Throat pathology

Question 1

What are laryngeal polyps?

Answer 1

present in <1% of the population

reactive change in the laryngeal mucosa secondary to vocal abuse, infection and smoking

Question 2

When are laryngeal nodules seen?

Answer 2

seen in women

bilateral on the middle 1/3rd-> posterior 1/3rd of vocal cords

Question 3

How are laryngeal polyps seen?

Answer 3

unilateral and pedunculated

Question 4

What is a contact ulcer?

Answer 4

benign response to injury on the posterior vocal cords

Question 5

What can cause injury to the posterior vocal cords?

Answer 5

intubation
GORD
voice abuse
chronic throat clearing

Question 6

What are the 3 types of throat/laryngeal cancers?

Answer 6

Squamous cell carcinoma
Paraganglioma
Squamous Papilloma

Question 7

When do squamous papillomas occur?

Answer 7

<5years

between 20-40 years

Question 8

What are squamous papillomas related to?

Answer 8

HPV exposure type 6 and 11

Question 9

Do squamous papillomas become recurrent?

Answer 9

in children yes

Question 10

What is a paraganglioma?

Answer 10

clusters of neuroendocrine cells dispered throughout the body

Question 11

What are the two types of paraganglioma?

Answer 11

Chromaffin positive

Non chromaffin

Question 12

Describe a chromaffin postive paraganglioma?

Answer 12

sympathetic nervous system can secrete catecholamines

usually the adrenal medulla or paravertebral

Question 13

Describe a non chromaffin paraganglioma?

Answer 13

found in carotid bodies, aortic bodies, jugulotumpanic ganglia, ganglia nodosum of vagus and clusters around the oral cavity, nose, oropharynx, larynx and orbit

Question 14

At what age do paragangliomas normally occur?

Answer 14

> 50 years

Question 15

What genetic disorder can paragangliomas be part of?

Answer 15

MEN 2 - autosomal dominant

Question 16

Describe squamous cell carcinomas?

Answer 16

common in head and neck

Question 17

What are the risk factors for squamous cell carcinomas?

Answer 17

smoking
alcohol
HPV type 16

Question 18

What is the role of HPV type 16?

Answer 18

reduces proteins E6&E7 which distrupts p53 and RB pathways leading to cellular immortality

Question 19

How are layngeal tumours staged?

Answer 19

T1a - one vocal cord
T1b - two vocal cords
T2 - extension to supra/subglottis
T3 - vocal cord, fixation or extension into paraglottic space, minor thyroid cartilage involvement
T4a - thyroid cartilage, trachea, muscles of the tongue, strap muscles, thyroid, oesophagus
T4b - prevertebral space, mediastinal structures, caroitid artery