General oto manifestations of systemic disease Flashcards
What is eosinophilic granuloma?
Eosinophilic granuloma is the most common form of
Langerhans cell histiocytosis and is characterized by the
formation of solitary or multiple discrete nodules within
bones.
What is Hand-Schüller-Christian disease?
It is multifocal Langerhans cell histiocytosis with bone
“granulomas,” associated with the triad of exophthalmos,
lytic skull lesions, and diabetes inspidus.
True or false. Most patients with Langerhans cell
histiocytosis have multisystem disease.
False. Approximately two-thirds of patients have disease
involving one site.
What is Letterer-Siwe disease?
Systemic Langerhans cell histiocytosis is the rarest (~ 10%
of cases) and the most severe form of disease. Initial
symptoms often include generalized skin eruption, anemia,
and hepatosplenomegaly.
Extranodal natural killer cell (NK)/T-cell lymphoma,
nasal type, is commonly associated with which
virus?
Epstein-Barr virus
How is extranodal NK/T-cell lymphoma, nasal-
type, commonly treated?
Chemotherapy (CHOP: cyclophosphamide, doxorubicin,
vincristine, prednisone) in conjunction with radiotherapy
Compared with other types of lymphoma involv-
ing the head and neck, what is the prognosis for extranodal NK/T-cell lymphoma, nasal type?
Much poorer
What is the most common laryngeal manifestation
of Wegener granulomatosis?
Subglottic stenosis
What is the most common otologic manifestation
of Wegener granulomatosis?
Serous otitis media
What histopathologic findings are seen in Wege-
ner disease?
Necrotizing granulomas and arteritis involving small vessels
What laboratory test is used to diagnose and
follow Wegener disease?
Antineutrophil cytoplasmic antibody (C-ANCA). Test will be
positive in more than 90% of cases.
What histopathological findings are seen in
sarcoidosis?
Noncaseating granulomas
What condition is characterized by uveitis, parotid
swelling, fever, and facial nerve palsy?
Heerfordt syndrome (uveoparotid fever), a manifestation of sarcoidosis
What is the most common site of laryngeal
involvement of sarcoidosis?
Supraglottis
What is the most common head and neck mani-
festation of sarcoidosis?
Cervical lymphadenopathy
Describe a common presentation for pyogenic
granuloma.
Less than 1-cm lobular red or purple lesion that develops on
the gingiva or nasal mucosa that is friable and prone to
bleeding. It occurs more commonly in women and is
associated with trauma and pregnancy.
Describe the treatment of pyogenic granuloma.
Lesions frequently resolve spontaneously when associated
with pregnancy. If frequent bleeding or cosmesis is a concern,
conservative cauterization or excision can be pursued.
Describe the natural history of untreated necro-
tizing sialometaplasia.
Spontaneous resolution over weeks to months
How does blastomycosis typically manifest?
A common triad includes cutaneous disease, pulmonary
involvement, and constitutional symptoms. Skin lesions
may involve the face with verrucous growth and scarring.
Oropharyngeal and laryngeal involvement are rare.
Describe the clinical manifestations of coccidiomycosis.
It is the cause of “valley fever.” Most patients have an
influenza-like illness that includes malaise, fever, myalgia,
arthralgia, and cough. Initial symptoms are pulmonary,
mucocutaneous involvement with maculopapular rash,
cervical lymphadenopathy, and/or meningeal involvement.
Where is Coccidioides immitis endemic?
Desert Southwest including New Mexico, Nevada, Califor-
nia, Texas, Utah, and northern Mexico
Histoplasmosis most commonly occurs in which
geographic location?
The Ohio, Missouri, and Mississippi River valleys
Describe the head and neck manifestations of
disseminated histoplasmosis.
Granulomatous lesions involving the lips, gingiva, tongue,
larynx, and pharynx manifesting with painful ulcers
containing heaped edges
What is the most common site of laryngeal
involvement of histoplasmosis?
Supraglottis