ENT pathology Flashcards
What lines the auditory meatus and external canal?
Epidermis (skin)
What lines the middle ear?
Columnar lined mucousa
What is the other name for the mucosa that lines the nose/sinuses?
Schneiderian epithelium (same as squamous)
What are the 2 components of a salivary gland?
Acinar component
Ductular component
What are serous cells?
Darklu staining cells that contain digestive enzymes (amylase etc.)
What is OM?
Inflammation of the middle ear
Most common bacterial causes of OM
Strep. pneumonaie
H. influenzae
Moxarella Catarrhalis
What is the most likely causative organism if OM is chronic?
Pseudomonas aerguinosa
What is a cholesteatoma?
Squamous epithelium in the middle ear (should be columnar)
What other histological findings are consistent with cholesteatoma?
High cell turnober
Abundant keratin production
Associated inflammation
What is the pathogenesis of cholesteatoma?
Chronic OM and perforated tympanic membrane
Where do vestibular schwannomas occur?
Within the temporal bone
If bilateral vestibular schwannomas in a young patient what should be considered?
NF type II
What is the inheritance pattern of NF type I?.
Autosomal dominant
Clinical presentation of NF type I?
Widespread neurofibromas Bony defects Cafe au lait spots Axillary freckling Lisch nodules (eyes)
What is the inheritance pattern of NF type II?
AD but usually sporadic
Clinical presentation of NF type II?
Bilateral vestibular schwannoma
Multiple meningiomas
Gliomas
Cafe au lait
What should be considered in nasal polyps in young children?
CF
Aetiologies of nasal polyps
Allergy Infection Asthma Aspirin sensitivity Nickel exposure
Features of nasal polyps
Fluid filled sacs (“red grapes”) up nose
Not painful
What type of reaction is allergic rhinitis?
IgE mediated type 1 hypersensitivity reaction
What is Wegners?
Small vessel vasculitis limitied to respiratory tract and kidneys
Clinical presentation of Wegners?
Pulmonary
Renal disease
Nasal symptoms of congestion, septal perforation
Examples of benign lesions of the nose
Squamous papillomas
“Schneiderian” papillomas
Angiofibromas
What is the most common malignant lesion of the nose?
Squamous cell carcinoma
Other examples of malignant lesions of the nose
Primary adenocarcinoma
Nasopharyngeal carcinoma
Neuroblastoma
Lymhoma
What is the likely presentation of nasopharyngeal carcinoma?
High incidence in far east
Males
Strong association with EBV
What are laryngeal polyps
Reactive change in the laryngeal mucosa
Causes of laryngeal polyps
Vocal abuse
Infection
Smoking
(occasionally hypothyroidism)
What is the difference between laryngeal nodules & polyps?
Nothing (they are interchangable terms)
Presentation of laryngeal polyps
Young women
Unilateral & predunculated
What is a contact ulcer?
Benign response to injry
Causes of contact ulcers
Chronic throat/voice abuse
GOrd
What age do squamous papillomas tend to arise in?
> 5 years
OR
20-24 years
What is squamous papilloma related to?
HPV exposure (types 6 and 11)
Are squamous papillomas more aggressive in children or adults?
Children
What are paragangliomas?
Rare tumours arising in clusters of neuroendocrine cells dispersed throughout the body
What 2 categories are paragangliomas split into?
Chromaffin positive
Non-chromaffin
What are chromaffin positive paragangliomas?
Sympathetic nervous system tumours than can secrete catecholamines
Where are chromaffin positive paragangliomas usually found?
Adrenal meddula
Paravertebral (organ of Zuckerkandl)
What are paragangliomas often occuring as part of?
MEN
Risk factors for squamous cell carcinoma
Smoking & alcohol
What are the majority of squamous cell carcinomas associated with?
HPV type 16
What is sialolithiasis?
Salivary gland stones
What does paramyovirus cause?
Mumps
Bilateral parotiditis
Orchitis
What is there a risk of with paramyovirus?
Secondayr meningitis
Which salivary gland is the most common site for almost all tumour?
Parotid gland
What is the most common salivary gland tumour?
Pleomorphic adenoma
Who usually presents with a pleomorphic adenoma?
Females over 60 in parotid with long history
What is the second most common benign salivary tumour?
Warthin’[s tumour
What are the association with Warthin’s tumour?
Males oer 50
Rare outwith parotid
Strong association with smoking
Often bilateral& multicentric
What is the most common malignant tumour of the salivary gland in the UK?
Adenoid cystic carcinoma
Which cancers is EBV associated with?
Burkitt’s lymphoma
ther B-vell lymphomas
Hodgkin’s lymphoma
