Pathology of nose

Question 1

what is meant by inflammation of the nose?

Answer 1

Inflammation: allergic (hay fever, due to hypersensitivity to allergens such as plant pollen, fungi, animal allergens, dust mites)

Question 2

which parts of nose mostly infection common? Most are due to what?

Answer 2

Infection of the nose, nasal sinusites, pharynx and larynx are common. Mild and self-limiting. Most due to viral infection often followed by bacterial superinfection.

Question 3

characteristics of viral infection of nose?

Answer 3

Characterised by features of acute inflammation but without exudation of neutrophils

Question 4

nose viral infection involves which viruses?

Answer 4

Adenovirus, influenza, parainfluenza and respiratory syncytial viruses can also invade the lower respiratory tract

Question 5

Explain bacterial phase of nose infection

Answer 5

bacterial commensals in the respiratory tract (e.g. streptococcis mutans, haeumophilus influenzae) and can superinfect the damaged tissue, whihc then exhibits the typical features of acute inflammation including exudation of neutrophils

Question 6

Allergy is the coomon cause of what?

Answer 6

Rhinitis

Question 7

Rhinitis usually appears as?

Answer 7

Hay fever or rhinorrhea

Question 8

Chronic inflammation may results in formation of what in the nose?

Answer 8

Nasal polyps

Question 9

what happen after reccurent attacks of rhinitis?

Answer 9

Polypoid protrusions of oedematous nasal mucosa

Question 10

Nasal polys size?

Answer 10

May be multiple and meause a few millimeters to several centimemters in size

Question 11

what happen when nasal polyps are large or multiple

Answer 11

Can encroach on the airway and impair drainage of secretion from the sinuses

Question 12

Histologically appearance of nasal polys 3 marks

Answer 12

Nasal polyps represent oedematous mucosa infiltrated with inflammatory cells, especially eosinophils and plasma cells, and dilated vessels).
Occasionally within submucosa: atypical stromal cells with dysplastic or bizarre nuclei.
Such changes usually are found in polyps with ulcerated surface epithelium and should not be mistaken for malignancy

Question 13

where does the Schneiderian papillomas= sinosal papilloma originates from?

Answer 13

originates from nasal mucosa

Question 14

The schneiderian papilloma arises from which viruses?

Answer 14

They may arise from human papillomavirus type 6 or 11

Question 15

The histological appearance of schneiderian papillomas

Answer 15

Histology: Comprises papillary fronds lined byrespiratory pseudostratified epithelium /hyperplastic immature squamous epithelium/ basaloid cells, with delicate fibrovascular cores. The surface epithelium may the invaginate extending beneath the surface. Occasionally show squamous differentiation, which may spare isolated mucin-containing respiratory cells as “microcysts“

Question 16

Reccurence of Schneiderian papillomas

Answer 16

30 % to 60% of surgically treated patients

Question 17

in schneiderian papillomas Does the histology predict reccyrence

Answer 17

There is no reliable way to histologically predict recurrence

Question 18

Necrotizing lesion of the nose na upper airways includes what?

Answer 18

Includes infectious conditions (e.g. acute fungal infections like Mucormycosis particularly in diabetics and immunosuppressed patients), inflammatory conditions (e.g. granulomatosis with polyangiitis) and neoplastic entities (e.g. extranodal NK/T-cell lymphoma)

Question 19

ENKTL stands for what?

Answer 19

Extranodal NK/T-cell lymphoma

Question 20

which subtype of ENKTL accounts for 80%

Answer 20

Nasal subtype

Question 21

ENKTL is characterised by what?

Answer 21

Characterised by vascular damage and prominent necrosis at initial sites of involvement in the nose and upper respiratory tract, which can extend to cause local destruction with complications,Regional spread to lymph nodes and, later, systemic spread

Question 22

ENKTL is associated with which virus

Answer 22

EBV

Question 23

Aggressive disease; better outcomes for localised disease with chemoradiotherapy
NAME THAT DISEASES

Answer 23

ENKTL

Question 24

One word

Occur in the nasal septum and is a rare cause of persistent nose bleeds.

Answer 24

Haemangiomas

Question 25

One word

Typically located in the nasal septum and affects male children

Answer 25

Angiofibroma

Question 26

One word

Benign mesenchymal tumour that is locally aggressive and grows throughout childhood but typically regresses

Answer 26

Angiofibroma

Question 27

what does the angiofibroma composed?

Answer 27

The tumor composed of a collagenous stroma with vascular network which is composed of innumerable small, thin-walled blood vessels evenly distributed throughot the lesion

Question 28

Histologically appearance of Angiofibroma

Answer 28

Benign

Question 29

Angifibroma can produce a mass effec to?

Answer 29

Block the nasal passages
Erode adjacent structures
Ulcerate and
Bleed

Question 30

The nasopharyngeal carcinoma (NPC) is strongly associated with what?

Answer 30

Associated with EBV infection and a distinctive geographi distribution

Question 31

Path

Pathogenesis of NPC

Answer 31

Pathogenesis: Multifactorial, with viral, environmental and genetic components, including diets high
in nitrosamines (salted fish, fermented foods) and smoking in addition to EBV infection

Question 32

Clinical features of NPC

Answer 32

Clinical features: Often clinically occult until advanced stage when they present with nasal
obstruction, epistaxis and lymph node metastases. Usually treated with radiotherapy, but the
keratinising subtype is less radiosensitive and has poorer outcomes

Question 33

Microscopic appearance of NPC

Answer 33

Non-keratinising (NK) squamous cell carcinoma is the commonest subtype of NPC;
Other subtypes include keratinising SCC and basaloid SCC

Question 34

NK-NPC is associated with what?

Answer 34

NK-NPC associated with
lymphocytes and plasma cells
positive with EBV in-situ hybridisation (EBER-ISH)