Pathology Flashcards
define otitis media
inflammation of the middle ear
causes of otitis media
usually viral
can be bacterial e.g. strep pneumonia, H. influenza and moraxella catarrhalis
causative organisms in chronic otitis media
pseudomonas
staph aureus
fungal
presentation of cholesteatoma
pearly white masses in the ear, often the middle ear
two types of cholesteatoma
acquired
congenital
histological presentation of cholesteatoma
abnormal stratified squamous epithelium with abundant keratin
management of cholesteatoma
lesions are usually scraped out
what is a vestibular schwannoma associated with location wise?
vestibular portion of CNVIII
where are vestibular schwannomas usually located?
inner ear within the temporal bone
what to consider if young and bilateral vestibular schwannomas
neurofibromatosis II
histology of vestibular schwannomas
well circumscribed
encapsulated
yellow benign
define neurofibromatosis II
AD condition affecting the NF-2 gene (tumour suppressor) which encodes for the merlin protein
presentation of neurofibromatosis II
neurofibromas bilateral vestibular schwannomas gliomas cafe au lait patches cataracts
are nasal polyps common?
yes, but not in children
causes of nasal polyps
allergy (eosinophils present) infection asthma aspirin sensitivity nickel exposure
if young with nasal polyps what cause to consider?
CF
what do sinonasal papilloma look like?
nasal polyps and they present the same way
can form micro-abscesses
presence of mucocytes is not normal (respiratory epithelium)
define granulomatosis with polyangiitis
AI small vessel vasculitis that is limited to the respiratory tract (nose too) and kidneys
who does GPA present in?
over 40s
presentation of GPA
pulmonary
renal
nasal symptoms
diagnosis of GPA
high ANCA (cANCA)
benign tumours of the nose
squamous papilloma’s
Schneiderian papilloma’s
angiofibromas
malignant tumours of the nose
squamous cell carcinomas adenocarcinomas nasopharyngeal carcinomas neuroblastomas lymphomas
three types of Schneiderian papilloma’s
inverted (lateral nasal wall)
exophytic (nasal septum)
oncocytic (lateral nasal wall)
who does Schneiderian papilloma’s present in?
tend to be over 50
males
causes of Schneiderian papilloma’s
HPV6 and 11 (low risk)
smoking
organic solvents
welding
presentation of Schneiderian papilloma’s
blocked nose
associations with nasopharyngeal carcinoma
male
EBV
nitrosamines in food
two types of nasopharyngeal carcinoma
keratinising (less of a link with EBV)
non-keratinising (EBV)
what is EBV associated with (tumours)
Burkitt’s lymphoma
other B cell lymphomas
Hodgkin’s lymphoma
what cells does EBV infect?
epithelial cells of oropharynx and B cells
define laryngeal polyps
reactive change in the mucosa
causes of laryngeal polyps
vocal abuse
infection
smoking
histology of laryngeal polyps
stratified squamous epithelium (+ulcer)
what condition can laryngeal polyps be seen in?
hypothyroidism
define contact ulcer
benign response to injury
where are contact ulcers usually found
posterior to vocal cord
causes of contact ulcer
chronic throat clearing
voice abuse
GORD
intubation
peak age related incidences of squamous papilloma
<5
20-40 year olds
what is squamous papilloma related to?
HPV 6 and 11
histology of squamous papilloma
stratified squamous epithelium often with keratin that is thicker than normal
define paragangliomas
tumours arising in clusters of neuroendocrine cells
locations of chromaffin positive paragangliomas
adrenal medulla
paravertebral
location of crhomaffin negative paragangliomas (no catecholamines secreted)
aortic
carotid bodies
oral cavity
nose
what age group get paragangliomas
over 50s
what is paragangliomas associated with?
MEN2
how to diagnose HPV associated carcinomas?
DNA check- PCR or in-situ hybridisation
salivary glands in the head and neck
parotid
submandibular
sublingual
minor salivary glands
define sialolithiasis
stones
infections of the salivary glands causes
paramyxovirus (mumps, parotitis, orchitis and pancreatitis, risk of secondary meningitis)
four types of salivary gland tumours
- pleomorphic adenoma (benign)
- Warthin’s tumour (benign)
- mucoepidermoid carcinoma (malignant)
- adenoid cystic (malignant)
describe pleomorphic adenoma
most common parotid females 40-60 risks malignant transformation well-circumscribed tumours that tend to be encapsulated
describe Warthin’s tumour
usually males over 50 rare outside the parotid associated with smoking often bilateral columnar cell and cystic lesions lymph node appearance
describe mucoepidermoid carcinoma
majority in parotid
describe adenoid cystic
over 40
usually parotid
most common malignant tumour of the palate
frequent perineural invasion (associated with pain and loss of function)
