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ENT > ENT Pathology > Flashcards

ENT Pathology Flashcards

1
Q

What lines the auditory meatus and external canal?

A

Epidermis

(containing sebaceous and ceruminous glands)

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2
Q

What lines the middle ear?

A

Columnar lined epithelium

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3
Q

Which type of epithelium lines the nasal vestibule?

A

Squamous epithelium

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4
Q

Which type of epithelium lines the nose and sinus?

A

Respiratory epithelium

(pseudostratified ciliated columnar, seromucinous glands)

It is also called Schneiderian epithelium

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5
Q

Which two components comprise a salivary gland?

A
  1. Acinar
  2. Ductular
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6
Q

Why are peripheral myoepithelial cells useful in salivary glands?

A

They have contractile properties

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7
Q

What is otitis media?

A

Inflammation of the inner ear

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8
Q

What can cause otitis media?

A

Viral infections mostly

Occasionally bacterial

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9
Q

Chronic otitis media may be as a result of which bacteria?

A

Pseudomonas aeruginosa

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10
Q

What is cholesteatoma?

A

Keratinised squamous epithelium in middle ear

(it is NOT a tumour)

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11
Q

Which age group is affected by cholesteatoma?

A

Any

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12
Q

Despite not being a tumour, which neoplastic property does cholesteatoma possess?

A

High cell turnover

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13
Q

What is the pathogenesis for cholesteatoma?

A

Chronic otitis media

Perforation of tympanic membrane

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14
Q

Which tumour is associated with the vestibular portion of the vestibulocochlear nerve?

A

Vestibular schwannoma

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15
Q

In which bone do vestibular schwannomas associate?

A

Temporal

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16
Q

What is the classic microscopic appearance of a schwannoma?

A

Verocay bodies

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17
Q

How do most vestibular scwannoma cases present?

A

Sporadic and unilateral

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18
Q

If a vestibular scwannoma presents bilaterally in a young patient, what should be suspected?

A

Neurofibromatosis Type 2

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19
Q

Which type of neurofibromatosis is more common?

A

Type 1

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20
Q

For which reasons may an individual develop neurofibromatosis type 2?

A
  1. AD inheritance
  2. Sporadic mutation in NF2 gene
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21
Q

Which clinical features will be seen in a patient with neurofibromatosis type 2?

A
  1. Multiple meningiomas
  2. Gliomas
  3. Bilateral vestibular schwannomas
  4. Posterior subcapsular cataracts
  5. Pigmentary retinopathy
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22
Q

Which common benign swelling is often found in the nasal cavity?

A

Nasal polyps

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23
Q

What can induce nasal polyps?

A
  1. Allergy
  2. Infection
  3. Aspirin sensitivity
  4. Cystic fibrosis (young)
24
Q

What must be ruled out if a child presents with nasal polyps?

A

Cystic fibrosis

25
Q

What are the identifying features of nasal polyps microscopically?

A

Highly oedematous

Eosinophils prominent

26
Q

How may a patient with GPA present?

A
  1. Pulmonary or renal disease
  2. Symptoms of nasal congestion
27
Q

How is GPA identified?

A

cANCA +ve

28
Q

What is the most common cause of septal ulceration?

A

Cocaine use

(GPA can also cause)

29
Q

What are the identifying features of GPA on microscopy?

A
  1. Liquefactive or coagulative necrosis
  2. Profuse eosinophils and multinucleated giant cells
  3. Pallisading histiocytes and giant cells with central necrosis
  4. Few lymphocytes and plasma cells
30
Q

Which benign tumours may be found in the nasal cavity?

A
  1. Squamous papilloma
  2. Angiofibroma
31
Q

Which malignant tumours may be found in the nasal cavity?

A
  1. Squamous cell carcinoma
  2. Primary adenocarcinoma
  3. Nasopharyngeal carcinoma
  4. Neuroblastoma
  5. Lymphoma
32
Q

Which specific thing is primary adenocarcinoma of the nasal cavity particularly associated with?

A

Wood dust exposure

(this should be asked about in the history)

33
Q

Nasopharyngeal carcinoma has a high associated with what?

A

Epstein barr virus

Volatile nitrosamines in food

34
Q

Which type of patient will likely present with nasopharyngeal carcinoma?

A

Male

High incidence in far east

35
Q

What are the main problems with squamous “Schneiderian” papillomas?

A

Recur frequently

Can become malignant

36
Q

In which situations can laryngeal polyps develop?

A
  1. Vocal abuse (contact)
  2. Infection
  3. Smoking
  4. Hypothyroidism
37
Q

Squamous papillomas have which two peaks of incidence?

A

< 5 years

20 - 40

38
Q

What are squamous papillomas associated with?

A

HPV exposure (types 6 and 11)

39
Q

What is koilocytosis?

A

Development of koilocytes

40
Q

What is a koilocyte?

A

A cell altered by the presence of HPV

Changes include:

  1. Nuclear enlargement (two to three times normal size).
  2. Irregularity of the nuclear membrane
  3. Hyperchromasia (dark nucleus)
  4. Perinuclear halo
41
Q

Which condition can be defined by “tumours arising in clusters of neuroendocrine cells dispersed throughout the body”?

A

Paraganglioma

42
Q

If a paraganglioma is chromaffin postitive what does this mean?

A

It contains chromaffin cells which, when stimulated by the sympathetic nervous system, secrete catechloamines such as adrenaline

43
Q

Which condition are paragangliomas associated?

A

MEN2

44
Q

What doe the majority of squamous cell carcinomas in the head/neck region relate to?

A

Smoking and alcohol

45
Q

Which virus is related to SCC?

A

HPV (type 16)

46
Q

Which other subtype of SCC is there besides type type associated with smoking/alcohol?

A

Affects young (30-50) healthy individuals

Lump in neck

47
Q

What is the prognosis for this type of SCC which affects young healthy people?

A

Good

(treated withchemoradiotherapy)

48
Q

What is the most common salivary gland to be affected by a pathology?

A

Parotid

49
Q

Tumours in smaller salivary glands tend to be _________

A

Tumours in smaller salivary glands tend to be malignant

50
Q

What is the most common salivary gland tumour?

A

Pleomorphic adenoma

51
Q

What are the problems with a pleomorphic adenoma?

A
  1. Difficult to excise
  2. Associated with recurrence
  3. Longstanding cases may become malignant
52
Q

What is the second most common benign tumour associated with the salivary glands?

A

Warthin’s tumour

53
Q

Who does a Warthin’s tumour usually affect?

A

Males over 50

54
Q

Who and where does a pleomorphic adenoma affect?

A

Females over 60

Parotid

55
Q

A Warthin’s tumour is assciated with what?

A

Smoking

(tumours are often bilateral in the parotid glands and multicentric)

56
Q

What is the most common malignant tumour associated with the salivary glands?

A

Mucoepidermoid carcinoma (worldwide)

Adenoid cystic carcinoma (in UK)

57
Q

What is the most common malignant tumour of the palate and where else does it commonly affect?

A

Adenoid cystic carcinoma (usually in those over 40)

Parotid gland

(It is the most common tumour of the palate)

ENT (17 decks)

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