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Applied Anatomic Pathology > Head and Neck > Flashcards

Head and Neck Flashcards

1
Q

what is a papilloma

A

benign, HPV associated papillary wart often caused by types 6 and 11

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2
Q

what is leukoplakia

A

pre-malignant, white plaque like lesions

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3
Q

where is squamous cell carcinoma most commonly located in the mouth

A

floor of mouth
lateral/ventral surfaces of tongue

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4
Q

where is mucosal melanoma most commonly located

A

hard palate/gingiva

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5
Q

what is most important when staging the oral cavity/tongue

A

tumor size and depth of invasion

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6
Q

a tumor of which size differentiates a T1 and T2 lip and oral cavity tumor

A

<2 cm = T1
>2 cm = T2 and beyond

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7
Q

what is the normal weight of a thyroid gland

A

18-25 g

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8
Q

what is the gross appearance of Hashimoto thyroiditis

A

enlarged, pale yellow-tan with a firm, nodular cut surface

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9
Q

how much will a thyroid with a multinodular goiter weigh

A

over 2000 g

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10
Q

what is the gross appearance of a follicular adenoma

A

spherical and encapsulated

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11
Q

what is the most common type of malignant thyroid lesion

A

papillary carcinoma

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12
Q

what is a hurthle cell adenoma

A

follicular adenoma with oxyphilia

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13
Q

how can one tell the difference between a follicular adenoma and a follicular carcinoma

A

follicular carcinomas will have capsular invasion

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14
Q

which thyroid malignancy is of neuroendocrine origin

A

medullary carcinoma

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15
Q

how should you section a thyroid specimen

A

lobes will be sectioned superior to inferior
isthmus will be sections from medial to lateral

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16
Q

what’s an important section to submit for a hemi-thyroid specimen

A

isthmus margin

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17
Q

what should you submit for a papillary thyroid lesion

A

1 section/cm

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18
Q

what should you submit for a follicular thyroid lesion

A

representative sections of lesions and entire capsule

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19
Q

what should you submit for a goiter

A

representative sections per nodule (up to 5)
also submit anything odd like hemorrhage or calcifications

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20
Q

what is the most important thing for staging thyroid

A

tumor size and confinement within thyroid

21
Q

which thyroid carcinoma is staged independent of the rest

A

medullary because it is a neuroendocrine tumor

22
Q

how should you measure a thyroid

A

each lobe and the isthmus should be measured separately

23
Q

what is the most common type of parathyroid lesion

A

adenoma (80%)

24
Q

what is the most important feature of a parathyroid specimen

A

weight

25
Q

what is the normal weight of a parathyroid gland

A

20-40 mg/gland

26
Q

what is the supraglottis

A

area from tip of epiglottis to apex of ventricle

27
Q

what is the glottis

A

area from ventricle to 1 cm below the free level of the true vocal cord

28
Q

what is the subglottis

A

area from 1 cm below the level of the true vocal cord to the inferior rim of the cricoid cartilage

29
Q

what is the order of the vocal cords and ventricle from superior to inferior

A

false vocal cords
ventricle
true vocal cords

30
Q

from which direction, anterior or posterior, is a larengectomy specimen opened

A

posteriorly through midline - then use a cotton swab to prop open and fix

31
Q

what is a type of benign laryngeal lesion

A

squamous papilloma

32
Q

95% of laryngeal carcinomas are what

A

squamous cell carcinoma

33
Q

where do malignant laryngeal lesions most commonly arise

A

vocal cords

34
Q

which sections should you submit for a laryngectomy specimen

A

inferior tracheal margin
superior mucosal margin
anterior/posterior soft tissue margins
tumor with three anatomic subsites
both sides of cords, ventricle, and paraglottic space
aryepiglottic fold, pyriform sinus, and anterior commessure

35
Q

what is the most important aspect of larynx staging

A

tumor site/anatomical subsite is critical to staging

36
Q

why is a subsite important for a laryngectomy case

A

used to identify where lesion is within the supraglottis, glottis, and epiglottis

37
Q

what does a standard radical lymph node dissection include

A

cervical nodes
sternocleidomastoid muscle
internal jugular vein
spinal accessory nerve
submandibular gland

38
Q

what does a modified radical lymph node dissection include

A

cervical nodes and submandibular gland

39
Q

what does an extended radical lymph node dissection include

A

cervical nodes
sternocleidomastoid muscle
internal jugular vein
spinal accessory nerve
submandibular gland
retropharyngeal nodes
paratracheal nodes
parotid
suboccipital nodes
mediastinal nodes

40
Q

what does a regional radical lymph node dissection include

A

nodes of first metastatic station

41
Q

how many lymph nodes typically come in a radcial lymph node dissection

A

30-40 nodes

42
Q

what’s something important to note for a lymph node dissection

A

if there are enmeshed/matted lymph nodes

43
Q

what is the CPT code for a mucosal biopsy

A

88305

44
Q

what is the CPT code for a parathyroid gland

A

88305

45
Q

what is the CPT code for a thyroid

A

88307

46
Q

what is the CPT code for a larynx without regional lymph nodes

A

88307

47
Q

what is the CPT code for lymph nodes

A

88307

48
Q

what is the CPT code for a tongue resection for tumor

A

88309

49
Q

what is the CPT code for a larynx with regional lymph nodes

A

88309

Applied Anatomic Pathology (17 decks)

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