Path- head and neck Flashcards
Peridontitis
inflammation involving peridontal ligs, alveolar bone, cementum
-Associations: DM, HIV/AIDS, granulocyte problems
-Morphology: alveolar bone; ligaments destroyed
Aphthous Ulcer (canker sore)
- Associations: Diet, GI disease- Celiac; AI disease- SLE, HIV
- Morphology: shallow, hyperemic, rimmed by erythema w/ mononuclear cell infiltrates
Pyogenic granuloma
-Associations: gingiva of children and pregnant women, bleeds readily
- Morphology: red/purple pedunculated; gumline proliferation of granulation tissue
- may mature into peripheral ossifying fibroma
Irritation fibroma
- Associations: bite line, reaction to trauma
- Morphology: located on buccal mucosa
ossifying fibroma
- Associations: arises from pyogenic granuloma; young teenage females
- Morphology:
*Periapical cyst (periapical “granuloma”)
inflammatory
-Associations: assoc. w/ caries, extends from pulpitis inflammation (chronic) - may give rise to dental abcess
-Morphology: granulation tissue,
- may be lined by epithelium;
- hygiene related
*Dentigerous cyst
developmental- odontogenic epithelium
-Associations: impacted molar (not hygiene related
-Morphology: cyst origin around crown of unerupted tooth/impacted molar
- lined by squamous epithelium
- dense lymphocytic infiltrate
*Keratocystic odontogenic tumor
developmental- odontogenic epithelium
- Associations: YOUTH, M>Fe
- Gorlin syndrome: nevoid basal cell, wide set eyes, asymmetry of mandible, palmar pits
- -PTCH gene mutation
- Morphology:
- lines by squamous epithelium
- PROMINENT basal cells
- locally aggressive, recurrence common
*Ameloblastoma
neoplastic- tumor of odontogenic (squamous) epithelium
-Associations: neoplasma-benign/malignant (most indolent)
- Morphology: squamous/cystic
- slow growing, prone to recurrence
*Odontoma
neoplastic- odontogenic epithelium
-Associations: hamartoma
-Morphology: tooth like (mixture of enamel, dentin, and epithelium)
Glossitis
- Associations: B-vit & iron deficiencies
- Morphology: red tongue: atrophy, thin mucosa
*Hairy Leukoplakia
- Associations: Immunosuppressed (80% occur in HIV)
- *EBV infection implicated
- Morphology: white-hairy on LATERAL border of tongue
- micro: hyperkeratosis, acanthosis
- ballloon cells in upper spinous layer
*Leukoplakia
- Associations: Tobacco/EtOH, HPV, immunosupressed; risk for squamous carcinoma
- CANNOT be removed by scraping and cannot be classified as another disease (thrush, lichen planus)
-Morphology: white, dysplasia squamous epithelium
Erythroplakia
- Associations: Tobacco/EtOH, HPV, immunosupressed; HIGH RISK for squamous carcinoma
- Morphology: red, velvet. eroded, epi usually very atypical
Nasal angiofibroma*
- Nasal tumor; benign
- Associations: post puberty males (gingers); nose bleeds
- Morphology: may be fatal by extension into cranium
- arises in stroma of post. lateral wall of roof of nasal cavity
Nasal polyp
- benign
- Associations: recurrent attacks of rhinitis
- may be assoc w/ allergic rhinitis; ASA sensitivity; cystic fibrosis
- Morphology: loose stroma w/ EOSINOPHILS, lymps and plasma cells, edema of submucosa
- Gross- glistening
Samter triad:
- asprin sensitive
- nonreaginic (not allergy) asthma
- nasal polyps
*Sinonasal/Inverted papilloma
benign
-Associations: some HPV 6, 11, males 30-60
- Morphology: nests of squamous; aggressive growth
- inward growth
- prone to recurrence
- extension into cranium
Olfactory neuroblastoma
malignant
-Associations: young adult
- Morphology: aggressively malignant, neuroendocrine cells
- NSE, synaptophysin, chromogranin, CD56
Solitary plasmacytoma
- Associations: not associated with myeloma (M protein neg.)
- unlikely to progress to multi myeloma
-Morphology: plasma cells
Nasopharyngeal carcinoma
-Associations: EBV in genetically predisposed
- Morphology: undifferentiated/basaloid malignant squamous cells w/ prominent lymphocytic infiltrate
- aggressively malignant
- often unresectable
Brachial cyst (cervical lymphoepithelial cyst)
Developmental neck cyst
-Associations: young adult; located anterolateral neck
-Morphology: epithelium surrounded by lymphs
Thyroglossal tract cyst
Developmental neck cyst
-Associations: child
-Morphology: midline neck, epithelial lined cyst
Paraganglioma/carotid body tumor
Neck tumor
-Associations: older adults; multiple in MEN 2
-Morphology: Zellballen (nests of cells); chromogranin
Sialadenitis
inflammation of salivary glands
- Associations:
- Lymphoid/ AI, Sjogrens
- Acute/bacterial
- mumps, HIV
- Morphology: ANA+
- duct obstruction → sialolithiasis → infect
*Mucocele
- Associations: lip, gland trauma, fluctuates in size
- -trauma → blockage or rupture of salivary gland duct
-Morphology: cystic space lined by inflammatory cells; granulation tissue resect completely
*Pleomorphic adenoma
Benign neoplasm
-Associations: most common, parotid, tends to RECURS following surgery
-**Morphology: epithlium forming glands + matrix (myxoid, chondroid, osseous tissue)
*Warthin
Benign neoplasm- second most common salivary tumor
-Associations: SMOKERS, MULTIFOCAL, recurrence uncommon
- **Morphology: double layer of oncocytic cells (pink cyto w/ abundant mito) lining spaces papillary, lymphs infiltrate of stroma
- almost exlusive to parotid
Mucoepidermoid
Malignant- most common malignant
-Associations: radiation
- Morphology: mucin producing malignant glands, and sheets of squamous cells
- more than 1/2 in parotids
Adenoid cystic; acinic cell
- Associations: slow growth, invades nerves
- Morphology:
Acute-serous otitis media
- Associations: viral infection
- give tubes can lead to conductive hearing loss
COMPLICATIONS:
- rupture of TM
- labrynithitis
-cholesteatoma- keratotic squamous lined cyst that grows and can impinge on local structures; arises from tretraction or perforation of ear drum
- dissolution of the bone- conductive hearing loss
- mastoiditis- temporal cerebritis/ abcess
Acute-suppurative otitis media
-Associations: pyogenic bacteria → strep. pneuomia, H. influenzae, moraxella
COMPLICATIONS:
- rupture of TM
- labrynithitis
cholesteatoma- keratotic squamous lined cyst that grows and can impinge on local structures; arises from tretraction or perforation of ear drum
- dissolution of the bone- conductive hearing loss
- mastoiditis- temporal cerebritis/ abcess
Chronic otitis media
- Associations: pseudomonas: necrotizing infection in diabetes
- Morphology: risk of necrosis
COMPLICATIONS:
- rupture of TM
- labrynithitis
-cholesteatoma- keratotic squamous lined cyst that grows and can impinge on local structures; arises from tretraction or perforation of ear drum
- dissolution of the bone- conductive hearing loss
- mastoiditis- temporal cerebritis/ abcess
Otosclerosis
-Associations: most common hearing loss in aging:
CONDUCTION type; also genetic
-Morphology: ankylosis of stapes at oval window
Laryngeal Nodule
-Associations: vocal overuse; not neoplastic
- Morphology: Myxoid stroma, hyperplastic squamous epi. punctate vasculatrity
- may have mirror image nodules
- present w/ hoarseness
Papilloma
-Associations: HPV-usually single in adults; often multiple, reccurent in children
- Morphology: BENIGN papillary squamous epithelium
- not precancerous
Squamous cell carcinoma of larynx
- Associations: Tobacco, EtOH most common assoc
- -Intrinsic: w/in larynx, most common, better prognosis
- -Extrinsic: supra/subglottic tumors
-Morphology: death by local invasion
HIV associations
- HSV
- Candida
- aphthous ulcers
- cheilitis
- kaposi sarcoma
- HAIRY leukoplakia
- (peridontitis)
