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Pathology II > Exam 2- Head and Neck Pathology > Flashcards

Exam 2- Head and Neck Pathology Flashcards

1
Q

realm of ENT?

A

-otolaryngology includes: dzs of nose, nasal cavity, nasopharynx, oral cavity, oropharynx, larynx & laryngopharynx

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2
Q

B/c ENT area is a tougher stratified squamous mucous, how does it behave? what does it behave similarly to?

A

-degenerative, inflammatory & neoplastic influences

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3
Q

what can cause tooth decay/cavities/caries?

A

processed carbohydrates
bacterial= acidic erosion of enamel
tartar–> plaque–> calculus= bac, proteins, cells can get trapped

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4
Q

what is periodontal dz? caused by and outcome?

A

infection with actinobacilli, porphyromonas and prevotella species which cause travel from the gingiva–> periodontal ligaments–> bone–> cementum and erode all of them

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5
Q

What is an irritation fibroma?

A

inflammatory endpoint or a true neoplasm

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6
Q

what is a pyogenic granuloma?

A

pops out like a tumor & is 100% indistinguishable from normal granulation tissue, looks like normal and healthy tissue

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7
Q

would you expect a pyogenic granuloma to blanch? a fibroma?

A

would expect a pyogenic granuloma to blanch

would NOT expect a fibroma to blanch

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8
Q

what is an aphthous ulcer? causes?

A

canker sore
40% of pop has had/has them
caused by: stress, fatigue, illness, trauma, hormonal changes, menstruation, sudden weight loss, food allergies, vit B12, iron & folic acid deficiencies

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9
Q

what causes glossitis? what else is it known as?

A
  • bacterial or viral infection
  • mechanical irritation or injury, trauma
  • tobacco, alcohol, hot foods or spices
  • allergic rxns to mouth products
  • iron deficiency anemia, pernicious, B vit deficiencies, oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris, syphilis, etc
  • occasionally can be inherited
  • geographic tongue
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10
Q

where does type 1 herpes infxn occur? type 2?

A

classically type 1 was oral and type 2 was genital but nowadays crossover is very common

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11
Q

how do you differentiate between something chronic and acute (such as in an oral herpes infxn)?

A

generally more inflammation= more acute

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12
Q

what is a Tzanck smear? when do you see a positive Tzanck?

A
  • gently scrape a vesicle, smear it, stain, look for much larger than usu squamous nuclei with inclusions
  • (+) Tzanck usu seen in herpes infection
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13
Q

what is candida also known as? what is it? who gets it? where do you see it?

A
  • monilia, thrush
  • whitish oral film, easily wiped off but bleeds afterwards
  • kids, immunocompromised, diabetics
  • see it in moist, non-keratinized stratified squamous mucous (mouth, vagina, moist genital skin areas)
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14
Q

what is PAS?

A
  • periodic acid-schiff

- staining method used to detect polysaccharides (glycogen) & mucosubstances (glycoproteins, glycolipids & mucins)

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15
Q

what does PAS illuminate in a slide?

A
  • non-septate hyphae along with yeasts & budding yeast

- DIAGNOSTIC if you find these things

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16
Q

what color does PAS turn yeasts & pseudohyphae relative to other squamous & inflammation, etc?

A

turns it BRIGHT RED

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17
Q

describe what leukoplakia looks like and where one finds it along with specific characteristics

A
  • dry flat plaque
  • oral mucosa
  • non-malignant, non-dysplastic, 100% reversible, some are PREMALIGNANT
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18
Q

is leukoplakia a clinical description or a specific clinical or pathological entity?

A

it is a CLINICAL DESCRIPTION

-can range anywhere b/w hyperkeratosis/inflammation to carcinoma

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19
Q

what is hairy leukoplakia usu a sign of ?

A

HIV

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20
Q

what is the progression from normal tissue to malignancy?

A

normal–> dysplasia–> carcinoma in situ–> infiltrating malignancy

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21
Q

where can SCC occur? no matter what?

A

can occur on ANY LOCATION no matter the genetics, molecular bio or etiology

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22
Q

what is a classic appearance of scc?

A

infiltrating or infiltrative scc of the mouth will have ulceration and induration under the ulcer bed

23
Q

what are the 3 types of differentiation in scc?

A

well, poor, moderate

24
Q

what can you see in well scc?

A

pearls

25
Q

what can you see in moderate scc?

A

usu see intercellular bridges but NOT pearls

26
Q

what can you see in poor scc?

A

usu have no idea you’re even looking at squamous cells, have to rely on squamous or immunochemical markers

27
Q

what are the 3 major salivary glands?

A

parotid, submandibular, sublingual

28
Q

what can be associated with salivary gland enlargement?

A
  • bac infxn
  • viral infxn
  • tuberculosis
  • sjogren’s syndrome
  • sarcoidosis
  • alcoholism
  • tumors
29
Q

what is sialolithiasis? risk factors?

A
  • salivary duct stones, most commonly calcium phosphate stones
  • risk factors: obstruction of duct (food, edema, cellular debris), prior traumatic injury and dehydration
30
Q

what is sialadenitis?

A

inflamm of gland causing mild to sever enlargement of gland which may produce serous or purulent d/c
term used to describe inflamm w/or w/o subsequent supra-infxn

31
Q

what are the 3 forms of sialadenitis?

A

acute, chronic, recurrent

32
Q

what is a very common finding in sialadenitis or any duct injury?

A

squamous metaplasia of interlobular duct

33
Q

what can cause sialadenitis?

A
  • viral infxn–> most common viral is secondary to mumps
  • bac infxn
  • trauma
  • food sensitivities
  • autoimmune–> sjogren’s
34
Q

where is the classic place for any visible parotid swelling or tumor?

A

between the tip of the ear and the angle of the mandible

35
Q

what is mikulicz syndrome? causes?

A
  • combo of salivary & lacrimal gland enlargement plus xerostomia
  • leukemia, lymphoma, sjogren’s, sarcoidosis & other granulomatous dzs
36
Q

what is xerostomia?

A
  • dry mouth
  • see in sjogren’s (also dry eyes)
  • lack of salivary secretions may be complication of radiation tx
  • oral cavity may be dry or there may be atrophy of papillae with fissuring and ulcerations
37
Q

what is a mucocele? where? what does it look like? does it fluctuate?

A
  • blockage or rupture of salivary gland duct with saliva leaking into surrounding CT stroma caused by trauma
  • lower lip commonly
  • in toddlers & young adults as well as geriatric pop
  • blue translucent hue, size may fluctuate esp in association w/meals
38
Q

what is a mucocele in terms of cell type and what’s in it?

A

big cyst filled w/mucin & lined by mucinous columnar epithelium often inflamed and/or squamous metaplastic

39
Q

prognosis of mucocele?

A

resolve spontaneously
if chronic, complete excision of cyst w/minor salivary gland lobule of origin may be necessary; if incomplete chronic mucocele can occur

40
Q

when do salivary gland neoplasms develop? men or women more? what about warthin tumors?

A
  • usu occurs in adults, slight female predominance

- warthin tumors occur much more often in males

41
Q

when do benign vs malignant tumors tend to appear?

A

-benign tumors appear 5th-7th decades whereas malignant tumors appear >7th decade of life

42
Q

what is the only clearly defined risk factor for development of salivary gland malignancy? what are NOT risk factors?

A
  • head and neck exposure to radiation is only clearly defined risk factor
  • heredity, alcohol, tobacco, salivary stones & trauma ARE NOT risk factors
43
Q

what are the %ages for salivary gland tumors (location) and their rate of malignancy?

A
  • 15-30% of all parotid gland tumors
  • 40% of submandibular
  • 50% of minor salivary gland tumors
  • 70-90% of sublingual gland tumors
44
Q

what are the two benign common salivary gland tumors?

A
  • pleomorphic adenoma (mixed tumor)

- warthin tumor

45
Q

what are malignant tumors? two types of salivary gland tumors that are malignant?

A
  • ALL are adenocarcinomas
  • mucoepidermoid carcinoma
  • adenoid cystic carcinoma
46
Q

what %age of malignant tumors come from the salivary glands? if its from the salivary glands, which one will it be from? who gets them?

A

<2%
partoid gland is site of origin for majority of salivary gland tumors, 65-80% of salivary gland neoplasma
typically older adults

47
Q

what is a pleomorphic adenoma?

A

painless, slow growing, mobile discrete mass w/in parotid or submandibular areas or in buccal cavity

48
Q

what is the recurrence rate with adequate parotidectomy? with enucleation?

A

adequate parotidectomy= about 4%

enucleation= recurrence of about 25%

49
Q

what can be in a pleomorphic adenoma?

A

epithelial elements dispersed through matrix along with myxoid, hyaline, chondroid and osseous tissue

50
Q

what is the risk of a pleomorphic adenoma transforming into a malignant adenocarcinoma or undifferentiated carcinoma?

A

-2% risk for tumors present 15 yrs

51
Q

what are the most aggressive salivary gland malignancies? mortality %age, in how many years?

A
  • salivary gland adenocarcinomas or undifferentiated carcinomas
  • 30-50% mortality in 5 yrs
52
Q

what is a warthin tumor also known as?

A

papillar cystadenoma lymphomatosum

53
Q

what is squamous metaplasia?

A

upper airway mucosa transforming into stratified squamous as a non specific response to wide variety of injurious stimuli

Pathology II (6 decks)

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