ENT Pathology I Flashcards
schneiderian mucosa
line nasal cavity and rhinonasal sinuses
sinonasal respiratory mucosa
- ciliated pseudostratified columnar cells
- mucin-containing goblet cells
- basal cells
green mucus
bacterial
acute rhinitis
will go away in week
may progress - pharyngitis, sinusitis, otitis media
coryza
inflammation of mucous membrane of nose
majority of acute rhintis
colds - viruses
rhinoviruses
-picornaviruses, ss-RNA, enterovirus
also adenovirus, echovirus, coronarvirus, parainfluenza, RSV
RAST testing
of allergens
allergic rhintis
hay fever
-rhinorrhea, sneezing, congestions, itching
seasonal hay fever
particular time of year
perennial hay fever
all year round
episodic hay fever
bouts at irregular intervals
hay fever
type I hypersensitivity
- IgE mediated
- Th2 response
- early - mast cells/histamine
- late - eosinophils
most common eosionphilia in US
allergies
other nations - parasites
chronic rhintis
longer than 1 months of symptoms
common with polyps or deviated septum
typical onset - after age 20
Sx 1 sneezing 2 rhinorrhea 3 nasal congestion 4 postnasal drainage
nasal polyps
with recurrent rhintis
-may cause obstruction
edematous tissue with eosinophils
maxillary sinus
can get infection through resp tract AND the mouth
sinusitis
inflammation of sinus with associated nasal mucosa often
aka rhinosinusitis
acute rhinosinusitis
< 1 month
subacute rhinosinusitis
1-3 months
chronic rhinosinusitis
> 3 months
mucocele of sinus
mucus blockage of sinus
in rhinosinusitis
facial pain, pressure, congestions
sinusitis
acute - has fever
-may spread to bone - osteomyelitis
acute viral infectious sinusitis
clears 7 days or less
-rhinovirus, influenzavirus, parainfluenzavirus
acute bacterial infectious sinusitis
complication of viral sometimes
streptococcus pneumoniae
haem influenza
moraxella catarrhalis (kids)
Sx more than 7 days**
Sx get worse**
associated with dental disease**
ASA triad**
chronic rhinosinusitis, nasal polyp, severe bronchial asthma
allergic rxn to aspirin
majority of chronic obstructive sinusitis
obstructive
kartagener syndrome
immotile cilia
-situs inversus possible
can lead to chronic obstructive sinusitis
diabetics
high glucose - fungal infections in chronic obstructive sinusitis
bacteria in chronic obstructive sinusitis
staph aureus majority
allergic mucus
recurrent sinusitis with lots eosinos with no organisms present
charcot leyden crystals
eosinophil mucus
allergic fungal sinusitis
recurrent sinusitis - with eosino mucus with fungi
fungal ball
mycetoma
fungal organisms, scant mucus, little inflammation
see mass lesion by Xray in sinus cavity
invasive fungal sinusitis
severe sinusitis
-neuro deficit
fungal organisms INVADE tissues and vessels
wegeners granulomatosis
granulomatosis with polyangiitis
c-ANCA
PR53
cocaine
vasoconstrictor
-perforated septum
necrotizing to upper airways
diabetic, chronic sinusitis, swelling around face, HAs
rhinocerebral mucormycosis
in immunocompromised
-mucor - does not pick up silver stain
hansen disease
lepromatous leprosy
mycobacterium leprosy
can lead to necrotizing lesions of upper airways
NK-T cell lymphoma
malignant lymphocytes
-go to wall of vessel
lumen compromised
midline - nose to testis
broad hyphae in diabetic
mucor
rhinocerebral mucormycosis
mucor - likes iron - diabetics hav higher iron content
18yo M, unilateral nasal obstruction, epistaxis, swelling of face, eye, cheek
nasopharyngeal angiofibroma
benign
highly vascularized
posterolateral wall
nasopharyngeal angiofibroma
posterolateral highly vascularized benign young males epistaxis
Tx - surgical resection - presurgical embolization of vessels
exophytic schneiderian papilloma
septal**
squamous
majority
associated with HPV
Tx - resection
20-50yo M
fugiform villous formation
schneiderian benign neoplasms
nasal cavity and septum
inverted schneiderian papilloma
lateral**
-near middle turbinate
squamous
harder to resect - can become malignant
associated with HPV
40-70yo M
squamous epithelium invaginates into lining
oncocytic schneiderian papilloma
lateral**
cylindrical/columnar
> 50yo
no HPV associated
abundant bright pink cytoplasm - oncocytic
some to invasive carcinoma
squamous papilloma
wart in nose
- verruca vulgaris
- anteior in nose toward nares
more common than schneiderian tumors
esthesioneuroblastoma
olfactory neuroblastoma
-from neuroendocrine cells
top of nose
see neuro markers
5 years survival 40-90%
Tx - surgery
small blue cell tumor
olfactory neuroblastoma
SYP, NSE, chronogrannin, CD55/57
markers for neuroendocrine tumors
synaptophysin
neuron specific enolase
tumor top of nose in back, small blue cells, neuro markers
esthesioneuroblastoma
nasopharynx
non-keratinizing squamous
and resp epithelium
oropharynx and laryngopharynx
100% non-keratinizing squamous
