the lungs?

A

–cysts throughout lungs that cause air-trapping

49
Q

True or False: recurrent respiratory papillomatosis has a malignant progression

A

True, but only rarely. Less than 1% are malignant.

50
Q

What type of cancer is laryngeal carcinoma?

A

squamous cell carcinoma

51
Q

In what demographic is laryngeal carcinoma seen more commonly?

A

men > 60 yrs

52
Q

What are risk factors for laryngeal carcinoma?

A
  • smoking
  • alcohol
  • HPV infxn
53
Q

What type of combined influence do smoking and alcohol have on laryngeal carcinoma?

A

synergistic

54
Q

What causes most of the cases of otitis media: viruses or bacteria?

A

viruses

55
Q

What bacteria are most commonly responsible for bacterial otitis media?

A
  • Step pneumo
  • Moraxella catarrhalis
  • Haemophilus influenzae

-Pseudomonas aeruginosa in diabetics

56
Q

What is cholesteatoma?

A
  • reactive process (not a neoplasm)
  • cystic lesion that arises d/t chronic otitis media
  • lined by benign squamous epithelium w/ trapped keratin debris
57
Q

Why must a cholesteatoma be removed?

A

-can enlarge and erode adjacent bone

58
Q

What is otosclerosis?

A
  • abnormal bony deposition

- typically at the stapedial footplate

59
Q

What complication does otosclerosis cause?

A

conductive hearing loss (d/t lack of vibration)

60
Q

With what inheritance pattern might otosclerosis be connected?

A

autosomal dominant

61
Q

What is the Tx for otosclerosis?

A

-stapes prosthesis

62
Q

Where is the most common location of a branchial cyst?

A

anterior to the SCM

63
Q

In what age group are branchial cysts most commonly diagnosed?

A

young adults

64
Q

How do branchial cysts appear on histology?

A

simple cyst lined by stratified squamous or respiratory epithelium w/ surrounding fibrous tissue

65
Q

What is the most common tumor of the neck in adults?

A

1) metastatic cystic carcinoma

2) thyroglossal duct cyst

66
Q

What is the most common tumor of the neck in adolescents and younger?

A

1) thyroglossal duct cyst

2) branchial cleft cyst

67
Q

What is a thyroglossal duct cyst?

A

remnant nest of tissue from thyroid migration, with cystic change

68
Q

What will you see on histology of a thyroglossal duct cyst?

A

thyroid follicles filled w/ pink colloid

69
Q

What is the cell origin of a carotid body tumor?

A

neural crest (arising from autonomic paraganglia)

70
Q

With what syndrome might a carotid body tumor be associated?

A

MEN 2

71
Q

What sign does a carotid body tumor produce on imaging?

A

Lyre Sign (splaying of the carotids)

72
Q

What does a carotid body tumor look like on histology?

A

-nests of cells (“zellballen”)

73
Q

True or False: malignancy of carotid body tumors can be distinguished from histology

A

False

CPR 2 Pulm Section (9 decks)

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