Head and Neck

Question 1

benign lesion of HPV origin, most commonly type 6/11 with exophytic, finger-like projectionsindic

Answer 1

papilloma

Question 2

premalignant lesion that is white plaque like

Answer 2

leukoplakia

Question 3

95% of head and neck malignancies

Answer 3

squamous cell carcinoma

Question 4

80% of these harbor oncogenic variants of HPV

Answer 4

squamous cell carcinoma

Question 5

most commonly on the hard palate or gingiva

Answer 5

mucosal melanoma

Question 6

most SCC occur on these 2 locations

Answer 6

-floor of mouth
-lateral/ventral surfaces of tongue

Question 7

for a shave/mucosal biopsy, what is it important to do

Answer 7

maintain orientation of the mucosa

Question 8

if there is suspicion of bone invasion, what should be done

Answer 8

radiograph the specimen

Question 9

if IHCs need to be performed for a specimen with bone, what must you make sure to do

Answer 9

make sure the appropriate decal is used

Question 10

staging oral cavity or tongue is largely dependent on these two things

Answer 10

tumor size and depth of invasion

Question 11

measurement from the horizon of basement membrane of the adjacent uninvolved mucosa perpendicularly to the deepest point of invasion

Answer 11

depth of invasion

Question 12

measured from the surface of the invasive SCC for an endophytic/exophytic tumor, and from the ulcer base for an ulcerated tumor to the deepest point of invasion

Answer 12

tumor thickness

Question 13

anterior thyroid is what shape

Answer 13

convex

Question 14

posterior thyroid is what shape

Answer 14

concave

Question 15

types of thyroid specimens you can receive (3)

Answer 15

-FNA
-hemi-thyroidectomy
-Thyroidectomy

Question 16

gross appearance is diffusely enlarged, pale yellow-tan, with a firm nodular cut surface

Answer 16

Hashimoto’s thyroiditis

Question 17

recurrent episodes of hyperplasia and involution

Answer 17

multinodular goiter

Question 18

caused by insufficient iodine, with gradual thyroid failure due to autoimmune destruction of the gland

Answer 18

Hashimoto’s thyroiditis

Question 19

thyroid enlargement with over 2000 g possible

Answer 19

multinodular goiter

Question 20

normal weight of thyroid

Answer 20

18-25 g

Question 21

gross cut section bulges from the cut surface, solitary spherical and encapsulated

Answer 21

follicular adenoma (of thyroid)

Question 22

gross appearance of well circumscribed, encapsulated with a friable, papillary surface

Answer 22

papillary carcinoma

Question 23

gross appearance of capsular invasion, multilobulated tan-yellow to pink, solid to cystic

Answer 23

follicular carcinoma

Question 24

neuroendocrine origin, well circumscribed, may contain central coarse/microcalcifications ranging from gray-white to yellow-brown

Answer 24

medullary carcinoma

Question 25

dark, maroon red "beefy" parenchyma is indicative of

Answer 25

normal thyroid

Question 26

serially section thyroid lobes this way

Answer 26

superior to inferior

Question 27

thyroid staging is largely dependent on these two characteristics

Answer 27

-tumor size -confinement within thyroid

Question 28

for papillary carcinoma, section this much

Answer 28

1 section per cm

Question 29

if a papillary carcinoma is friable these should be used

Answer 29

bags/paper to wrap

Question 30

for a goiter, a representative sections must be taken for

Answer 30

each nodule, up to 5

Question 31

what are parathyroids usually removed for

Answer 31

hyperparathyroidism (adenoma)

Question 32

most important feature of a parathyroid specimen

Answer 32

weight

Question 33

parathyroid specimens are often received for this process

Answer 33

frozen section

Question 34

extends from tip of epiglottis to apex of ventricle, contains false vocal cords and ventricle, folds etc.

Answer 34

supraglottis

Question 35

extends from ventricle to about 1.0cm below the free level of true vocal cords, contains ant. and pos. commissures and true vocal cord

Answer 35

glottis

Question 36

extends from free level of true vocal cord to inferior rim of cricoid cartilage

Answer 36

subglottis

Question 37

laryngeal carcinomas are

Answer 37

squamous cell carcinoma

Question 38

bengin lesion on larynx

Answer 38

squamous papilloma

Question 39

most laryngeal carcinomas are typically on the

Answer 39

vocal cords

Question 40

measure laryngeal specimens in this orientation

Answer 40

3D

Question 41

open a laryngeal specimen this way

Answer 41

posteriorly

Question 42

larynx staging is dependent on

Answer 42

Anatomic Subsite/Tumor Site

Question 43

this often accompanies head and neck malignancies

Answer 43

radical lymph node dissection

Question 44

cervical lymph nodes, sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve, submandibular gland (maybe tail of parotid)

Answer 44

standard radical lymph node dissection

Question 45

does not include sternocleidomastoid muscle, spinal accessory nerve or internal jugular vein

Answer 45

modified radical lymph node dissection

Question 46

also includes retropharyngeal, paratracheal, parotid, suboccipital, and/or upper mediastinal nodes

Answer 46

extended radical lymph node dissection

Question 47

only the nodes of the first metastatic station

Answer 47

regional radical lymph node dissection

Question 48

if you have low yield of lymph nodes, you may

Answer 48

submit surrounding soft tissue (oriented per level)

Question 49

it is important to describe these types of lymph nodes that have gross tumor involvement, and submit the whole thing

Answer 49

matted

Question 50

mucosal biopsy CPT code

Answer 50

88305

Question 51

parathyroid gland CPT code

Answer 51

88305

Question 52

lymph node CPT code

Answer 52

88305

Question 53

thyroid total/lobe CPT code

Answer 53

88307

Question 54

larynx partial/total resection

Answer 54

88307

Question 55

lymph nodes regional resection

Answer 55

88307

Question 56

tongue resection for tumor

Answer 56

88309

Question 57

larynx, partial/ total resection with regional lymph nodes

Answer 57

88309