Head Neck Path Flashcards
sequence of development of squamous cell carcinoma
hyperplasia
dysplasia (progressive pleomorphism, hyperchromasia, nuclear size, nucelar/cytomplasmic ratio) (increasing risk with increasing dysplasia)
carcinoma
tissue type posterial nasal cavity and sinuses
ciliated psuedo stratified columnar
submucosa: sermucinous glands, thickwalled vessels, mixed inflamm cells
septum = cartilage and lamellar bone
gland with no lymph nodes, drains to oral cavity
submandibular
candidiasis
white plaque-like psuedo membrane
scraping > erythamatous base
fungal hypahae attached to mucosa
silver stain
squamous papilloma
soft fingerlike appearance in lingual, labial, buccal, and larynx epithelia, papillary hyperplasia of squamous mucosa with fibrovascular cores
Salivary glands
epithelial ductal cells
myoepthelial cells
mesenchymal compoeents - mxoid, hyaline, chondroid
pleomorphic adenoma
most common carcinoma of OC
squamous cell carcinoma
leukoplakia
white patch caused by epidermal thickening or hyperkeratosis
cannot be scraped off
localization nasopharyngeal carcinoma
northern african
China and SE Asia
pathology and associations sjorgream syndrome
associated with other autoimmune
anti-SS-B and SS-A
lymphocyte inflitration of glands with eventual gland destruction
mikulicz disease (benign lymphoepithelial lesion)
morphology minor salivary glands
unencapsulated
throughout OC
variable - mixed, mucoinous or serous
common sites of metatasis of oral squamous cell carcinoma
regional lymph nodes (submental, cervical)
lung, liver, bone, mediastinal lymph nodes
microscopy warthin tumor
bilayered oncocytic (pink) epithelail cells and lymphocyte proliferation
HPV serotypes associated with sqaumous cell carcinoma
other associations
serotypes 16 and 18
tobacco and alcohol
family history
erythroplakia (common)
leukoplakia
major and minor salivary glands
perinerual ivasion
cribiform architecture (sieve)
adenoid cystic carcinoma
sqaumous papilloma association, infection site and gross appearance
HPV
soft fingerlike appearance in lingual, labial, buccal, and larynx epithelia
gross and microscopic appearnace schneiderian papillmomas
proliferations from schneiderian membrane - nasal mucosa of ciliated columnar cells
histo Mucoepidermoid carcinoma
parotid and minor salivary glands
squamous, muscous, and intermediate cells
squamous cells with mucin vacuoules
nests of cells with pink cytoplasm,
most common salivary gland tumor
most common malignant
pleomorphic adenoma
mucoepidermoid carcinoma (maligant)
parotid and minor salivary glands
squamous, muscous, and intermediate cells
squamous cells with mucin vacuoules
nests of cells with pink cytoplasm,
mucoepidermoid carcinoma
oral cavitiy candidiasis clinical appearance, microscopy
white plaque-like psuedo membrane
scraping > erythamatous base
fungal hypahae attached to mucosa
silver stain
gross appearance and microscopy rhinosinusitis
complications?
edamtous nasal mucosa
enlarged turbinates
mixed inflamm infiltrate, edema, thickened basement membrane
complication = polyps
multinucleated cells with intranuclear viral inclusions, multinucleation, molding, margination herpes somatitis
herpes somatitis
location, demographics olfactory neuroblastoma (estheisionneruoblastom)
superal and lateral olfactory mucosa of nose
50 years median age
smaller nests invading below basement membrane
deep pink whirling keratin
possible invasion to skeletal muscle
perineural invasion > difficult ressection and recurence
squamous cell carcinoma
lorder of likelihood of maligancy in salivary glands
sublingual pervasively malignant
minor salivary glands
submandibular glands
partoid gland tumors more rarely malignant
location, gross and microscopic appearance franchial celft cyst
2nd branchial pouch, anterior border of SCM
thin walled, filled with cheesy mucoid material
squamous lining, lymphoid tissue
resembles metastic squamous carcinoma!
typical disease course nasopharyngeal carcinoma
grow silently until unressectable
local and distant metastasis
imunnohistochemistry markers for olfactory neuroblastoma
neurondocrine markers - synaptophysin, chromogranin
histo non-keratinizing nasopharyngeal squamous cell carcinoma
undifferentiated
lympoepithelial carcinoma - numerous lymphocytes between tumor cells oscuring epithelial cohesive derivation
(sheets of blue lymphocytes wiwth larger carcinoma cells)
symptomology olfactory neruoblastoma
epistais
nasal obstruction
headache
common location of squamous cell carcinoma
tounge and floor of mouth
association schneiderian papillomas
HPV 6 and 11
presentation sjogren syndrome
(sicca syndrome)
dry mouth (xerostomia)
dry eyes (keratoconjunctivitis)
3 categories schneiderian papillomas
Exophytic
inverted
oncocytic
Red granular area with/without elevation, poorly defined boundries
ethroplakia
cellular makeup of major salivary glands
parotid - serous glands (sides)
submandibular glands -mainly serous and mucinous (mixed)
lublingual gland - mainly mucinous, serous (mucinous midline)
appearance and histo adenoid cystic carcinoma
major and minor salivary glands
perinerual ivasion
cribiform architecture (sieve)
squamous cell carcinoma histology
same at any site
smaller nests invading below basement membrane
deep pink whirling keratin
possible invasion to skeletal muscle
perineural invasion > difficult ressection and recurence
thyroglassal duct cyst lined with
histology
lined with repsiratoyr or squamous epithelium
thyroid tissue in wall of cyst
most common infection of OC
causes
candidiasis
dentures
Diabetes M
steroids/antibiotic therapy
widespread cancer
imunnosuppression
HPV strains associate with non-keratinizing squamous cell carcinoma
17, P16 IHC
(HPV proteins E6 and E7 inactivate p53 and Rb)
undifferentiated
lympoepithelial carcinoma - numerous lymphocytes between tumor cells oscuring epithelial cohesive derivation
(sheets of blue lymphocytes wiwth larger carcinoma cells)
nasopharyngeal non keratizing squamous cell carcinoma
epithelial dysplasia = proliferation of ___ cells
proliferation of immature basal cells
histology olfactory neuroblastoma
uniform cells with round nuclei and scant cytoplasm
salt and pepper chromatin
neuroscretory granules
rossets or pseudoorsets
Exophytic
or
inverted
or
oncocytic
schenederian papilloma
white patch caused by epidermal thickening or hyperkeratosis
cannot be scraped off
leukoplakia
typical course olfactory neuroblastoma
locally invasive
metastasizes widely
5 year survival 50-70%
pathogenesis/appearance herpes somatitis
intraepithelial edema > clear fluid vesicle > rupture > ulcer
cellular makeup of acinar ductal unit + cell types
serous: basophilicc, zymogen granules
mucinous - clear, mucin
myoepithelal cells - acini, intercalated ducts
histo nonkeratining squamous cell carcinoma
proliferation of basal cells in sheets (vs nests)
brown staining showing inactivation of pathway leading to increased P16 iHC protein
gross appearance vocal cord nodules and polyps
nodules = bilateral on opposing surface of middle third of vocal cord
polyps - single in ventricle or reinke’s space
grossly smooth and round
herpes stomatitis microscopy
multinucleated cells with intranuclear viral inclusions
multinucleation, molding, margination (3Ms)
demographics neoplasms of salivary glands
adults, slight female predominance
benign 5-7th decade
maligancies later
cellular components of peleomorphic adenoma
epithelial ductal cells
myoepthelial cells
mesenchymal compoeents - mxoid, hyaline, chondroid
2nd branchial pouch, anterior border of SCM
thin walled, filled with cheesy mucoid material
squamous lining, lymphoid tissue
resembles metastic squamous carcinoma!
branchial cleft cyst
most common location of laryngeal carcinoma
other locations
glottis (diagnosed early)
supraglottic or inflraglottic
spread - with hemoptyisis or dysphagia
warthin tumor
restricted to partoid
bilateral
papillary cystic change
erythroplakia
Red granular area with/without elevation, poorly defined boundries
associations nasopharngeal carcinoma
EBV infection
salted fish diet
smoking
heriditary
proliferation of basal cells in sheets (vs nests)
brown staining showing inactivation of pathway leading to increased P16 iHC protein
non keratining squamous cell carcinoma
erythroplakia, leukoplakia associated with
risk of malignancy?
associated with epithelial displasia (more so erthroplakia)
5-25% risk in leukoplakia
50% risk in erythroplakia
