ENT Pathology Flashcards
Most common head and neck cancer?
Squamous cell carcinoma
Most common epidemiologic assoications with squamous cell carcinoma of the head and neck?
Smokingt/tobacco, alcohol, HPV.
Most common salivary gland to get a tumor?
Parotid - most are benign.
Pre-malignant lesions of the oral cavity?
Leukoplakia, erythroplakia
if you see them, you must biopsy
Are all leukoplakia pre-malignant?
No. Some are from trauma.
Why are leukoplakia white?
Hyperkeratosis, due to dysplasia
Where should you look for dysplasia in a biopsy of leukoplakia?
In the basal layers. (just like with cervical cancer… it starts with dysplasic cells in basal layers)
Which is more likely to be dysplastic / cancerous: leukoplakia or erythoplakia?
Erythroplakia - 50%
vs. leukoplakia - 5%
Why is erythroplakia red?
Vascular proliferation.
High risk genotypes of HPV?
HPV 16 and 18.
the lecture slides only have 16… but 18’s definitely important too
Is squamous cell carcinoma of the oral cavity slow-growing?
Yes. Just like cervical carcinoma… prognosis is good if found early.
Histologic appearance of squamous cell carcinoma of oral cavity?
Same as other squamous cell carcionmas…
slide highlighted ulcerated surface and keratin pearls.
3 non-cancerous lesions of the oropharynx?
Idiopathic - apthous ulcers.
Infections - herpes, candida.
Systemic - pemphigus
Most common cancer of larynx?
Squamous cell carcinoma again.
2 benign tumors of the larynx?
Vocal cord nodules and papillomas.
What’s unique about the larynx that allows it to develop nodules? What precipitates their formation?
Smoking / trauma (e.g. lots of singing) -> edema.
The vocal cords have no lymphatic drainage -> nodules firm -> horseness, voice changes.
What does a vocal cord nodule look like histologically?
Well defined. The mesenchyma tissue is just separated out with edema.
Why can papillomatosis (multiple papules) be life-threatening even if not malignant?
Etiology?
Can progress down tracheobronchial, block airways.
Associated with HPV 6/11 infection. Usually in children < 6 years.
What causes a nasal polyp to form?
Why are they a problem?
Recurrent nonspecific or allergic rhinitis…
The obstruct airway, and the inflammation predisposes to proliferation/malignancy.
Acute invasive fungal sinusitis is quite bad.
Yeah, it can invade the brain, esp. via the cavernous sinus.
What’s a nasopharyngeal angiofibroma?
A highly vascularized benign tumor… often expressing androgen receptors and seen in adolescent males.
2 types of nasal papilloma?
Exophitic.
Endophytic…
Epidemiologic risk factors for nasopharyngeal carcinoma?
EBV infection.
What is nasopharyngeal carcinoma?
aka. undifferentiated or lymphoepithelial carcinoma…
3 forms of nasopharyngeal carcinoma?
How does this affect treatment?
Keratinizing - squamous cell carcinoma - usu. radioresistant.
Non-keratinizing squamous cell carcinoma.
Undifferentiated -radiosensitive.
Example of a benign tumor of salivary glands?
Pleomorphic adenoma.
Example of a malignant tumor of salivary glands?
Mucoepidermoid carcinoma.
How does size of gland relate to likelihood that a tumor found there is malignant?
The smaller the gland, the more likely that a tumor there is malignant.
(high risk in sublingual glands, low risk in parotid)
Appearance of pleomorphic adenoma of a salivary gland?
Histologic heterogeneity -“mixed tumor” - loose myxoid tissue, with some cartilage, occassionally bone.
Common epidemiological association with mucoepidermoid carcinoma?
Radiation.
