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84 Cards in this Set
- Front
- Back
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What are the infectious diseases of the oral/oropharynx?
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Candida
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What are the non-infectious, non-neoplastic diseases of the oral/oopharynx?
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(1) Extravasation mucocele
(2) Lingual Thyroid (3) Sarcoidosis |
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What is the neoplastic growth in the oral/oropharynx?
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(1) Squamous Cell Carcinoma
(2) Tonsillar Lymphomas |
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Candida - clinically?
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- Immunocompromised Patients
- "Thrush" |
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Candida pathology?
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- superficial infection by oral flora
- hyphal = spaghetti - yeast = meatballs. |
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Excravasation mucocele Clinically?
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- lower lip mass
- floor of mouth cyst ("ranula") - Ranula form sporadically and can track inferiorly --> asymmetry beside the neck |
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Extravasation Mucocele Pathology?
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Etiology: minor salivary duct trauma
Mucin extravasation Alcian blue (+) |
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Lingual Thyroid clinical?
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- Children - old age - can be anyone
- dysphagia, foreign body sensation - 10% are hypothyroid |
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Lingual Thyroid Radiograph?
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- scintigraphy to demonstrate other thyroid and function of lingual thyroid
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Pathology of Lingual Thyroid?
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- only thyroid gland in greater than 70% (if remove it, the individual will become hypothyroid)
- unencapsulaed - low malignant potential |
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Sarcoidosis clinical?
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- young adults with fever, weight loss
- pulmonary, cutaneous involvement - ENT: oral, S/N, larynx, salivary gland, ear |
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Sarcoidosis radiographic?
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- screen with chest x-ray: hilar adenopahty
- ENG: non-destructive (Wegner's is destructive) |
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Sarcoidosis pathology?
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- well definied, non-necrotizing granulomas
- no vasculitis - elevated angiotensin converting enzyme - lip biopsy (+) in --> 50% |
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SCC clinical?
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- lower lip most common (sun smoking)
- tongue>FOM>gingiva>palate> tonsil (smoking) |
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SCC radiographic?
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- staging - local extent, regional LNs, CXR
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SCC Pathology?
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Etiology: mutagens
- Prognosis is a function of size, grade, and stage. The histology must have (1) intracellular bridges and (2) Cytokeratin |
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What disease of the salivary glands is infectious?
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Sialadenitis +/- sialolithiasis (stones)
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What disease of the salivary gland is non-infectious or non-neoplastic?
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Sjogren’s syndrome
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What disease of the salivary gland is neoplastic.
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Pleiomorphic adenoma
Mucoepidermoid CA Adenoid cystic CA |
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Siladeniits/Sialolithiasis clinica?
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- Inflammation, parotid or sub-mand
- Non-obstructive – staph, strep, mumps - Obstructive – duct stones +/- infxn |
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Why do you need radiogrphs for sialadenits or sialolithiasis?
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Plain films to document stone (most stones are radio-opaque)
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Sialadenitis/Sialolithiasis pathology?
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-ductal stones: SMG>parotid
- acinar inflammation, fibrosis, atrophy |
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Sjogren's sydnrome clinical?
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- Adults
- F>M - Associated w/ keratoconjunctivitis sicca, xerostomia, connective tissue disease (RA, SLE, PAN, etc) |
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Sjogren's syndrome pathology?
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- Major and minor glands involved
- Benign lymphoepithelial lesions - Epimyoepithelial islands |
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Pleiomorphic Adenoma clinical?
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- Adults
- F>M - Slow growing, painless mass of major or minor salivary gland - Parotid >others |
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Pleiomorphic adenoma pathology?
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- Most common benign sal. gland neoplasm
- Discrete, unifocal, encapsulated - Epithelium, myoepithelium, myxoid stroma - Local recurrence potential, rare malignancy |
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Mucoepidermoid CA clinical?
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- Children-adults
- Major or minor glands - May have h/o prior irradiation |
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Mucoepidermoid CA pathology?
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- Most common malignant sal. gland neoplasm
- Low/intermed grade: mucous > epidermoid - High grade: epidermoid > mucous - Mucicarmine stain (+) |
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Adenoid cystic CA clinical ?
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- Adults
- M=F - Salivary gland mass - Major>minor |
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Adenoid cystic CA pathology?
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- unencapsulated, infiltrative, perineural
- tubular or cribiform architecture - mucinous basement membrane material - course: local recurrences, late metastases |
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What is the infectious disease of sinonasal?
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Allergic Fungal Sinusitis
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What are the non-infectious, non-neoplastic diseases of the sinonasal?
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Inflammatory (allergic) polyps
Sarcoidosis Wegener's granulomatosis |
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What are the neoplastic diseases of the sinonasal?
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Schneiderianpapillomas
Skin Lesions of Nasal Vestibule |
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Allergic fungal sinusitis clinical?
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- Allergic response to fungi (Aspergillus)
- Children-young adults w/ headache |
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Allergic Fungal Sinusitis radiographic?
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- Sinus opacification
- Maxillary, ethmoid most common |
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Allergic Fungal Sinusitis pathology?
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- Mucoid plug w/ fungal hyphae
- GMS silver stain (+) |
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Inflammatory (allergic) polyps clinical?
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- Any age
- Rhinnorhea, headaches - Airborne allergens - Children: r/o CF and Kartagener’s |
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Inflammatory (allergic) radiographic?
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ST mass(es) in sinuses or nasal cavity
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Inflammatory (allergic) pathology?
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- Boggy polyps, up to several cm
- Respiratory epith, stromal edema, eos |
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Wegener's granulomatosis clinical?
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- Adults
- M>F - ENT, lung, and GU - ENT: nasal cavity > sinuses > other ENT |
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Wegener's granulomatosis Radiographic?
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- Sinus opacification
- Bone/ST destruction |
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Wegenere's granulomatosis pathology?
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- Necrotizing granulomatous vasculitis
- ↑c-ANCA in >85% w/ active disease |
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Schneiderian papillomas Clinical?
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- Adolescents, adults
- Local symptoms - ST mass on either nasal septum or lat wall |
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Schneiderian papillomas Radiographic?
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- Unilateral nasal cavity ST mass
- +/- sinus opacification |
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Schneiderian papillomas pathology?
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- Fungiform/exophytic: septal wall, no ↑risk CA
- Oncocytic – lateral wall, 5-10% risk of CA - Inverted – lateral wall, 5-10% risk of CA |
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What are the infectious diseases of the nasopharynx?
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Infectious Mononucleosis
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What are the non-infectious, non-neoplastic diseases of the nasopharynx?
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Sarcoidosis
Wegener's granulomatosis |
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What are the neoplastic diseases of the nasopharynx?
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Teratoma
Angiofibroma Nasopharyngeal Carcinoma |
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Infectious Mononucleosis clinical?
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- Adolescents, young adults most common
- Fever, sore throat, malaise - Tender posterior LNs, hepatosplenomegaly |
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Infectious Mononucleosis pathology?
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- Tonsillitis/lymphadenitis
- Reactive B and T lymphocyte hyperplasia - IgM and IgG serologies against viral Ags - Self-limited in immunocompetent patients |
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Teratoma clinical?
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- Majority in children; rare after 2 yrs old
- Dysphagia or airway obstruction |
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Teraoma Radiographic?
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ST mass in NP
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Teratoma Pathology?
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- Germ cell tumor: 3 germ cell layers present
- Mature vs. immature - Pure teratoma or mixed w/ other GCTs - No malignant potential in kids |
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Angiofibroma clinical?
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- Adolescent-young adult males
- Nasal obstruction & epitaxis - Lateral or posterior NP wall mass |
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Angiofibroma radiographic?
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- CT: ST mass w/ contrast enhancement
- Angiography: vascular hypretrophy |
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Angiofibroma pathology?
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- Sessile, lobulated ST mass
- Benign fibrous tumor w/ ↑numbers of thin-walled vessels w/o smooth muscle |
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Nasopharyngeal carcionoma clinical?
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- Adults
- M>W - China>US - Associated w/ EBV |
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Nasopharyngeal carcionoma radiographic?
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- ST mass of lat NP (fossa of Rosenmuller)
- +/- bone destruction/invasion |
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Nasopharyngeal Carcinoma pathology?
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- Undifferentiated>squamous
- Undiff. type has admixed benign lymphs - Undiff. also easier to treat (unlike other neoplasms) |
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What are the infectious diseases of the ear?
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Otis Media
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What are the non-infectious, non-neoplastic diseases of the ear?
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Sarcoidosis
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What are the neoplastic diseases of the ear?
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- Cholesteatoma
- 8th CN Schwannoma - Jugulotympanic Paraganlioma - External canal SCC |
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Otitis Media Clinical?
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- Young children w/ recent URI, fever, otalgia, ↓hearing, bulging immobile TM due to undrained middle ear fluid
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Otis Media Pathology?
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- Never biopsied
- Micro: sterile or (+) staph, strep, H. flu |
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Cholesteatoma clinical?
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- Any age; peak 20s-30s
- M>F - Hearing loss, pain - Middle ear +/- mastoid mass |
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Cholesteatoma Pathology?
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- Cyst of benign squamous epithelium w/ accumulation of loose keratin
- May show foreign body reaction |
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Jugulotympanic Paraganglioma clinical?
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- Adults
- F>M - Middle ear ST mass associated w/ jugular vein bulb |
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Jugulotympanic Paragnaglioma
Radiographic? |
- CT: ST mass w/ local destruction
- Angio: well-vascularized |
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Jugulotympanic Paragnaglioma Pathology?
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- Benign but invasive paraganglioma
- Chief and sustentacular cells, “zellballen” - Synaptophysin/chromogranin Ab stains |
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External Canal SCC clinical?
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- Adults
- M>F - Non-healing mass or ulcer of external ear |
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External Canal SCC pathology?
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- Etio: sun exposure (actinic damage)
- Differential: melanoma, basal cell CA |
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What are the infectious diseases of the larynx?
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- Sqaumous Papillomas (HPV)
- Acute Epiglottits |
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What are the non-infectious, non-neoplastic diseases of the larynx?
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Vocal Cord Polyps
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What are the neoplastic lesions of the larynx?
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Squamous Cell Carcinoma
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Squamous Papillomas clinical?
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- Children: 2-3 yrs, multiple lesions, frequent local recurrence
- Adults: single lesions, less frequent recurrence, less frequent spread |
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Squamous Papillomas (HPV) pathology?
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- Bland squamous papilloma
- May have HPV changes - 10% spread distally - 2% CA |
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Acute Epiglottitis clinical?
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Child or adult w/ fever, upper airway obstruction, stridor
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Acute Epiglottitis radiographic?
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Lat view showing epiglottic edema
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Acute Epiglottits Pathology?
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- Acute inflammation, bacteria, usually H. flu
- Course: may die if airway not established |
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Vocal Cord Polpys clinical?
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- Adults w/ hoarseness & history of voice abuse
- AKA laryngeal nodule, “singer’s nodule” |
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Vocal Cord Polyps Pathology.
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- Benign stromal expansion
- Benign surface squamous epithelium |
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Squamous cell carcinoma of the larynx clinical?
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- Adults
- M>W - Smokers/drinkers w/ voice changes |
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Squamous Cell Carcinoma of the larynx radiographic.
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For staging, local extent, regional LNs, mets
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Squamous Cell Carcinoma of the larynx pathology.
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- Etio: tobacco, EtOH, prior neck irradiation
- Incidence: glottic > supraglottic >subglottic |
