Pathology Flashcards
what glands are in the auditory meatus and external canal
sebaceous and ceruminous glands
what lines the middle ear
columnar epithelium lined mucosa
what lines the eustachian tube
respiratory epithelium
what gland produce cerumen (ear wax)
ceruminonus glands
what lines the nasal vestibule
squamous epithelium (keratinised)
what lines the rest of the nose and nasal sinus (apart from the nasal vestibule- most anterior part of nose)
respiratory epithelium with sero negative glands
what is respiratory epithelium
pseudostratified ciliated columnar epithelium (with goblet cells)
what type of epithelium lines the throat
depends on site:
- oropharynx stratified squamous
- everywhere else respiratory
what makes up the oropharynx
tongue from the circumvallate papillae, posteriorly to the epiglottis, the tonsils, the associated pharyngeal walls, and the soft palate
what type of gland is the salivary gland
exocrine
describe the components of the salivary gland
acinar and ductular component
serous cells
mucinous component
peripheral myoepthelial cells
what organisms cause chronic otitis media
Pseudomonas Aeruginosa
Staph aureus
fungal
what would you worry about if there was chronic otitis media infection
a tumour
what are the complications of otitis media
can perforate tympanic membrane or spread to e.g. mastoid
what is a cholesteatoma
not a tumour
lesion made of keratin in the middle ear caused by inflammation (chronic otitis media and perforated tympanic membrane) creating high cell turnover
can erode surrounding structures so need to be removed
what is the normal lining of the middle ear
cuboidal or columnar glandular epithelium
what is a vestibular schwannoma
an acoustic neuroma
most common tumour of the temporal bone
what are the symptoms of a vestibular schwannoma
hearing loss, tinitis, loss of balance, headaches, can grow and compress brain, brain stem
what nerve are vestibular schwannomas associated with
vestibular portion of the CN VIII
what should you suspect in young patients with bilateral vestibular schwannomas
neurofibromatosis type 2
what do vestibular schwannomas look like
will circumscribed, white/tan/yellow mass
what are the features of neurofibromatosis type 2
autosomal dominant mutation in tumour suppressor gene neurofibromas bilateral vestibular schwannomas multiple meningiomas gliomas cafe au lait spots cataracts
what are the causes of rhinitis and sinusitis
infections- cold, viral, bacterial
allergy- hay fever
who gets nasal polyps
not children
equal in both genders
what can cause nasal polyps
allergy, infection, asthma, aspirin sensitivity, nickle exposure
what should you consider in a young patient with nasal polyps
cystic firbosis
what is granulomatosis with polyangitis
autoimmune disorder
small vessel vasculitis and necrosis
usually limited to the respiratory tracts and kidneys
how dors granulomatosis with polyangitis present
pulmonary, renal disease (haematuria, glomerulonephritis, hypertension), nasal symptoms (congestion, septal perforation)
what is in high levels in GPA
ANCA +ve
multinucleated giant cells
what is cANCA associated with
GPA
what is pANCA associated with
microscopic polyangitis
what is the most common malignant tumour of the nose
squamous cell carcinoma
can also get adenocarcinomas, nasopharyngeal carcinomas, neuroblastomas, lymphomas
what benign tumours do you get in the nose
squamous papillomas, scheiderian papillomas, angiofibromas
what is a schneiderian papilloma
benign nasal tumour
patients over 50, more common in males
presents with a blocked nose
what are the causes of a schneiderian papilloma
HPV, smoking, organic solvents, welding
what are the types of schneiderian papilloma
inverted and oncocytic (on lateral walls and paranasal sinuses)
exophytic (nasal septum)
what does a nasopharyngeal carcinoma have a strong association with
esptein barr virus + volatile nitrosamines in food
occupation and family history
what are the types of nasopharyngeal carcinoma
keratinising SCC or non keratinising
how does epstein barr virus cause carcinogenesis
hi-jacks and mimicks helper T-cell responses leading to proliferation and survival of B-cells
what are laryngeal polyps
Reactive change in laryngeal mucosa secondary to - vocal abuse, infection and smoking. Occ. in hypothyroidism (due to oedema build up).
what is a contact ulcer
benign response to injury
e,g, chronic throat clearing, voice abuse, GORD, intubation
who gets squamous papiloma/papillomatosis
<5 years and between 20-40 years
related to HPV exposure
what is a paraganglioma
Tumours arrising in clusters of neuroendocrine cells
can be chromaffin positive or negative
what are squamous cell carcinomas in the head and neck associated with
smoking, alcohol, HPV
how do you diagnose SCC
need to see keratinisation and pickle cells on biopsy
what are sialolithiasis
stones of the salivary glands
what infections can you get in the salivary glands
paramyxovirus (mumps)
where is the most common site for all salivary gland tumours
parotid
what salivary gland tumours are more likely to be malignant
those in the smaller glands
what should a young patient with a painful salivary gland mass make you think
malignancy
what is a pleomorphic tumour
most common salivary gland tumour- risk of malignant transformation, usually in parotid
what is a warthins tumour
benign tumour of the salivary glands associated with smoking
what is the most common malignant tumour of the salivary glands
adenoid cystic carcinoma
outside of uk most common mucoepidermoid carcinoma
what is an adenoid cystic
most common malignant tumour of the palate
what is the histology of nasal polyps like
resp epithelium on surface
lots of inflammatory cells inside
what is aspergillis
a ball of fungus found in a single lung cavity - which may improve or disappear, or change very little over a few years. Chronic cavitary pulmonary aspergillosis (CCPA) where cavities are present in the lungs, but not necessarily with a fungal ball (aspergilloma)
what tumours are associated with ebstein barre virus
Burkitt’s lymphoma. B-cell lymphoproliferative syndromes, and nasopharyngeal carcinoma
with Hodgkin’s disease, T-cell lymphomas, and gastric carcinoma, as well as being the causal agent for infectious mononucleosis.
what is a histiocyte
a stationary phagocytic cell present in connective tissue
what covers the vocal chords
stratified squamous epithelium
what virus is squamous cell carcinoma associated with
HPV types 6 and 11
what do paragangliomas look like
nested appearance
what do parotid glands look like histologcally
very serous
