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FRCR 2A > Head & Neck > Flashcards

Head & Neck Flashcards

1
Q

Thyroid cancer

  1. Most common thyroid cancer?
  2. Classic appearance of papillary ca?
  3. Characteristic feature of follicular ca?
  4. Medullary carcinoma association? US appearance?
  5. Which cancer does Hashimoto’s increase the risk of?
  6. Classic type of lung metastasis?
A
  1. Papillary ca (70-80%)
  2. Hypoechoic nodules with punctate foci of calcification
  3. Invasion of blood vessels with metastases to lung and bone
  4. MEN2. Coarse calcification. Lymph node calcification.
  5. Primary thyroid lymphoma
  6. Miliary type
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2
Q

Features in a thyroid nodule on US that suggest malignancy?

A
  • Microcalcs, peripheral calcification
  • Solid hypoechoic
  • Invasion of surrounding structures
  • Intranodular vascularity

Halo sign indeterminate

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3
Q
  1. Classic US appearance of Hashimoto’s?
  2. Characteristic US finding of colloid nodule?
A
  1. Acutely you get heterogenous appearance so called “giraffe skin”; hypoechoic areas of lymphocytic infiltration. Vascularity may be normal or low. Rare - hyperechoic nodules “white knights” which represent regenerating tissue.
  2. Comet artefact
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4
Q

Findings on triple phase CT of parathyroid adenoma?

A

Early arterial enhancement and delayed wash out.

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5
Q

Differential for parotid space lesion?

A

Parotid gland
- Benign - pleomorphic adenoma, Warthin’s
- Malignant - mucoepidermoid ca and adenoid cystic ca

Lymph nodes within parotid gland
- lymphoma
- metastatic nodes

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6
Q
  1. Classic imaging features of a pleomorphic adenoma?
  2. Features of Warthin’s?
A
  1. Well-circumscribed, bright T2, heterogenous enhancement post contrast
  2. Cystic tumours that take up pertechnetate, seen in older men who smoke, can be bilateral, don’t enhance - these last two supposedly help differentiate from pleomorphic adenoma
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7
Q

Differential for carotid space lesion?

A

Paraganglioma
Schwannoma
Neurofibroma

Lymph node - SCC met
Lemierre’s - thrombophlebitis of jugular vein

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8
Q

Characteristic imaging features of a paraganglioma?

A

CT - bright and rapid enhancement, splaying of ICA and ECA

MRI - “salt and pepper” appearance due to a combination of flow voids (pepper) and haemorrhage/slow flow (salt) - this can be seen on T1 and T2; intense enhancement post contrast

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9
Q

Differential for masticator space lesion?

A

Odontogenic infection
Sarcoma
Cavernous haemangioma
Nerve sheath tumour
Things related to V3…perineural spread

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10
Q

Differential for retropharyngeal space abnormality?

A

Retropharyngeal abscess
Infection from tonsillar region
Necrotic nodes - SCC or papillary thyroid ca
Lymphoma

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11
Q

Orbital pseudotumour - most common orbital tumour in adults!
1. Most commonly involves which muscle?
2. Painful or painless?
3. Myotendinous junction?
4. Characteristic MR appearance?
5. Differential?

Key point is it can involve any structure in the orbit…

A
  1. Lateral rectus
  2. Painful
  3. Involves the myotendinous insertion
  4. Low on T2
  5. Graves, lymphoma
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12
Q

Nasal mass with bony destruction in older patient >60 which is homogenous in appearance and low T2?

A

Sinonasal lymphoma

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13
Q

Mass in adolescent male with dark flow voids on T1 and avid enhancement?

A

Juvenile nasopharyngeal angiofibroma

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14
Q

Sinus mass with bony destruction in >40 yr old, low T2 and not particularly enhancing?

A

Squamous cell carcinoma

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15
Q

Adult with lateral nasal wall/maxillary sinus mass, cerebriform pattern, bony destruction, vascular?

A

Inverting papilloma (also called Schneiderian papilloma)

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16
Q

Antrochoanal polyp
- demographics
- location
- CT/MR appearance
- bony involvement

A

Young
Maxillary sinus going into the nasal cavity/choanae
CT low attenuation, MR low/iso T1, T2 bright, peripheral enhancement
Expands the ostium not the sinus, no bony destruction

17
Q

Completely blocked and expanded sinus, with peripheral enhancement of the lesion?

Association?

A

Mucocele/pyomucocele

Cystic fibrosis

18
Q

Dentigerous cyst features?

A

Associated with crown of an unerupted molar (usually 3rd)
Well-defined, not scalloped

19
Q

Odontogenic keratocyst?
Multiple?

A

Expansile solitary unilocular lesion, borders may be scalloped

Gorlin syndrome

20
Q

Cavernous haemangioma
- who does it affect?
- imaging appearance?
- enhancement?
- management?

A

Most common orbital vascular lesion in ADULTS

Round, well-defined, T2 bright

Gradual progressive enhancement - this is a slow flow venous malformation

Watch & wait if no symptoms, or surgical resection if symptomatic

FRCR 2A (10 decks)

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