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ENT > Pathology > Flashcards

Pathology Flashcards

1
Q

what conditions affect the ear?

A

otitis media
cholesteatoma
tumours
vestibular schwannoma

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2
Q

what is otitis media?

A

inflammation of the middle ear

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3
Q

what causes otitis media?

A

occasionally bacterial but usually viral.

Strep. pneumonia, H. influenzae and Moxarella catarrhalis

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4
Q

what causes chronic otitis media?

A

pseudomonas aeruginosa, Staph. aureus, fungal

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5
Q

when is otitis media seen in the pathology department?

A

only if requires exclusion

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6
Q

what is a cholesteatoma?

A

abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum.

A cholesteatoma often develops as a cyst, or sac, that sheds layers of old skin.

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7
Q

who gets cholesteatoma?

A

common, any age group

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8
Q

where do you get cholesteatoma?

A

superior posterior middle ear and/or petrous apex

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9
Q

what is the pathogenesis of cholesteatoma?

A

chronic otitis media and perforated tympanic membrane (acquired)

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10
Q

what is the pathology of cholesteatoma?

A

the normal lining of middle ear is cuboidal or columnar glandular epithelium.

Abnormally situated squamous epithelium. High cell turnover and abundant keratin production. Associated inflammation

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11
Q

what is a vestibular schwannoma?

A

associated with vestibular portion of vestibulocochlear nerve (VII)
occur within the temporal bone

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12
Q

what percent of cerebellopontine angle tumours do vestibular schwannoma?

A

80-90%

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13
Q

who gets vestibular schwannoma?

A

95% are sporadic and unilateral

equal gender distribution

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14
Q

what should you consider if you have vestibular schwannoma when you are bilateral and young?

A

consider neurofibromatosis (NF) type 2

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15
Q

what is grossly seen in vestibular schwannoma?

A

circumscribed tan/white/yellow mass

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16
Q

what is neurofibromatosis type 2?

A

AD but usually sporadic mutation.

1:40000 incidence. NF-2 gene encodes merlin protein at Ch22q12

Neurofibromas
Bilateral vestibular schwannoma
Multiple meningiomas
Gliomas
Café au lait
Cataracts
17
Q

what conditions affect the nose?

A 
rhinitis 
sinusitis 
polyp 
GPA (Wegner's) 
tumors
18
Q

rhinitis and sinusitis:

A

Infectious – common cold

Allergic – hay fever. IgE mediated type 1 hypersensitivity reaction.

19
Q

nasal polyps:

A

common (not in children)

equal gender distribution

20
Q

what is the numerous etiologies of nasal polyps?

A

allergy, infection, asthma, aspirin sensitivity, nickel exposure

21
Q

what should you consider in a young person with nasal polyps?

A

CF

22
Q

what is granulomatosis with polyangiitis?

A

it is an autoimmune disorder of unknown etiology characterized by a small vessel vasculitis and necrosis, usually limited to respiratory tract and kidneys

23
Q

who gets GPA?

A

rare. >40 years

24
Q

what do patients with GPA present with?

A

Present with pulmonary, renal disease or nasal symptoms of congestion, septal perforation etc.

25
Q

what is the characteristics of GPA?

A

Characterised by high frequency of anti-neutrophil antibody levels – ANCA +ve
cANCA – GPA
pANCA – microscopic polyangiitis

26
Q

what are nasal tumors?

A

they are relatively rare

27
Q

what are benign nasal lesions?

A

squamous papillomas, “Schneiderian” papillomas. Angiofibromas

28
Q

what are malignant nasal lesions?

A

Most commonly Squamous cell carcinoma

Also primary adenocarcinoma, nasopharyngeal carcinoma, neuroblastoma, lymphoma

29
Q

what is schneiderian papilloma?

A

inverted, exophytic or oncocytic

30
Q

who gets schneiderian papilloma?

A

tends to be over 50’s and more common males

31
Q

what is the etiology of schneiderian papilloma?

A

HPV (low risk), smoking, organic solvents, welding

32
Q

what re the symptoms of schneiderian papilloma?

A

blocked nose

33
Q

where do you find schneiderian papilloma?

A

Inverted and oncocytic on lateral walls and paranasal sinuses, exophytic on nasal septum

34
Q

what is the incidence of nasopharyngeal carcinoma?

A

low incidence in UK

Very high in Far East

35
Q

who gets nasopharyngeal carcinoma?

A

males>females

36
Q

what is nasopharyngeal carcinoma associated with?

A

EBV as well as volatile nitrosamines in food

occupation, family history

37
Q

what is the histological appearance of cells in nasopharyngeal carcinoma?

A

keratinising SCC or non-keratinizing

38
Q

EBV carcinogensis:

A

Seen in association with Burkitt’s lymphoma, other B-cell lymphomas and Hodgkin’s lymphoma
Infects epithelial cells of oropharynx and B-cells
Ubiquitous infection – most subclinical.

Occasional infectious mononucleosis
EBV hi-jacks and mimicks helper T-cell responses leading to proliferation and survival of B-cells.

Mediated largely by latent membrane protein 1 (LMP-1). EBV encodes EBNA-2 activating cyclin D and promoting transition from G0 to G1.

ENT (13 decks)

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