Singh Respiratory Pathology #6 Flashcards
What epithelium lines Nose, nasopharynx, and paranasal sinuses?
Respiratory type epithelium
How does allergic fungal sinusitis occur?
- Result of hypersensitivity to fungal organisms such as Aspergillus that have colonized the sinus tract
- allergic mucin is seen
- May get a mycetoma (fungal ball)
Acute invasive sinusitis, who does it occur in, histo findings, and treatment?
- Occurs in diabetic or immunocompromised patients
- ID necrotic sinusitis with non septate hyphae
- Due to zygomycosis
- Emergent situation requiring IV antifungal tx
GPA? affects who, where, and histo?
- Typically middle aged adults
- affects nasal passages and sinuses with ulcerations necrosis and perforation of septum
- can also affect lung and kidney
- granulomatous inflammation
- classic necrobiotic necrosis
Nasopharyngeal angiofibroma?
- Occurs in young men
- Vascular fibrous core lined by benign epithelium
- Benign but may bleed
- Assoc. with FAP
Sinonasal (Schneiderian) papilloma types and epidemimology?
- Middle aged men
- HPV association
- 3 types
- exophytic
- endophytic
- oncocytic
Olfactory neuroblastoma? describe histo, characteristic finding, age
- Small round blue cell tumor
- arises from neuroectoderm in superior nasal passage
- peaks in adolescence and middle age
- Dumbell shaped tumor
Nasopharyngeal carcinoma? (what is it where does it present)
- Basically Squamous carcinoma
- Arises in the nasopharynx but presents in the neck as the lymph node metastasis is larger than primary tumor
Risks for Nasopharyngeal carcinoma?
- Hereditary
- Age
- EBV
- ingestion of smoked fish (chinese/SE asian adults)
- young african children (EBV related)
Vocal cord nodules?
- Edematous inflammation of soft tissue on vocal fold
- grossly soft and translucent
- Histologically see edema and loose stroma under benign squamous epithelium
What is Laryngeal squamous papilloma? What is it associated with?
- Benign squamous neoplasm with papillary appearance
- Associated with HPV 6 and 11
- Grossly friable papillary mass
- can be solitary or in association with recurrent respiratory papillomatosis
What is recurrent respiratory papillomatosis? Who/how do you get it? Association?
- Starts at larynx but spreads down to airways and can diffusely involve the lungs
- associated with HPV 6 and 11 acquired during childbirth
- mothers <20
- vaginal delivery
- first born
- kids and adolescents get it
Rare complication of RRP?
malignancy <1%
What type of carcinoma is Laryngeal carcinoma?
Squamous carcinoma
Who is laryngeal carcinoma seen in and what are the risks?
- Men >60
- Smoking
- Alcohol
- HPV infection
Otitis media bacteria causes?
- S. pneumonia
- M. catarrhalis
- H. influenza
In diabetics what causes chronic otitis media?
P. aeruginosa
What is a cholesteatoma? What lines it and what is the complication?
- Cystic lesion that arises in chronic otitis media
- Lined by benign squamous epithelium with trapped keratin debris
- Reactive process but can enlarge and erode bone
Otosclerosis?
- bony deposition usually at stapedial foot plate
- conductive hearing loss is primary complication
- appears familial with AD pattern
Who do branchial cysts occur in, where does it arise from, what lines it?
- unilateral occur in young adults and arises from the second branchial arch
- Histologically its lined by stratified squamous or respiratory epithelium with fibrous tissue surrounding it
- +/- lymphoid tissue
- keratin
What needs to be considered in an adult >40 with a cystic neck mass?
- Metastatic carcinoma
What is a thyroglossal duct cyst?
Remnant nest of tissue from thyroid migration with cystic change
Where do carotid body tumors arise from?
- tumor of neural crest origin arising from autonomic paraganglia
- May be sporadic
- May be associated with MEN 2
What is the prognosis of carotid body tumor, and what is seen in histoloogy?
- 15%-40% will be malignant and you CAN’T tell with histology
- See nests of cells called Zellballen on histo with S-100 stain highlighting sustentacular cells
