Pathology Flashcards
What type of cells line the auditory meatus and external canal
Epidermis (squamous epithelial cells)
This contains sebaceous and ceruminous glands
What type of cells line the middle ear
Columnar lined mucosa - contains ossicles
What is the function of the organ of corti ?
It contains the hair cells that give rise to nerve signals in response to sound vibrations.
What essentially is Schneiderian epithelium
Pseudo stratified columnar epithelium with goblet cells -> respiratory epithelium
What type of cells are found in the throat
Respiratory and squamous epithelium depending on anatomical site
What are the cells of the vocal cord
Squamous epithelium. Everything below is respiratory
What type of gland is the salivary gland
Exocrine
What is the biggest salivary gland
Parotid
What are the components of a salivary gland
Acinar component and ductular component
What is otitis Media
inflammation of the middle ear
What usually causes otitis media
Viral infection - occasionally bacterial Strep Pneumoniae, h influenzae
Who is most likely to develop otitis media
Children
What is a cholesteatoma
Not a tumour and doesn’t contain cholesterol!
It is abnormally situated squamous epithelium. High cell turnover and abundant keratin production
Who can develop a cholesteatoma
Any age group
What is a Vestibular Schwannoma
Benign tumour of Schwann Cells
Associated with vestibular portion of vestibulocochlear nerve (VIII)
Where do vestibular Schwannomas occur
Within the temporal bone
Describe the histological appearance of a Vestibular Schwannoma
Pretty
Lots of spindle cells
Haphazard cells and occasionally the nuclei line up which causes a linear appearance
Why is there no mitosis, necrosis etc. in a vestibular schwannoma
It is a benign tumour
What should be considered if a child presents with a bilateral vestibular schwannoma
Neurofibromatosis type 2
What are some features of Neurofibromatosis type 1
Widespread neurofibromas - bony defects, cafe au lat spots, axillary freckling and Lisch nodules
Where on the body are Lisch nodules found
In the eye
What is more common, NF1 or NF2
NF1
Who is mostly likely to develop a nasal polyp
Adults
What are the aetiologies for nasal polyps
Allergy infection asthma aspirin sensitivity nick exposure
What should be considered if a young patient presents with nasal polyps
Cystic Fibrosis
What can often be seen histologically with nasal polyps
Inflammatory cells - mast and eosinophils
What is a good diagnosis sign of a nasal polyp
Pain free even on prodding around
What are some causes of rhinitis and sinusitis
Infectious
allergic - IgE mediated type 1 hypersensitivity
What is Wegener’s granulomatosis
Autoimmune disorder of unknown aetiology characterised by a small vessel vasculitis limited to respiratory tract and kidneys
What sort of people are likely to get a Wegener’s granulomatosis
Very rare but usually white patients >40 years old
How do Wegener’s granulomatosis usually present
Pulmonary, renal disease or nasal symptoms of congestion, septal perforation
If a patient presented with a nasal polyp and renal failure, what test would need to be done?
ANCA test
positive cANCA is Wegener’s
What are the most common malignant lesions in ENT
squamous cell carcinoma
Who is most likely to develop a nasopharyngeal carcinoma
Low incidence in UK but very high in the far east especially in males
What do nasopharyngeal carcinomas have a strong association with
Epstein Barr virus
What type of virus is more likely to cause carcinoma
HPV
What type of virus is more likely to cause lymphoma
EBV
What does EBV target
T cells and tells them to proliferate
What does LMP-1 do
encodes other proteins that activate cyclins
Where are laryngeal polyps found
middle 1/3 to posterior 1/3 on vocal cord.
What is an ulcer
A break in the endothelium below the basement membrane
What is a squamous papilloma often associated with
HPV exposure - types 6 and 11
When are the 2 peaks of incidence of squamous papillomas
What are paragangliomas
tumours arising in clusters of neuroendocrine cells dispersed throughout the body
Where is a phaeochromocytoma found
adrenal medulla of the kidney
It is chromaffin positive
Why might a paraganglioma occur
As part of MEN 2 (multiple endocrine neoplasia 2)
What are the 2 main risk factors for a squamous cell carcinoma
Smoking and alcohol
Describe the link between HPV and squamous cell carcinoma
HPV produces proteins E6 and E7 which disrupt p53 and RB pathways respectively, leading to cellular immortality
How do we stage squamous cell carcinomas
TNM staging
Where is the most common site for almost all salivary tumours
Parotid gland
True or false.
Tumours in smaller glands are more likely to be malignant
True
They also cause pain = red flag
What is the most common type of tumour in the salivary glands
Pleomorphic adenoma
Who is most likely to develop a pleomorphic adenoma
Females over 60
What are some of the difficulties with pleomorphic adenomas
Lots of different shapes and sizes
Difficult to excise as they have a very jelly like material that can ooze out
High recurrence rate
What is a Warthin’s Tumour
Second most common benign tumour that are rare outwith the parotid gland
What are Warthin’s tumours associated with
smoking
What is the most common malignant tumour in the palate worldwide
Mucoepidermoid carcinoma
In the UK it is an adenoid cystic carcinoma
Who is most likely to develop an adenoid cystic tumour
Usually over 40 years
What is the survival rate for adenoid cystic tumours
35% 5 year survival and tends to kill you slowly
What is one of the difficulties with an adenoid cystic tumour
Can miss the tumour growing along the nerves
