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Anatomical Pathology RCPA Part 2 > Other head and neck > Flashcards

Other head and neck Flashcards

1
Q

epulides

A

fibrous epulis (=peripheral ossifying fibroma): ulceration, superficial granulation tissue, +/- bone

giant cell epulis (=peripheral giant cell granuloma)

vascular epulis (=pyogenic granuloma)

congenital epulis (=granular cell epulis)

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2
Q

giant cell lesions of jaw

A

giant cell tumour (sphenoid and temporal bones): cellular, large evenly spaced giant cells

giant cell reparative granuloma (=central giant cell granuloma) (mainly jaw): smaller fewer clustered giant cells

aneurysmal bone cyst: cystic spaces, USP6 rearrangement

brown tumour of hyperparathyroidism: hypercalcaemia, raised PTH

cherubism: children, bilateral, symmetrical

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3
Q

odontogenic cysts

A

inflammatory:

periapical/radicular cyst (apex, inflamed fibrous wall)

paradental (same histo)

developmental:

dentigerous cyst (at crown of unerupted tooth)

keratocystic odontogenic tumour (multiple if Gorlin syndrome, corrugated parakeratinized)

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4
Q

epithelial jaw neoplasms

A

ameloblastoma

keratocystic odontogenic tumour

adenomatoid odontogenic tumour

calcifying epithelial odontogenic tumour (Pindborg tumour)

squamous odontogenic tumour

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5
Q

oropharyngeal SCC classification

(NB: if HPV+, morph subtype doesn’t matter)

A

keratinising: 20% HPV+

non-keratinising with maturation (maturation in 10%): 80% HPV+

non-keratinising: most HPV+, better prognosis

undifferentiated: most HPV+ (cf NPC: EBV+)

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6
Q

benign mimics of malignancy - nose and sinuses

A

atypical stromal cells in inflammatory polyps

exophytic/inverted papilloma vs SCC

oncocytic papilloma vs non-intestinal type adenoca

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7
Q

granulomatous infection - nose and sinuses

A

bacterial:

rhinoscleroma (foamy macrophages, plasma cells, gram- bacilli)

leprosy (foamy macrophages, plasma cells, acid fast bacilli)

TB

fungal: aspergillus, mucormycoses, cryptococcus
protists: rhinosporidium (vs myospherulosis)

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8
Q

non-infectious granulomas - nose and sinus

A

vasculitis: Wegeners, Churg-Strauss
drugs: cocaine
idiopathic: sarcoid, Crohns, idiopathic midline destructive disease
malignant: NK/T cell lymphoma

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9
Q

sinonasal adenocarcinoma

A

intestinal type (CDX2+)

nonintestinal type: low grade, high grade

salivary type

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10
Q

undifferentiated sinonasal tumours - site specific

A

NPC: EBV+

NUT carcinoma: EBV-

NK/T cell lymphoma: EBV+

SNUC

SCUNT (small cell undiff NE tumour)

Olfactory neuroblastoma

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11
Q

undifferentiated sinonasal tumour - not site specific

A

Basaloid SCC

Ewings

Rhabdomyosarcoma

Melanoma

Small cell carcinoma

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12
Q

NPC vs SNUC vs SCUNT

A

NPC: syncytial sheets, lots of inflammation, EBV+

SNUC: mitoses/apoptosis/necrosis but less inflammation, EBV-, CK5/6- (LMWCK+)

SCUNT: CK+, NE+, no s100 sustentacular cells (cf O.N.)

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13
Q

NPC classification

(EBV trumps p16/HPV for prognosis)

A

keratinising (EBV-)

non-keratinising (EBV+): differentiated, undifferentiated

basaloid (rare)

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14
Q

nested sinonasal lesions

A

olfactory neuroblastoma

paraganglioma (fossa of Rosenmuller)

pituitary adenoma

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15
Q

HPV like vessel - nose and sinuses

A

angiofibroma (always young men, B-catenin+)

glomangiopericytoma (SMA, FXIIIa+, CD34-)

solitary fibrous tumour (CD34+)

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16
Q

cranial lesions in nose

A

pituitary adenoma

meningioma

craniopharyngioma

glial heterotopia

17
Q

nested lesions - larynx

A

paraganglioma

NE tumours

medullary thyroid ca

melanoma

18
Q

laryngeal rhabdomyoma vs granular cell tumour

A

RM: MSA, desmin+

GCT: CD68+

(both s100+)

19
Q

ear: kimura disease vs epithelioid haemangioma

A

KD: younger, postauricular/scalp, lymphoadenopathy, deep (fat, fascia, muscle), fewer vessels

EH: older, periauricular/forehead, no lymphadenopathy, superficial (dermis), nodular vascular proliferation

other DDX: pyogenic granuloma (less inflammation), angiosarcoma (diffuse, pleomorphic)

20
Q

external auditory canal

A

ceruminal gland adenoma

ceruminal gland pleomorphic adenoma

skin adnexal type tumours

21
Q

middle/inner ear lesions

A

middle ear adenoma +/- NE differentiation

paraganglioma (familial: SDH gene)

acoustic neuroma (NF2 if bilateral)

meningioma (also NF2 assoc)

rhabdomyosarcoma

endolymphatic sac papillary tumour (VHL syndrome): specific clinical/radiology cf MEA

22
Q

middle ear heterotopias

A

salivary gland

neuroglial

23
Q

branchial cleft cyst vs metastatic SCC

A

BrCC: unilocular, clear fluid, resp or sq epithelium, younger

SCC: multilocular, keratin filled, dysplastic, older

Anatomical Pathology RCPA Part 2 (30 decks)

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