Pulmonary Pathology 6

Question 1

What does chronic rhinitis/sinusitis eventually lead to?

Answer 1

a reactive in nature inflammatory sinonasal polyps

Question 2

what are inflammatory sinonasal polyps?

Answer 2

edema in stroma with eosinophilic infiltrates

Question 3

what are the consequences of sinusitis (aka obstructed sinus)?

Answer 3

empyema or mucocele

Question 4

where can ethmoid sinusitis spread?

Answer 4

orbital cellulitis or subperiosteal abscess

Question 5

where can frontal sinusitis spread?

Answer 5

meningitis, epidural abscess, subdural abscess

Question 6

what is allergic fungal sinusitis?

Answer 6

occurs as a result of hypersensitivity to fungal organism that have colonized the sinus tract

Question 7

what are the histologic features of fungal sinusitis?

Answer 7

allergic mucin and maybe fungal hyphae

Question 8

what might you get when fungal organisms accumulate?

Answer 8

a mycetoma

Question 9

which fungal sinusitis is not deadly? which one is deadly?

Answer 9

not deadly: aspergillus mycetoma

deadly: zygomycosis

Question 10

what are the histologic features of zygomycosis fungal sinusitis?

Answer 10

necrotic sinusitis with non-septate hyphae

Question 11

what does histology of GPA show?

Answer 11

classic nephrobiotic necrosis

Question 12

what are two benign tumors of the nose, sinuses, and nasopharynx?

Answer 12

nasopharyngeal angiofibroma and sinonasal papilloma

Question 13

what is a malignant tumor of the nose, sinuses, and nasopharynx?

Answer 13

olfactory neuroblastoma

Question 14

if a patient present with a nasalpharyngeal angiofibroma, what do they need to be worked up for?

Answer 14

familial adenomatous polyposis (FAP)–> they could have colon cancer

Question 15

what are sinonasal papillomas?

Answer 15

relatively common tumors of the sinonasal area, more common in men, and many are associated with HPV

Question 16

what are the three different types of of sinonasal papillomas?

Answer 16

exophytic, endophytic, and oncocytic

Question 17

which type of sinonasal papillomas could progress to malignancy?

Answer 17

endophytic

Question 18

what does an olfactory neuroblastoma arise from?

Answer 18

neuroectoderm in the superior nasal passageway (neuroendocrine tumor)

Question 19

how does an olfactory neuroblastoma appear on radiograph?

Answer 19

dumb bell shaped

Question 20

where does nasopharyngeal carcinoma arise?

Answer 20

it is a squamous carcinoma that arises in the nasopharynx, but the majority of the cases present in the neck–> metastasizes quickly

Question 21

what are the risk factors for a nasopharyngeal carcinoma?

Answer 21

hereditary, age, EBV

Question 22

where is nasopharyngeal carcinoma more common?

Answer 22

chinese/ southwest asian adults–> smoked fish with nitrosamines, EBV; young african children

Question 23

what is laryngeal squamous papilloma?

Answer 23

a benign squamous neoplasm

Question 24

what does laryngeal squamous papilloma have a strong association with?

Answer 24

HPV types 6 and 11

Question 25

how can laryngeal squamous papilloma present?

Answer 25

it can be solitary or it can be in association with recurrent respiratory papillomatosis

Question 26

what is recurrent respiratory papillomatosis?

Answer 26

when the laryngeal squamous papilloma doesn’t just stay on the vocal cord but goes further extending down into the airway

Question 27

what is recurrent respiratory papillomatosis associated with?

Answer 27

HPV 6 and 11; thought to be acquired during birth from mothers less than 20, vaginal delivery, and first born

Question 28

what is laryngeal carcinoma associated with?

Answer 28

smoking, alcohol (synergistic), HPV infection

Question 29

what 3 pathogens cause otitis media in immune competent individuals?

Answer 29

streptococcus pneumoniae, moraxella catarrhalis, and h. influenza

Question 30

what pathogen causes chronic otitis media in diabetics?

Answer 30

P. aeruginosa

Question 31

what is a cholesteatoma?

Answer 31

a mass lesion because of a cystic growth but it is reactive in nature; arises in chronic otitis media

Question 32

what are the morphological features of a cholesteatoma?

Answer 32

lined with benign squamous epithelium with trapped keratin debris

Question 33

what are 2 examples of neck cysts?

Answer 33

parenchymal cysts, thyroglossal duct cysts

Question 34

when and where do branchial cysts arise?

Answer 34

most often in young adults; SCM m

Question 35

what are thyroglossal duct cysts?

Answer 35

remnant nests of tissue from thyroid migration with cystic change

Question 36

what are carotid body tumors?

Answer 36

tumors of neural crest origin arising from autonomic paraganglia

Question 37

what might carotid body tumors be associated with?

Answer 37

MEN 2 syndrome

Question 38

how do you diagnose carotid body tumors?

Answer 38

s-100 stain highlighting nests of cells