Pulmonary Pathology 6 Flashcards
What does chronic rhinitis/sinusitis eventually lead to?
a reactive in nature inflammatory sinonasal polyps
what are inflammatory sinonasal polyps?
edema in stroma with eosinophilic infiltrates
what are the consequences of sinusitis (aka obstructed sinus)?
empyema or mucocele
where can ethmoid sinusitis spread?
orbital cellulitis or subperiosteal abscess
where can frontal sinusitis spread?
meningitis, epidural abscess, subdural abscess
what is allergic fungal sinusitis?
occurs as a result of hypersensitivity to fungal organism that have colonized the sinus tract
what are the histologic features of fungal sinusitis?
allergic mucin and maybe fungal hyphae
what might you get when fungal organisms accumulate?
a mycetoma
which fungal sinusitis is not deadly? which one is deadly?
not deadly: aspergillus mycetoma
deadly: zygomycosis
what are the histologic features of zygomycosis fungal sinusitis?
necrotic sinusitis with non-septate hyphae
what does histology of GPA show?
classic nephrobiotic necrosis
what are two benign tumors of the nose, sinuses, and nasopharynx?
nasopharyngeal angiofibroma and sinonasal papilloma
what is a malignant tumor of the nose, sinuses, and nasopharynx?
olfactory neuroblastoma
if a patient present with a nasalpharyngeal angiofibroma, what do they need to be worked up for?
familial adenomatous polyposis (FAP)–> they could have colon cancer
what are sinonasal papillomas?
relatively common tumors of the sinonasal area, more common in men, and many are associated with HPV
what are the three different types of of sinonasal papillomas?
exophytic, endophytic, and oncocytic
which type of sinonasal papillomas could progress to malignancy?
endophytic
what does an olfactory neuroblastoma arise from?
neuroectoderm in the superior nasal passageway (neuroendocrine tumor)
how does an olfactory neuroblastoma appear on radiograph?
dumb bell shaped
where does nasopharyngeal carcinoma arise?
it is a squamous carcinoma that arises in the nasopharynx, but the majority of the cases present in the neck–> metastasizes quickly
what are the risk factors for a nasopharyngeal carcinoma?
hereditary, age, EBV
where is nasopharyngeal carcinoma more common?
chinese/ southwest asian adults–> smoked fish with nitrosamines, EBV; young african children
what is laryngeal squamous papilloma?
a benign squamous neoplasm
what does laryngeal squamous papilloma have a strong association with?
HPV types 6 and 11
how can laryngeal squamous papilloma present?
it can be solitary or it can be in association with recurrent respiratory papillomatosis
what is recurrent respiratory papillomatosis?
when the laryngeal squamous papilloma doesn’t just stay on the vocal cord but goes further extending down into the airway
what is recurrent respiratory papillomatosis associated with?
HPV 6 and 11; thought to be acquired during birth from mothers less than 20, vaginal delivery, and first born
what is laryngeal carcinoma associated with?
smoking, alcohol (synergistic), HPV infection
what 3 pathogens cause otitis media in immune competent individuals?
streptococcus pneumoniae, moraxella catarrhalis, and h. influenza
what pathogen causes chronic otitis media in diabetics?
P. aeruginosa
what is a cholesteatoma?
a mass lesion because of a cystic growth but it is reactive in nature; arises in chronic otitis media
what are the morphological features of a cholesteatoma?
lined with benign squamous epithelium with trapped keratin debris
what are 2 examples of neck cysts?
parenchymal cysts, thyroglossal duct cysts
when and where do branchial cysts arise?
most often in young adults; SCM m
what are thyroglossal duct cysts?
remnant nests of tissue from thyroid migration with cystic change
what are carotid body tumors?
tumors of neural crest origin arising from autonomic paraganglia
what might carotid body tumors be associated with?
MEN 2 syndrome
how do you diagnose carotid body tumors?
s-100 stain highlighting nests of cells
