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ENT > ENT Pathology > Flashcards

ENT Pathology Flashcards

1
Q

What is a cholesteatoma?

A

Abnormal non-cancerous skin growth in middle ear behind tympanic membrane

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2
Q

What causes cholesteatoma?

A

Birth Defect

Repeated middle ear infections

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3
Q

What happens in cholesteatoma?

A

Squamous epithelium evades and forms abnormal adhesions

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4
Q

Describe a vestibular schwannoma

A

Tumour from schwann cells of the vestibular portion of CNVIII

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5
Q

Where does a vestibular schwannoma occur?

A

Temporal Bone

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6
Q

How does a vestibular schwannoma present?

A

Deafness

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7
Q

What causes vestibular schwannoma?

A

Bilateral - neurofibromatosis type 2

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8
Q

What will a vestibular schwannoma look like pathologically?

A

Cerebelopontine angle

Circumscribed tan/white/yellow mas

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9
Q

Describe neurofibromatosis type 2

A

Autosomal dominant but often a sporadic mutation in gene that codes for the merlin protein (tumour suppressor)
Meningiomas, gliomas, café au lait patches and cataracts

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10
Q

What disease is aggressive papillary adenocarcinoma associated with?

A

Hippel-Lindau

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11
Q

Describe the pathology of nasal polyps

A

Grey masses of pedunculate tissue which look like a bunch of grapes - oedematous mucosa, respiratory epithelium with goblet cell hyperplasia

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12
Q

What causes nasal polyps?

A

Allergy, infection, asthma, aspirin sensitivity, nickel exposure

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13
Q

If nasal polyps present in young kids what should be considered?

A

Cystic Fibrosis

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14
Q

Name five tumours that can present in the nose

A 
Squamous Papilloma 
Angiofibroma 
Schneiderian Papilloma 
SCC 
Nasopharyngeal Carcinoma
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15
Q

What causes schneiderian papilloma?

A

Unknown

Associated with HPV, smoking, organic solvents, welding

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16
Q

Who usually gets schneiderian papilloma?

A

Men >50 years old

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17
Q

What is an angiofibroma?

A

Rare, tumour of angromatous tissue and fibrous stroma - benign and expands locally may involve adjacent cranial bones

18
Q

What is the typical presentation of an angiofibroma?

A

Young male with nasal obstruction and bleeding

19
Q

What virus is nasopharyngeal carcinoma associated with?

A

EBV

20
Q

How will nasopharyngeal carcinoma present?

A

Enlarged painless lymph nodes, nasal obstruction, epistaxis, hearing problems

21
Q

What does EBV mimic?

A

Helper T cell response to cause proliferation

22
Q

Where do vocal nodules occur?

A

Area of maximum vibration of vocal cords - anterior third and posterior two thirds

23
Q

Define vocal nodules

A

Bilateral, localised hard thickenings on the edge of each cord

24
Q

What causes vocal nodules?

A

Misuse of voice

25
Q

Define vocal polyp

A

Unilateral pedunculated smooth glistening body attached to one cord

26
Q

How does a vocal polyp present?

A

Hoarseness

27
Q

What is a contact ulcer?

A

Thickening and heaping of the mucous membrane

28
Q

What causes a contact ulcer?

A

Chronic throat clearing, voice abuse, GORD, intubation

29
Q

Where do contact ulcers usually occur?

A

Posterior vocal cord

30
Q

State the two peak incidences of squamous papillomatosis

A

< 5 years old

20-40 years old

31
Q

What is the key risk factor for squamous papillomatosis?

A

HPV type 6 and 11

32
Q

Describe squamous papillomatosis

A

Non-keratinised squamous papilloma - presents gradually with increasing hoarseness/stridor but may affect the entire respiratory tract

33
Q

What is a paroganglioma?

A

Tumours arising in clusters of neuroendocrine cells throughout the body

34
Q

SCC tumours in the oropharynx are related to what?

A

HPV type 16

35
Q

Describe the classification of SCC in the oropharynx

A

T1a - one cord
T1b - both cords
T2 - extension into supra/subglottis
T3 - vocal cord fixation/extension into paraglottic space, thyroid cartilage
T4a - thyroid cartilage, trachea, tongue, strap, oesophagus
T4b - prevertebral space, mediastinal structures, carotid artery

36
Q

What is the name for a stone in the salivary gland?

A

Sialolithiasis

37
Q

What is the most common site of tumour in the salivary glands?

A

Parotid gland

38
Q

What tumours can present in salivary glands?

A

Pleomorphic adenoma
Warthin’s tumour
Mucoepidermoid carcinoma
Adenoid cystic carcinoma

39
Q

Describe Warthin’s Tumour

A

Adenolymphoma, males >50 years old, rare outwit parotid. Often bilateral and multicentric - strongly associated with smoking

40
Q

Describe a mucoepidermoid carcinoma

A

Most common worldwide - majority in parotid galen

High/low risk, high survival

41
Q

Describe a adenoid cystic carcinoma

A

Most common in UK, wide age range and range of sites. Usually >40 years old and parotid/palate
Perineural invasion associated with pain/loss of function

ENT (11 decks)

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