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OS 212 ORL > Patho/Radio > Flashcards

Patho/Radio Flashcards

1
Q

reactive lesions (benign fibroepithelial lesions)

etiology

A

chronic irritation

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2
Q

pyogenic granuloma vs peripheral fibroma vs irritation fibroma

A

both gingival

pyogenic - more vascular
peripheral fibroma - more fibrous
irritation fibroma - buccal, more fibrous

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3
Q

denture-induced proliferations

A

epulis fissuratum, gravidarum

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4
Q

leukoplakia (white plaque)

etiology

A

cannot be ascribed to any identifiable etiology

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5
Q

leukoplakia (white plaque)

histology

A

sq hyperplasia w hyperkeratosis (white bc of keratin)

parakeratosis - w nuclei

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6
Q

acanthosis

A

elongation of rete ridges

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7
Q

most important determinant of premalignant potential

A

dysplastic features (pleiomorphism, nucleoli, inc mitosis, hyperchromasia)

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8
Q

most common presentation of EARLY ORAL CANCERS

A

erythroplakia (red plaque)

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9
Q

erythroplakia (red plaque)

histology

A

thin, atropic epithelium, without keratin

LP with engorged capillaries

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10
Q

erythroplakia (red plaque)

grading

A

2/3 sq epith replaced by atypical cells = SEVERE

1/3 replaced = mild

full thickness = carcinoma in situ (intact BM/no invasion)

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11
Q

major oral cavity cancer

A

SCCA

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12
Q

non-keratinizing oral cavity cancer etiology

A

HPV 16, 18

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13
Q

oral cancer histology

A

keratin pearls, intercellular bridges (well differentiated)

poorly differentiated if hardly any (more aggressive)

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14
Q

oral cancer treatment (3)

A

surgery
radiotherapy/chemo
targeted molecular therapy/EGFR targeted drugs

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15
Q

oral cancer prognosis (best and worst)

A

best - lip

worst - floor of the mouth, base of tongue

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16
Q

most common ODONTOGENIC TUMOR

A

ameloblastoma

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17
Q

ameloblastoma presentation (lesions)

A

lytic cysts (soap bubble lesions) - multi-locular radioluscencies (with scalloped margins)

*slow-growing, painless, benign but locally invasive and recurrent

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18
Q

ameloblastoma microscopic landmarks/pathologic hallmarks (3)

A

peripheral palisading cells

reverse nuclear polarization (nuclei at inner edge)

central stellate reticulum

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19
Q

ameloblastoma treatment (2)

A

hemimandelectomy

total mandiblectomy

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20
Q

fibrous dysplasia affects

A

pediatric age group, stops growing near skeletal maturation

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21
Q

ossifying fibroma; osteosarcoma

affects?

A

OF - middle age

osteosarcoma - late teens/ early 20’s

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22
Q

inflammatory nasal polyps etiology

A

chronic inflammation (systemic allergies, asthma)

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23
Q

inflammatory nasal polyps histology

A

PCCE

stroma w edematous inflammatory cells (glistening polyp)

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24
Q

inflammatory nasal polyps treatment (2)

A

polypectomy

treat underlying cause

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25
Q

inflammatory nasal polyps radio

A

thinned out skull bones (due to pressure, chronic sneezing?)

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26
Q

tonsilitis etiology (2)

A

viral

bacterial (b-hemolytic strep most common -> rheumatic fever, rh heart disease)

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27
Q

tonsilitis treatment

A

medical treatment

tonsillectomy if obstructing airflow (kissing tonsils)

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28
Q

necrotizing lesions (“lethal midline granuloma”) (3)

A

fungal (mucor - invasive, aspergillus - non-invasive)
auto-immune (wegener’s granulomatosis)
t/nk lymphoma

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29
Q

most neoplasms in nasopharynx are

A

scca

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30
Q

nasopharyngeal angiofibroma (juvenile angiofibroma) histology

A

branching thin-walled bv in fibrous stroma

*unilateral

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31
Q

nasopharyngeal angiofibroma treatment

A

surgery (but complications may arise e.g. hemorrhage)

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32
Q

most common benign nasopharyngeal mass

A

nasopharyngeal (juvenile) angiofibroma

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33
Q

nasopharyngeal angiofibroma imaging (2)

A

angiography with contrast

ct/mri: like sinusitis/polyp; bony structures intact

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34
Q

tonsillitis vs asymmetrical tonsils

A

ddx by persistence of asymmetry

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35
Q

sinonasal (schneiderian) papilloma etiology

A

hpv 6, 11

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36
Q

sinonasal (schneiderian) papilloma histology

A

inverting type papilloma: sq invaginates into stroma

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37
Q

sinonasal (schneiderian) papilloma treatment

A

excision (but formidable; high recurrence)

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38
Q

olfactory neuroblastoma (esthesioneuroblastoma) - how to ddx from other nasopharyngeal neoplasms?

*malignant; roof of nasal cavity; glabellar protrusions

A

anosmiaaa

39
Q

olfactory neuroblastoma histology

A

small round dark blue cells (ddx lymphoma)

homer-wright pseudorosettes!

40
Q

olfactory neuroblastoma treatment

A

surgery, chemo

41
Q

nasopharyngeal carcinoma

affects?

A

bimodal - young adults, 30-60 y/o

endemic in africa & asia

42
Q

nasopharyngeal carcinoma etiology

A

EBV

43
Q

nasopharyngeal carcinoma presentation (4)

A

lateral neck mass (late sign of cervical LN metastasis) - most common
hot potato voice
nasal obstruction
unilateral HL & otalgia

44
Q

nasopharyngeal carcinoma histo

A

small blue round cells ulit
undifferentiated - no keratin pearls/intercellular bridges
ddx: IHC (detect cytokeratin, present in carcinoma)

45
Q

nasopharyngeal carcinoma treatment

A

radiotherapy (primary modality) - very effective

difficult surgical access. “swing-out method”

46
Q

nasopharyngeal carcinoma imaging

A

mass at nasopharynx can extend in all directions

bone invasion (characteristic of CA; ddx from angiofibroma)

47
Q

laryngeal cancer treatment

A

total or partial laryngectomy

48
Q

branchial cleft cyst presentation, etiology

A

anterior end of scm
does not move with swallowing!

remnants of branchial arches

49
Q

thyroglossal duct cyst presentation, etiology

A

anterior midline
moves with swallowing! or protrusion of tongue

remnants of thyroid cell left behind during migration (recall: from foramen cecum/floor of mouth migrate downward to throat)

50
Q

thyroglossal duct cyst

imaging

A

beaking of infrahyoid strap muscles over cyst

51
Q

thyroglossal duct cyst histo

A

sse (above hyoid)
pcce (below hyoid)
with (functional) thyroid tissue underneath (hyperplastic or resemble follicular/papillary CA)

52
Q

thyroglossal duct cyst treatment

A

complete excision (cis-trunk). may necessitate removal of hyoid

*recurrence; malignant transformation

53
Q

otitis imaging

*mastoiditis

A

chronic irritation can lead to mastoiditis and cholesteatoma

in mastoiditis: no honeycombing and air cells due to sclerosis

54
Q

otitis treatment

A

ab for infections, surgery if severe

55
Q

cholesteatoma etiology

A

(congenital or acquired)

severe otitis media w tm rupture, ingress of sse from external to middle ear (pcce)

56
Q

very common cause of PREVENTABLE DEAFNESS (in child?); conduction deafness

A

cholesteatoma

57
Q

cholesteatoma histo

A

sse with keratin debris

58
Q

cholesteatoma treatment

A

surgical excision

59
Q

tumors

pinna
pinna & canal
child middle ear

A

pinna - bcc
pinna and canal - scc
child middle ear - embryonal rhabdomyosarcoma

*ceruminous gland tumors

60
Q

sialadenitis etiology (2)

A

viral - viral parotitis/mumps

bacterial - s. aureus; strep viridans

61
Q

sialadenitis risk factors

A

dehydration -> viscous fluid -> obstruction (sialolithiasis may be seen in imaging) –> stasis –> infection

62
Q

sialadenitis histo

A

neutrophilic infiltrates in duct & between acini - BACTERIAL

63
Q

sialadenitis treatment

A

rarely surgical unless may stone

64
Q

most common salivary gland TUMOR

A

benign mixed tumors/pleomorphic adenoma

65
Q

benign mixed tumors/pleomorphic adenoma histo

A

pleomorphic;

epithelial (ducts)
mesenchymal (chondromyxoid stroma/loose cartilage-like)

66
Q

benign mixed tumors/pleomorphic adenoma treatment

A

complete excision (mary recur/transform if not complete)

67
Q

SECOND most common salivary gland TUMOR

A

warthin’s tumor (oncocytic papillary cystadenoma lymphomatosum)

68
Q

most common BILATERAL salivary gland tumor

A

warthin’s tumor

*synchronous or metachronous (even decades)

69
Q

warthin’s tumor location

A

exclusively in PAROTID

70
Q

warthin’s tumor histo

A

papillary lined by ONCOCYTES (tall columnar eosinophilic)

abundance of LYMPHOCYTES

71
Q

most common salivary gland MALIGNANCY, most common salivary gland malignancy in CHILDREN

A

mucoepidermoid carcinoma

72
Q

mucoepidermoid carcinoma histo

A

epidermal - squamous cells

mucoid - mucus-secreting cells

73
Q

mucoepidermoid carcinoma grading

A 
low-grade = more mucin, more cystic
high-grade = more squamous, more solid
74
Q

mucoepidermoid carcinoma parameters

A

anaplasia, necrosis, solid component

75
Q

mucoepidermoid carcinoma treatment

A

high-grade = total removal (facial nerve sacrifice)

low-grade = superficial parotidectomy

76
Q

most common malignancy of MINOR salivary glands; oral cavity (also affects lacrimal)

A

adenoid cystic carcinoma

77
Q

adenoid cystic carcinoma presentation

A

oral cavity ulcer (ddx oral cavity scc?)

pain due to perineural invasion

78
Q

adenoid cystic carcinoma histology

A

cribriform (swiss cheese) + hyaline in the lumina

79
Q

adenoid cystic carcinoma prognosis

A

can recur 10-15 yrs after surg so do long-term follow-up

80
Q

2nd most common BILTERAL salivary gland MALIGNANCY in CHILDREN

A

acinic cell carcinoma

81
Q

acinic cell carcinoma presentation

A

pre-auricular masses (well circumscribed and movable, usually in parotid)

82
Q

acinic cell carcinoma histo

A

dark blue neoplastic acinar cells

acini look normal but no adipocytes and ductal system

83
Q

acinic cell carcinoma treatment

A

complete excision

84
Q

common in the elderly (6th-7th)

A

carcinoma ex-pleomorphic adenoma (from bmt)

*most commonly poorly differentiated

85
Q

carcinoma ex-pleomorphic adenoma histo

A

residual cartilage (indicates lesions was benign dati)

86
Q

carcinoma ex-pleomorphic adenoma treatment

A

practically hopeless :(

87
Q

most common lacrimal gland tumor…?

A

adenoid cystic ca

*lacrimal is a specialized salivary gland so salivary gland-type tumor

88
Q

most common MALIGNANT eye tumor of CHILDHOOD

A

retinoblastoma

89
Q

retinoblastoma presentation

A

leukocoria

loss of ror –> cat’s eye (eye can still be salvaged)

90
Q

retinoblastoma histo

A

blue small round cell

flexner-wintersteiner true rosettes (embryonic rods and cones; with central lumen!)

91
Q

small blue round cell (4)

A

olfactory neuroblastoma
nasopharyngeal ca
lymphoma
retinoblastoma

92
Q

retinoblastoma treatment

A

enucleation

laser/cryotherapy + chemotherapy (aggressive but chemoreactive)

93
Q

retinoblastoma imaging

A

intraocular calcification

94
Q

acute and chronic sinusitis imaging

A

air fluid levels seen with gravity

thickened mucosal swelling & periosteum (pressure)

OS 212 ORL (7 decks)

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