nasopharyngeal Ca

Question 1

STEM: Middle aged diabetic Chinese male with ulcer in nasopharynx, on recent chemo and radiotherapy
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Q1. Risk factors for nasopharyngeal carcinoma?

Answer 1

1- Ethnicity; Southeast of asia .. 2- Family Hx .. 3- Smoking .. 4-Salted fish
5- HLA Gene 6- Infection: EBV

Question 2

Q2: Define carcinoma?

Answer 2

Malignant Epithelial Neoplasm

Question 3

Q4: What are other non-epithelial tumors can be here?
( NASOPHARYNX)

Answer 3

-At this site may find NH Lymphoma

Question 4

Q5. If palpable lymph nodes, how to assess?

Answer 4

FNAC

Question 5

Q6: What is Cytology vs histology?

Answer 5

C; Study the cells alone, H; Study of architecture of tissue not cells alone

Question 6

Q8: If swab grows hyphae, what do you think it is?

Answer 6

Candida Albicans

Question 7

Predisposing Fx for Infection?

Answer 7

Being DM,
Dead tissue from the pharynx by radiotherapy and Immunocompromised because of chemo

Question 8

Q7. Scale of radiation dose?

Answer 8

grey

Question 9

Q10. How IHC confirms Carcinoma?

Answer 9

Pathological methods use ab to bind against epithelial cells. The binding is visualized by chemical reaction under microscope.

Question 10

Q11. Steps for the carcinoma to spread to Cervical LN ?

Answer 10

As Tumor grows in nasopharynx without control the cells start to penetrate the local soft tissue then it will go to lymphatics and embolizes to distal nodes. After that tumor grows in the nodes

Question 11

Q12. How does radiotherapy work against malignancy?

Answer 11

It causes destruction of DNA of Cell tumor and cause cell death by two ways direct damage and produced reactive chemicals that cause tumor cell to die