Nasopharyngeal Carcinoma (23)

Question 1

What is carcinoma?

Answer 1

Carcinoma is a type of cancer that develops from epithelial cells.

Question 2

What are the differences between benign and malignant cells?

Answer 2

Benign tumors:
- Resemble the tissue of origin and are well differentiated.
- Are slow-growing.
- Are well circumscribed and have a capsule.
- Remain localized to the site of origin.

Malignant tumors:
- Are poorly or completely undifferentiated (anaplastic).
- Generally grow faster.
- Are poorly circumscribed and invade the surrounding normal tissues.
- Are locally invasive and metastasize to distant sites.

Question 3

What is the mechanism of radiotherapy?

Answer 3

Ionizing radiation works by damaging the DNA of cancerous tissue, leading to cellular death.

Question 4

What are the system of units for radiotherapy?

Answer 4

• Coulomb/kg: Exposure.
• Gray (Gy): Dose.
• Sievert (Sv): Dose equivalent.
• Becquerel: Activity.

Question 5

What are the risk factors for nasopharyngeal carcinoma?

Answer 5

• Gender: twice as often in males as it is in females.
• Ethnicity and race: most common in southern China (including Hong Kong), Singapore, Vietnam, Malaysia, and the Philippines. It is also fairly common in Northwest Canada and Greenland.
• Diet: consumption of salted fish containing carcinogenic volatile nitrosamines.
• Infection with the Epstein-Barr virus.
• Genetic factors.
• Family history.
• Tobacco and alcohol use.

Question 6

What is the cause of oral lesion with swab showing hyphae?

Answer 6

Candida.

Question 7

What are the routes of spread of nasopharyngeal carcinoma?

Answer 7

• Lymphatic spread.
• Local invasion.

Question 8

What are the risk factors for oral candidiasis?

Answer 8

• Immunocomprimised
• As a complication of radiotherapy or chemotherapy.
• Being a diabetic.

Question 9

Where does nasopharngeal cancer spread locally?

Answer 9

Question 10

What are the common lymph node tumors?

Answer 10

• Lymphoma (Hodgkins and Non-Hodgkins)
• Leukemia
• Metastatic

Question 11

How will you investigate for metastasis in lymph nodes?

Answer 11

Tissue biopsy:
- FNAC
- Excisional biopsy
- Sentinel biopsy for histopathological assessment with or without immunohistochemistry

Imaging modalities:
- Ultrasound scan
- CT scan
- MRI
- PET-CT