Head and Neck Pathology Flashcards
What are the differential diagnoses for a lateral cystic mass in the neck?
Branchial cyst
Epidermoid cyst
Thyroid cyst
What are the differential diagnoses for a midline cystic mass in the neck?
Thyroglossal duct cyst Thyroid cyst Bronchogenic cyst Epidermoid cyst Thymic cyst
What are the differential diagnoses for a lateral solid mass in the neck?
Enlarged lymph node Salivary gland enlargement/lump Thyroid mass Lipoma Paraganglioma
What are the differential diagnoses for a midline solid mass in the neck?
Thyroid mass
Thyroid goitre
Why may a thyroid mass not move on swallowing?
Profound infiltration of malignancy
What is a branchial cyst?
Congenital epithelial cyst
Due to failure of obliteration of 2nd branchial cleft
What is an epidermoid cyst?
From ectodermal tissue
Lined by benign squamous epithelial cells
What is a thyroglossal duct cyst?
Some cells from where thyroid descends from base of tongue can remain
Usually between tongue and hyoid bone
What is a paraganglioma?
Carotid body tumour
What are some infective causes of cervical lymphadenopathy?
Cat scratch disease
Toxoplasma
Any infections in mouth
TB
What are some non-infective inflammatory causes of cervical lymphadenopathy?
Sarcoidosis
Rheumatoid arthritis
What are options available for sampling a palpable mass?
FNA
Core biopsy
Incisional biopsy
Excisional biopsy
What is the epidemiology of squamous cell carcinoma of the upper aerodigestive tract?
M»_space;F
6th-7th decades
What are the risk factors for squamous cell carcinoma of the upper aerodigestive tract?
Smoking
Alcohol
HPV
EBV
What is oral leukoplakia?
White patch of plaque > can’t be scraped off and can’t be characterised clinically/pathologically as any other disease
Until proven otherwise, considered pre-cancerous
What is oral erythroplakia?
Red, velvelty growth, often associated with squamous dysplasia
What is the normal function of the parotid??
Salivary gland
What is a pleomorphic adenoma?
Mixed epithelial and myoepithelial cells
Set within myxoid/chondroid matrix and sometimes osseus tissue
After a parotidectomy, what can cause ipsilateral facial weakness and loss of taste?
Mechanical trauma during surgery
Reactivation of virus
Bell’s palsy
What are the benign salivary gland tumours?
Pleomorphic adenoma
Warthin’s tumour
Oncocytoma
Adenoma
What are the malignant salivary gland tumours?
Carcinoma
Where is a pleomorphic tumour most likely to occur?
Parotid
Why does adenoid cystic carcinoma recur?
Propensity for nerves
What can a goitre be?
Diffuse/multinodular
Grave’s disease
Hashimoto’s disease
What can a solitary thyroid nodule be?
Benign - Colloid nodule - Follicular adenoma Malignant - Papillary carcinoma - Follicular carcinoma - Medullary carcinoma - Anaplastic/undifferentiated carcinoma
What is a colloid nodule?
Dominant nodule from within multinodular goitre
May be cystic
What is a follicular adenoma?
Neoplasm made of thyroid micro-follicles/trabeculae with well-defined thin capsule
What is the most common malignant thyroid nodule?
Papillary carcinoma
What is a medullary carcinoma?
C-cell derived Associated with - MEN2 - RET oncogene mutation - Amyloid deposition
What ages does papillary thyroid carcinoma affect?
25-50
What is the risk factor for papillary thyroid carcinoma?
Exposure to ionising radiation
What are the clinical features of papillary thyroid carcinoma?
Painless mass in thyroid/enlarged cervical node
Radionuclide scan - cold nodule
Excellent prognosis
Cervical lymph node involvement common
