Pathology (Sections 11-15) Flashcards
Pattern of sarcomere formation associated with COVERLOAD?
Parallel
Pattern of sarcomere formation associated with VOLUME OVERLOAD?
Series
Heart Failure Cells
Hemosiderin-laden Macrophages
Nutmeg Liver
Centrilobular congestion and ischemia
Most common genetic cause of congenital heart defects
Trisomy 21
Marker of irreversibility in Congestive Heart Disease
Pulmonary Hypertension
Most common type of ASD
Secundum (90%)
Timetable for PFO Closure
Closed in 80% of individuals by 2 years
Most common Congenital Heart Disease
VSD
Most common type of VSD?
Perimembranous (90%)
Size of defect in non-restrictive VSD
> 10mm
Factors involved in PDA closure
Increased:
Oxygen Tension
Decreased:
Pulmonary Vascular Resistance
Prostaglandin E2
Components of ductus arteriosus in preterm infants that are ABSENT in term infants?
Mucoid Epithelium
Muscular Media
Most common cyanotic CHD
Tetralogy of Fallot
Primary defect in ToF
Anterosuperior displacement of infundibular septum
Mild pulmonary stenosis in ToF; clinically resembles isolated VSD
Pink ToF
Ventriculoarterial Discordance
CXR: Egg-on-the-side, Apple-on-a-stem
TGA
Absence of direct communication between RA and RV
Tricuspid Atresia
Coarctation found proximal to the PDA
Lower extremity cyanosis
RVH/Biventricular
Infantile Type
Coarctation distal to the arch vessels Upper extremity HPN Ribnotching Increased blood flow to intercostal vessels LVH
Adult Type
Vessels most commonly involved in MI
Left Anterior Descending (40-50%) Right Coronary (30-40%) Left Circumflex (15-20%)
Myocardial Infarction Progression:
Pale zone seen with triphenyltetrazolium chloride
2 to 3 hours
Myocardial Infarction Progression:
Conversion to a pale, soft, tan infarct
12 to 24 hours
Myocardial Infarction Progression:
Conversion to a fibrous scar
10 days to 2 weeks
Myocardial Infarction Progression:
Microscopically apparent coagulative necrosis
6 to 12 hours
Myocardial Infarction Progression:
Acute inflammation; neutrophilic predominance
1 to 3 days
Myocardial Infarction Progression:
Macrophagocytic predominance
3 to 7 days
Most sensitive and specific cardiac biomarkers for MI
Troponin T, Tropinin I
Biomarker used to assess possible rinfarction
CK-MB
returns to normal levels within 2 to 3 days
Pathophysiology: Dressler Syndrome
Fibrinous pericarditis in a post-MI setting
Also known as:
Postmyocardial infarct syndrome
Most common CAUSE of Sudden Cardiac Death
Coronary Artery Disease (80%)
Most common MECHANISM of Sudden Cardiac Death
Lethal Arrhythmia
Most common cause of arrhythmias
Ischemic injury
Earliest histologic change in hypertensive heart disease
Increased transverse diameter of cardiac myocytes
Most common valvular heart disease
Calcific Aortic Stenosis
Aschoff Bodies
Foci of T-Cells, Plasma Cells, and Anitschkow Cells
Pathognomonic of Rheumatic Fever
Anitschkow Cells
Enlarged macrophages found in Aschoff Bodies
Also called Caterpillar Cells
Fequency of involvement of valves in RF
Decreasing frequency:
Mitral
Aortic
Tricuspid
Pulmonic
MacCallum Plaques
Irregular subendocardial thickenings seen in regurgitant processes
Small cardiac vegetations seen along lines of closure, overlying fibrinoid necrosis
Verrucae
Deformity seen in calcification and fibrous bridging of valvular commisures
Fish Mouth / Button Hole
Major manifestations of RF
Mnemonic: J<3NES
Joints (Arthritis) Heart (Carditis) Nodules (Subcutaneous) Erythema Marginatum Sydenham Chorea
Hallmark of infective endocarditis
Vegetations
Most commonly affected valves in infective endocarditis
In general: Left-sided (Mitral, Aortic)
IV Drug Users: Right-sided (Pulmonic, Tricuspid)
Small-medium sized vegetations on BOTH sides of the valve leaflet
Libman-Sacks Endocarditis
Small, BLAND vegetations attached to the lines of closure
Nonbacterial Thrombotic Endocarditis
Previously known as Marantic Endocarditis
Flushing
Diarrhea
Dermatitis
Bronchoconstriction
Carcinoid Syndrome
Glistening white, intimal, plaque-like thickenings in endocardium
Usually affects right side of the heart
Associated with massive hepatic metastases
Carcinoid Heart Disease
Cardiomyopathy with systolic dysfunction
(EF < 40%)
Titin defect (in 20% of cases)
Dilated Cardiomyopathy
Massive, assymetric myocyte hypertrophy with myofiber disarray and interstitial fibrosis
Associated with defective Beta Myosin Heavy Chain
Diastolic dysfunction; EF may be preserved
Hypertrophc Cardiomyopathy
Cardiomyopathy secondary to excess catecholamines from psychologic stress
Tako-tsubo Cardiomyopathy
Pathophysiology: Arrhythmogenic RV Cardiomyopathy
Defective desmosomes
Severely thinned RV myocardium with fatty infiltrates and fibrosis
Pathophysiology: Naxos Syndrome
Plakoglobin Mutation
SSx of ARVC + Hyperkeratosis of plantar and palmar skin surfaces
Most common infectious cause of myocarditis
Viral (Coxsackie A and B, Enterovorus)
Atrial involvement (LA > RA) Ball-valve Obstruction Solitary, sessile/pedunculated mass mottled with hemorrhage
Most comkon primary cardiac tumor in adults
Myxoma
Ventricular involvement
Multiple gray-white masses
Spider cells
Most common primary cardiac tumor in children
Rhabdomyoma
Beck Triad
- Increased JVP
- Arterial hypotension
- Muffled Heart Sounds
Systolic retraction of the rib cage and diaphragm and pulsus paradoxus in the setting of CHRONIC pericarditis
Adhesive mediastinopericarditis
Single most important long-term limitation of cardiac transplantation
Allograft arteriopathy (Diffuse intimal proliferation of coronary arteries leading to ischemia)
Clinically significant neutropenia (< 500/mm^3)
Most common cause: Drug Toxicity
Agranulocytosis
Lymphadenitis histologically composed of:
- Light zone of Centrocytes
- Dark zone of Centroblasts
- Tingible Body Macrophages
Follicular Hyperplasia (B-Cell)
Lymphadenitis histologically composed of:
- Immunoblasts
- Hypertrophic sinusoidal and vascular endothelial cells
Parafollicular Hyperplasia (T-Cells)
Lymphadenitis histologically composed of an increased number of macrophages and cells lining lymphatic sinusoids
Sinus Histiocytosis / Reticular Hyperplasia
Congenital form of Neutropenia
Korstmann Syndrome
Most common cancer in children
Acute Lymphocytic blastic Leukemia
Most common leukemia of adults in the western world
Chonic Lymphocytic Leukemia,
Small Lymphocytic Lymphoma
Most commonly n ndolent lymphoma in adults
Follicular Lymphoma
Most common lymphoma of adults
Diffuse Large B-Cell Lymphoma
Most common form of Non-Hodgkin Lymphoma
Diffuse Large B-Cell Lymphoma
Early childhood Presents as BM Failure Hypercellular marrow with lymphoblasts Immunostain: TdT (95%) Metastases: Meninges, Testes (sanctuary site)
B-Cell Acute lymphoblastic leukemia
Adolescent males Presents as thymic masses NOTCH-1 Mutation (70%) Hypercellular marrow with lymphoblasts Immunostain: TdT (95%) Metastases: Meningeal, Testes (sanctuary site)
T-Cell Acute lymphoblastic leukemia
Poor prognostic factors in ALL
- Age less than 2 and greater than 10 years
2. WBC > 100,000
Favorable prognostic factors in ALL
- Age 2-10
- WBC < 100,000
- Hyperdiploidy
- Trisomy 4, 7, and 10
- T(12;21) mutation
60 years, M > F
Hypogammaglobulinemia
PBS: Small lymphocytes, Smudge Cells
Peripheral lymphocytosis: > 5,000/mm^3
Chronic lymphocytic leukemia
Difference between Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL)
Peripheral Blood Lymphocytosis
CLL: > 5,000 / mm^3
SLL: < 5,000 / mm^3
Pathophysiology: Richter Syndrome
Transformation of CLL into more aggressive lymphomas, usually Diffuse Large B-Cell Lymphoma
Middle Age
Painless, generalized lymphadenopathy
BCL2/t(14;18) Mutation in 90%
BMA: Paratrabecular Lymphoid Aggregates (85%)
Histologically similar to B-Cell Hyperplasia WITHOUT Tingible Body Macrophages
Incurable
Follicular Lymphoma
60 years, M > F
Rapidly enlarging nodal or extranodal mass
BCL6, BCL2 Mutation (10-20%)
Aggressive, rapidly fatal
Diffuse Large B-Cell Lymphoma
Immunostians used in DLBCL
- CD45 (lymphoid)
- CK (Epithelial)
- Vimentin (mesenchymal)
Mandibular mass Latent EBV Infection in ALL cases MYC t(8:14) Mutation "Starry Sky" Pattern Aggressive but treatable
Endemic Burkitt Lymphoma
Ileocecal or peritoneal mass Latent EBV Infection in 10-20% MYC t(8:14) Mutation "Starry Sky" Pattern Aggressive but treatable
Sporadic Burkitt Lymphoma
"Punched-out" bony lesions Pain, Hypercalcemia, Recurrent Infections Cyclin overexpression Histology: Russel Bodies, Dutcher Bodies Bence-Jones Proteinuria (Ig light-chain) M Proteins (monoclonal antibodies)
Multiple Myeloma
Indicator of poor prognosis in Multiple Myeloma
Elevated IL-6
“Solitary MM”
Most progress to multiple myeloma within 7-10 years
Solitary Plasmacytoma
Same presentation as CLL/SLL
Plasma Cell Differentiation
Hyperviscosity Syndrome
No bone manifestations
Lymphoplasmacytic Lymphoma
Waldenstrom Macroglobulnemia
Features: Hyperviscosity Syndrome
- Visual Changes
- Neurologic Deficits
- Bleeding
- Cryoglobulinemia
Painless lymphadenopathy
Naive B-Cell origin
No prolymphocytes, centroblasts
Poor prognosis
Mantle Cell Lymphoma
Seen in tissues with CHRONIC inflammation
Memory B-Cell origin
Regresses when inciting agent is removed
Marginal Zone Lymphoma
Splenomegaly B-Cell Origin Associated with atypical mycobacteria "Dry Tap" Excellent prognosis
Hairy Cell Leukemia
T-Cell Origin
Hallmark: Large anaplastc cells with horseshoe-shaped nuclei
(+) CD30, ALK
Anaplastic Large Cell Lymphoma
CD4+ T-Cell Origin
Cloverleaf Cells (multilobulated nuclei)
HTLV-1 (retrovirus) infection
Poor prognosis
Adult T-Cell Leukemia/Lymphoma
CD4+ Helper T-Cell Origin in skin
Pautrier Microabscesses
Sezary Syndrome
Mycosis Fungoides
Also known as Cutaneous T-Cell Lymphoma
Pautrier Microabscess
Infiltration of epidermis and upper dermis by Sezary Cells
Seen in Cutaneous T-Cell Lymphoma
Pathophysiology: Sezary Syndrome
Generalized exfoliative erythroderma with leukemia of Sezary Cells
T-Cells with cerebriform nuclei
Seen in Cutaneous T-Cell Lymphoma
Sezary Cells
Reed-Sternberg Cells
“Owl-eye Nuclei”
Diagnostic of Hodgkin Lymphoma
Lymphoma more often localized to single axial group of nodes
Contiguous Spread
Rare extranodal presentation
Hodgkin Lymphoma
Sexual predisposition of HL
M > F
except Nodular Sclerosis-type; M=F
Hodgkin Lymphoma most commonly associated with HIV
Lymphocyte Depleted HL
FAB M3 Mutation
Faggot Cells
Associated with DIC
Treatable: ATRA
Acute Promyelocytic Leukemia
Cells with multiple needle-like azurophilic granules (Auer Rods)
Seen in Acute Promyelocytic Leukemia
Faggot Cells
Defective hematopoietic maturation
Bone Marrow Failure
Poor prognosis
Ringed Sideroblasts (erythroid) Pseudo-Pelget-Huet Cells (granulocytic) Pawn Ball (megakaryocytic)
Myelodysplastic Syndrome
Erythroblasts with Prussian Blue (+) iron-laden mitochondria
Seen in MDS
Ringed Sideroblasts
PMN’s with only 2 lobes
Seen in MDS
Pseudo-Pelget-Huet Cells
Megakaryocytes with single, multilobulated nuclei OR multiple, separated nuclei
Seen in MDS
Pawn Ball Megakaryocyte
BCR-ABL t(9;22)
Philadelphia Chromosome
Seen in CHronic Myelogenous Leukemia
Preferential proliferation of granulocytic and magakaryocytic lines
Philadelphia Chromoosome
Hypercellular marrow with sea-blue histiocytes
Chronic Myelogenous Leukemia
Chronic Myelogenous Leukemia
10-19% Myeloblasts
Increasing splenomegaly
Accelerated Phase
Chronic Myelogenous Leukemia
>20% Myeloblasts
Large cluster of blasts in BMA
Chloroma (focus of leukemia outside BM)
Blast Crisis
Plethoric
Erythromelalgia
JAK2 Mutation in most cases
Increase in all cell lines, esp. erythroid
Polycythemia Vera
Increase in megakaryocyte cell line
Erythromelalgia
Giant platelets in peripheral blood
JAK2 Mutation in HALF of cases
Essential Thrombocytosis
Extensive, non-neoplastic deposition of collagen in BM Hepatosplenomegaly Decreased Erythroid line Leukoerythroblastosis Dacryocytes
Primary Myelofibrosis
Tear-drop Cell
Abnormally-shaped poikilocyte
Seen in Myelofibrosis
Dacryocyte
Proliferative disorder of Dendritic Cells
Birbeck Granules
Langerhans Cell Histiocytosis
Racket-shaped cytoplasmic organelles found exclusively in Langerhans Cells
Contain Langerin Proteins
Birbeck Granules
Most common Thymic Malignancy
SCCA
Intrinsic type of hemolysis with INTRAVASCULAR hemolysis
Paroxysmal Nocturnal Hemoglobinuria
(Intrinsic)
G6PD
(Mixed)
Autosomal Dominant
Spherical cells without central pallor
Elevated MCHC
Diagnostic: Osmotic Fragility Test
Hereditary Spherocytosis
X-Linked Recessive Reduced NAPH for glutathione reduction Heinz Bodies in asplenic patients Bite Cells Protective against Malaria
Diagnostic: NBS
Glucose-6-phosphate Dehydrogenase Deficiency
Autosomal Recessive
Mutation in 6th codon of Beta-Globulin gene (Glu to Val)
Target Cells (Codocytes)
Howell-Jolly Bodies (in asplenic patients)
Protective against Malaria
Diagnostic: Hemoglobin Electrophoresis
Sickle Ccell Anemia
Heinz Body
Intracellular inclusion in RBCs composed of denatured hemoglobin
Seen in G6PD Deficiency
Howell-Jolly Bodies
Basophilic nuclear remnants in RBCs
Seen in Sickle Cell Anemia
Major hemoglobins of Beta-Thalassemia
Major:
HbF (a2y2)
Minor:
HbA2 (a2d2)
Major hemoglobins of Alpha-Thalassemia
Newborns:
Barts (y4)
Older:
HbH (b4)
PIGA Mutation Decreased DAF (CD55), CD59, C8 Binding Protein MAC-mediated intravascular hemolysis Mechanism enhanced by acidic nocturnal blood pH
Diagnostic: Flow Cytometry
Paroxysmal Nocturnal Hemoglobinuria
Hemolysis characterized by partial phagocytosis and conversion of RBCs to spherocytes
Warm Hemolysis
Cold Hemolysis
Hemolysis characterized by opsonization via C3b
Common function of Folic Acid and Cobalamin
Conversion of homocysteine to methionine during tetrahydrofolate regeneration
MoA: decreased transferrin in Anemia of Chronic Disease
IL-6 upregulates Hepcidin;
Hepcidin promotes intracellular storage of Iron, and inhibits its GIT absorption
Infectious etiology of Pure Red Cell Aplasia
Parvovirus B19
Pathophysiology: Myelophthisic Anemia
Anemia from ANY space-occupying lesion that replaces normal marrow elements
Autoantibodies involved in ITP
Antibodies (IgG) against Gp IIb/IIIa and Gp Ib-IX (80%)
Pathophysiology: Heparin-induced Thrombocytopenia
Type I:
Direct aggregating effect of Heparin
Type II:
Platelet activation and aggregation initiated by antibodies directed against Heparin-Platelet Factor 4 Complex
Most common hematologic manifestation of HIV
HIV-associated Thrombocytopenia
Microangiopathic hemolytic anemia Thrombocytopenia Renal Failure Fever Neurologic Manifestations
Decreased ADAMTS13 (metalloproteinase that degrades vWF)
Thrombotic thrombocytopenic Purpura
Microangiopathic hemolytic anemia
Thrombocytopenia
Renal Failure
Normal ADAMTS13
Associated with EHEC infections (Typical variant)
Hemolytic-Uremic Syndrome
True or False?
Glanzmann Thrombasthenia presents with Thrombocytopenia
True
Most common inherited bleeding disorder
vWF Disease
Autosomal Dominant
Types of vWF Disease
Type 1: Mild, Quantitative
Type 2: Qualitative
Type 3: Severe, Quantitative
Most common hereditary syndrome associated with life-threatening bleeding
Hemophilia
X-linked Recessive
X-linked Recessive
Factor VIII Deficiency
Diagnostic: Factor Assay
Hemophilia A
X-linked Recessive
Factor IX Deficiency
Diagnostic: Factor Assay
Hemophilia B
Christmas Disease
Hemophilia Severity
Mild: 6-50%
Moderate: 2-5%
Severe: < or = 1%
Pathophysiology: Transfusion-related Acute Lung Injury (TRALI)
Activation of PMNs in the lung vasculature
Bilateral adrenal hemorrhage secondary to fibrin thrombi
Waterhouse-Friedrichsen Syndrome
- Large vascular tumors
- Thrombocytopenia
- Consumptive Coagulopathy
Kasabach-Merritt Syndrome
Histologic manifstation of ARDS
Diffuse alveolar damage
Type of emphysma involving the respiratory bronchioles and the alveoli.
Deficiency in anti-proteases dictate pathogenessis
Panacinar
versus Centriacinar
Curschmann Spirals
Whorls of shed epithelium
Seen in Status Asthmaticus
Charcot-Leyden Crystals
Eosinophilic crystals seen in Status Asthmaticus
Pathophysiology: Kartagener Syndrome
Prmary ciliary dyskinesia
Earliest lesion in interstitial pneumonia
Fibroblast Focus
Late lesion in Interstitial Pneumonia
Honeycomb Fibrosis
Nonneoplastic lung reaction to inhaled organic/inorganic dust, usually in the workplace
Pneumoconioses
Coal macules (macrophages) within a collagen fiber network
Coal Nodules
Most commonly implicated: Quartz
Increased susceptibility to TB
CXR: Eggshell Calcifications
Silicosis
Carcinogenic mechanism of Asbestos
- Amphibole geometric form
- Free radical generation
- Surface for adhesion of other carcinogenic substances
Most common malignancy associated with Asbestos
Lung carcinoma
Mean PA pressure at rest
> 25mm Hg
Most common cause of CAP
Streptococcus pneumoniae
Most common bacterial cause of acute COPD exacerbation
Hemophilus influenzae
Second most common bacterial cause of acute COPD exacerbations
Moraxella catarrhalis
Organism associated with: Post-viral pneumonia Pneumonia in IV drug users HCAP Lung Abscesses Empyema
Staphylococcus aureus
Most common cause of gram negative bacterial pneumonia
Klebsiella pneumoniae
Pontiac Fever
Legionnaire’s Disease
Legionella pneumophila
Major cause of pandemic and epidemic viral pneumonia
Influenza A Virus
Orthomyxovirus
Cardinal histologic change in Lung Abscesses
Suppurative destruction of parenchyma within the cavitation
Most common lung carcinoma
Peripherally located
Female, Non-smokers
No paraneoplastic syndromes
Adenocarcinoma
Second most common lung carcinoma
Centrally located
Males, Smokers
Paraneoplastic: Hypercalcemia
Squamous Cell
Third most common lung carcinoma Either central or peripheral Strongest association with smokers Paraneoplastic: SIADH, Cushing No precursor lesions
Small Cell
Azzopardi Effect
Basophilic staining of vascular walls, indicating adherent DNA from necrotic cells
Pathophysiology:
Lambert Eaton Myesthenic Syndrome
Paraneoplastic syndrome characterized by the presence of autoantibodies against presynaptic calcium channels in the NMJ
Paraneoplastic syndrome associated with Pancoast tumors
Horner Syndrome
Low-grade malignant epithelial neoplasm
Neuroendocrine origin
Intraluminal polypoid mass in mainstem bronchi
“Collar Button” Lesion
Carcinoids
Volume of pleural fluid
15 L
Light Criteria
- Pleural fluid to serum protein ratio > 0.5
- Pleural fluid to serum LDH ratio > 0.6
- Pleural fluid greater than 2/3 the normal upper limit in serum
If suspecting transudative fluid, difference between serum and pleural fluid protein >31 g/dL
Pneumothorax sufficient to cause compression of the mediastinal structures
Tension
Pulmonary tumor
Dense fibrous tissue with occasional cysts
Whorls of reticulin and collagen with spindle cells
CD34 (+)
Keratin (-)
Solitary Fibrous Tumor
Pulmonary Tumor
Thick, soft, gelatinous, pink tumor
Histology: Epithelioid (60%), Sarcomatoid, Mixed
Strong association with Asbestos
Malignant Mesothelioma
Main cause of tooth loss before age 35
Dental carries
Calcified dental plaque
Calculus
Inflammation of periodontal ligaments, alveolar bone, and cementum
Periodontitis
Common pathogens for Periodontitis
Actinobacillus
Porphyromonas
Prevotella
Painful, shallow oral ulcers
Most common during first 2 decades of life
Associated with Behcet Disease
Regresses in 7-10 days
Aphthuous Ulcer
High risk of recurrence is an indication for complete excision to the level of the periosteum
Pyogenic Granuloma
HSV 1 Infection
Gingival involvement
Painful ulcerations with serous vesicles/bullae
Intracellular and intercellular edema (Acantholysis)
Diagnostic: Tzanck Smear
Acute Herpetic Gingivostomatitis
HSV 2 Infection
Reactivation of latent infection
Site of primary inoculation and areas sharing same innervation
Painful ulcerations with serous vesicles/bullae
Intracellular and intercellular edema (Acantholysis)
Diagnostic: Tzanck Smear
Recurrent Herpetic Stomatitis
Most common oral fungal infection
Candidiasis
Histologic manifstation of ARDS
Diffuse alveolar damage
Type of emphysma involving the respiratory bronchioles and the alveoli.
Deficiency in anti-proteases dictate pathogenessis
Panacinar
versus Centriacinar
Curschmann Spirals
Whorls of shed epithelium
Seen in Status Asthmaticus
Charcot-Leyden Crystals
Eosinophilic crystals seen in Status Asthmaticus
Pathophysiology: Kartagener Syndrome
Prmary ciliary dyskinesia
Earliest lesion in interstitial pneumonia
Fibroblast Focus
Late lesion in Interstitial Pneumonia
Honeycomb Fibrosis
Nonneoplastic lung reaction to inhaled organic/inorganic dust, usually in the workplace
Pneumoconioses
Coal macules (macrophages) within a collagen fiber network
Coal Nodules
Most commonly implicated: Quartz
Increased susceptibility to TB
CXR: Eggshell Calcifications
Silicosis
Carcinogenic mechanism of Asbestos
- Amphibole geometric form
- Free radical generation
- Surface for adhesion of other carcinogenic substances
Most common malignancy associated with Asbestos
Lung carcinoma
Mean PA pressure at rest
> 25mm Hg
Seen in EBV Infections
White, confluent, hyperkeratotic plaques that cannot be scraped off
Hairy Leukoplakia
Comprise 95% of head and neck cancers
Tumors associated with smoking and alcoholism (Classical) have worse prognoses than thos associated with HPv 16
Squamous Cell CA
True cyst
Usually solitary
Associated with impacted third molar
Recurrence in incomplete resection
Dentigirous Cyst
True Cyst Keratinized Solitary (80%), posterior mandible Locally aggressive; recurs with incomplete excision Associated with Gorlin Syndrome
Kertatocystic Odontogenic Tumor
Odontogenic Keratocyst
Pathophysiology: Gorlin Syndrome
Inherited multisystemic disorder characterized by an increased risk of developing non-melanoma skin cancer
Most common epithelial odontogenic tumor
Ameloblastoma
Pathophysiology: Schneiderian Papilloma
Histologically benign, biologically aggressive nasopharyngeal tumor.
Associated with HPV 6 and HPV 11
Most radiosensitive type of nasopharyngeal carcinoma
Undifferentiated
Single or multiple laryngeal nodules
Squamous cortex with loose myxoid core
Associated with smoking and voice straining
No risk of malignancy
Reactive Nodules
Elderly males (60’s)
Persistent hoarseness, dysphagia, dysphonia
Hyperplasia-dysplasia-carcinoma sequence
Most common type: Squamous Cell
Laryngeal Carcinoma
Most common causes of acute bacterial otitis media
- Streptococcus pneumoniae
- Haemophilus influenzae, non-typable
- Moraxella catarrhalis
Common site of Otosclerosis
Rim of the Oval Window
Remnant of the second branchial arch
Presents as lateral neck mass along SCM
True cysts
Branchial Cleft Cyst
Also known as
Cervical Lymphoepithelial Cyst
Remnant of embryonic thyroid descent
True cyst
Presents as midline neck mass
Most common congenital anomaly of the Thyroid
Thyroglossal Duct Cyst
Types of Paragangliomas by location
Paravertebral (Sympathetic)
Aorticopulmonary Chain (Parasympathetic)
Histologic features of Paragangliomas
Zellballen with delicate vascular septae
Salt-and-pepper Chromatin
No Atypia
Most common cause of Xerostomia
Drugs
Most common type of salivary gland lesion
Mucocoele
True cysts associated with sublingual duct damage
Ranula
Most common form of viral sialadenitis
Mumps
Most commonly affected gland in sialolithiasis
Submandibular
Most common site of salivary gland tumors
Parotid Gland
Most common salivary gland tumor
Pleiomorphic Adenoma
Most common primary malignant salivary gland tumor
Mucoepidermoid Carcinoma
Second most common bengn tumor of the salivary glands
Almost exclusively involves Parotids
Associated with smoking
Warthin Tumor
Also known as:
Papillary Cystadenoma Lymphomatosum
Seen in EBV Infections
White, confluent, hyperkeratotic plaques that cannot be scraped off
Hairy Leukoplakia
Comprise 95% of head and neck cancers
Tumors associated with smoking and alcoholism (Classical) have worse prognoses than those associated with HPV 16
Squamous Cell CA
True cyst
Usually solitary
Associated with impacted third molar
Recurrence in incomplete resection
Dentigirous Cyst
True Cyst Keratinized Solitary (80%), posterior mandible Locally aggressive; recurs with incomplete excision Associated with Gorlin Syndrome
Kertatocystic Odontogenic Tumor
Odontogenic Keratocyst
Pathophysiology: Gorlin Syndrome
Inherited multisystemic disorder characterized by an increased risk of developing non-melanoma skin cancer
Most common epithelial odontogenic tumor
Ameloblastoma
Pathophysiology: Schneiderian Papilloma
Histologically benign, biologically aggressive nasopharyngeal tumor.
Associated with HPV 6 and HPV 11
Most radiosensitive type of nasopharyngeal carcinoma
Undifferentiated
Single or multiple laryngeal nodules
Squamous cortex with loose myxoid core
Associated with smoking and voice straining
No risk of malignancy
Reactive Nodules
Elderly males (60’s)
Persistent hoarseness, dysphagia, dysphonia
Hyperplasia-dysplasia-carcinoma sequence
Most common type: Squamous Cell
Laryngeal Carcinoma
Most common causes of acute bacterial otitis media
- Streptococcus pneumoniae
- Haemophilus influenzae, non-typable
- Moraxella catarrhalis
Common site of Otosclerosis
Rim of the Oval Window
Remnant of the second branchial arch
Presents as lateral neck mass along SCM
True cysts
Branchial Cleft Cyst
Also known as
Cervical Lymphoepithelial Cyst
Remnant of embryonic thyroid descent
True cyst
Presents as midline neck mass
Most common congenital anomaly of the Thyroid
Thyroglossal Duct Cyst
Types of Paragangliomas by location
Paravertebral (Sympathetic)
Aorticopulmonary Chain (Parasympathetic)
Histologic features of Paragangliomas
Zellballen with delicate vascular septae
Salt-and-pepper Chromatin
No Atypia
Most common cause of Xerostomia
Drugs
Most common type of salivary gland lesion
Mucocoele
True cysts associated with sublingual duct damage
Ranula
Most common form of viral sialadenitis
Mumps
Most commonly affected gland in sialolithiasis
Submandibular
Most common site of salivary gland tumors
Parotid Gland
Most common salivary gland tumor
Pleiomorphic Adenoma
Most common primary malignant salivary gland tumor
Mucoepidermoid Carcinoma
Second most common bengn tumor of the salivary glands
Almost exclusively involves Parotids
Associated with smoking
Warthin Tumor
Also known as:
Papillary Cystadenoma Lymphomatosum