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Radiology > Head & Neck Imaging > Flashcards

Head & Neck Imaging Flashcards

1
Q

Pleomorphic adenoma on histology

A

50% of all salivary gland tumours (60% of parotid tumours)

Shows both epithelial and mesenchymal differentiation

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2
Q

Most common multifocal salivary gland tumour

A

Warthin tumour (2nd most common salivary gland tumour)

Usually 60M and 8X more common in smokers

Cystic spaces lined by eosinophilic epithelial cells with a lymphoid stroma (oncocytic appearance)

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3
Q

Which NPC is radiosensitive and what % present with nodal mets?

A

Undifferentiated carcinoma most radiosensitive

keratinising and non-keratinising less

90% have nodal mets at presentation

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4
Q

3 types of laryngeal cancer

A

Glottic (60%): arise from true vocal cords. Nodal mets rare and effectively treated with XRT

Supraglottic (30-35%): arise from false cords, epiglottis, arytenoid. Nodal mets in 40%

Subglottic (less than 5%): nodal mets and tracheal/ oesophageal invasion

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5
Q

Name 3 complications of head and neck infections

A

Epidural abscess

Osteomyelitis

Septic thrombophlebitis and lung abscess

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6
Q

Name the top 4 malignant salivary gland tumours

A

Mucoepidermoid (15% of all tumours)

Adenocarcinoma (10%)

Adenoid cystic carcinoma (5%)

Acinic cell carcinoma (5%)

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7
Q

Sudden SNHL after minor trauma

A

LVAS

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8
Q

Histology of inverting papilloma

A

Respiratory epithelium enclosed by basement membrane

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9
Q

Most common location of inverting papilloma

A

Lateral wall of nasal cavity related to middle turbinate and maxillary ostium

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10
Q

Nasopharyngeal tumour with intracranial extension- peritumoral cysts between it and the brain. Dx?

A

Enthesioneuroblastoma (bimodal- 20 years and 60 years)

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11
Q

Most common benign and malignant tumour of lacrimal gland?

A

Benign: pleomorphic adenoma

Malignant: adenoid cystic carcinoma

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12
Q

Most common organism to cause necrotizing otitis externa

A

Pseudomonas

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13
Q

Otosclerosis: 2 types

A

Fenestral: 80% fixation of stapes to oval window (CHL)

Retro-fenestral: 20% demineralisation of the cochlear capsule (SNHL)

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14
Q

Top 3 primary tumours of skull base

A

Meningioma

Chondrosarcoma

Chordoma

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15
Q

What causes epiglottis?

A

H. Influenza type B

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16
Q

How is NPC treated?

A

radiotherapy +- chemoRx

Surgery is only for histological Dx

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17
Q

What is Grisel syndrome?

A

Associated with RP abscess

Atlanto-axial subluxation due to inflammatory ligament instability

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18
Q

Most common organism to cause necrotizing otitis externa

A

Pseudomonas

19
Q

Otosclerosis: 2 types

A

Fenestral: 80% fixation of stapes to oval window (CHL)

Retro-fenestral: 20% demineralisation of the cochlear capsule (SNHL)

20
Q

Top 3 primary tumours of skull base

A

Meningioma

Chondrosarcoma

Chordoma

21
Q

What causes epiglottis?

A

H. Influenza type B

22
Q

How is NPC treated?

A

radiotherapy +- chemoRx

Surgery is only for histological Dx

23
Q

What is Grisel syndrome?

A

Associated with RP abscess

Atlanto-axial subluxation due to inflammatory ligament instability

24
Q

Pertechnetate and radioiodine for the 3 major thyroid ca

A

PTC: radioiodine but not pertechnetate

FTC: pertechnetate but not radioiodine

MTC: neither (arises from parafollicular cells)- Thallium 201

25
Q

What do you do if FNA shows follicular adenoma?

A

Need excisional biopsy

Overlap between follicular adenoma, follicular carcinoma and FV PTC

26
Q

Name 3 conditions associated with medullary thyroid ca.

A

MEN type 2

VHL

NF-1

27
Q

Name 2 features of Gorlin-Goltz syndrome

A

Also called basal cell naevus syndrome

Multiple BCCs

Multiple KCOTs

28
Q

Best Nuc Med test for MTC?

A

Octreotide scan

DMSA

29
Q

Best Nuc Med test for phaeo?

A

MIBG

30
Q

Coats disease

A

Retinal telangiectasia

Exudative retinal detachment

No calcification

31
Q

Name 2 features of NPC on CT

A

Isodense to muscle

Infiltration of parapharyngeal space (T2) in 65-84%

32
Q

Most common location for giant cell reparative granuloma?

A

Midline mandible

33
Q

Name 3 features of Reidel thyroiditis

A

Autoimmune thyroiditis

Lymphocytic infiltration and replacement of whole gland by fibrous tissue (as opposed to Hashimoto where only capsule becomes fibrotic)

Only 30% have hypothyroidism (majority euthyroid)

34
Q

Name 3 features of De Quervain thyroiditis

A

Post-viral granulomatous thyroiditis (self-limiting)

Hyperthyroidism (followed by hypo then return to normal)

LOW uptake on thyroid scan (Rx with radioiodine CI!)

35
Q

Most common location of orbital haemangioma and signal characteristics on MR?

A

83% intraconal (most often lateral retrobulbar- slow painless proptosis)

Intermediate T1, high T2 and slow peripheral enhancement with delayed washout

36
Q

What is Gradenigo syndrome and name 3 features

A

Head and neck infection from pseudomonas and enterococcus

Triad of:

Apical petrositis

CN VI palsy as it passes through Dorello canal

Retro-orbital pain or pain in V1-V2 distribution due to involvement of Meckel’s cave

37
Q

PG vs SMG calculi. Which more common and which more likely to be radio-opaque?

A

SMG more common (80% vs 20%)

SMG more likely radio-opaque (95% vs 60%)

38
Q

Name 4 conditions associated with Hashimoto

A

Turner syndrome

Primary thyroid lymphoma

Down syndrome

Other autoimmune disorders: SLE, RA, Sjögren

39
Q

Macroscopic appearance of De Quervain

A

Unilateral or bilateral enlargement of lobes

40
Q

FNA of parotid lesion shows lymphocytes and polygonal cells

A

Warthins (papillary cystadenoma lymphomatosum)

41
Q

Normal radioactive iodine uptake value?

A

10-30% at 24 hours

If more and uniform, suggestive of Graves disease

42
Q

Treatment for ameloblastoma and KCOT?

A

Surgical resection

NOT curettage as high risk of recurrence

43
Q

Cholesteatoma- origin?

A

Chronic inflammation

Retraction pocket in pars flaccida of TM

Gives rise to cystic lesion with keratinising stratified squamous epithelium

44
Q

Lethal midline granuloma?

A

NK-cell lymphoma involving nose

Poor Px

Radiology (16 decks)

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