Tumours of the upper resp tract

Question 1

Epidemiology of papilloma?

Answer 1

Most common benign neoplasm of the nasal cavity & paranasal sinuses; more common in men aged 50-60 years.

Question 2

Clinical feature of papillomas

Answer 2

Nasal obstruction & epistaxis.

Question 3

Types of papilloma

Answer 3

Exophytic
Endophytic

Question 4

Grows outward from the epithelial surface, commonly on lateral walls.

Answer 4

Exophytic

Question 5

Grows inward into tissues in finger-like projections, commonly at the nasal diaphragm.

Answer 5

Endophytic

Question 6

Microscopic Features of papilloma?

Answer 6

Cylindrical epithelium with increased cellular rows.
Squamous metaplasia.
Resemblance to transitional epithelium

Question 7

What is angiofibroma and its clinical manifestation?

Answer 7

Rare vascularized lesion, common in adolescent males.
Clinical manifestation: Epistaxis.

Question 8

What are the microscopic findings of angiofibroma?

Answer 8

Numerous blood vessels in a fibrotic matrix.

Question 9

Prognosis of angiofibroma

Answer 9

Good

Question 10

What is squamous cell carcinoma of the nose and its microscopic findings?

Answer 10

Most common malignant nasal tumour.
Microscopic findings: Large eosinophilic cells, keratin production, & keratin pearl

Question 11

What causes nasopharyngeal carcinoma?

Answer 11

Caused by Epstein-Barr virus.

Question 12

Localisation of nasopharyngeal carcinoma

Answer 12

Localized in the pharyngeal fossa of Rosenmüller.

Question 13

What are the microscopic features of nasopharyngeal carcinoma?

Answer 13

Sheets of undifferentiated cells with non-neoplastic T lymphocytes.
Vesicular nuclei and prominent cytoplasm.
No keratinization.

Question 14

What is adenocarcinoma of the nose and its types?

Answer 14

5% of malignant nasal tumours.
Types: Intestinal-type adenocarcinoma (resembling colon cancer) and non-intestinal type (e.g., adenoid cystic carcinoma).

Question 15

What is olfactory neuroblastoma (aesthesioneuroblastoma)?

Answer 15

Tumour in older male patients.

Question 16

Microscopic findings of olfactory neuroblastoma

Answer 16

Small round blue cells with Flexner-Wintersteiner rosettes.

Question 17

olfactory neuroblastoma is +ve for

Answer 17

Chromogranin, ACTH, Neurofilament (NF), Neuron Specific Enolase (NSE), S-100 & Cytokeratins

Question 18

What are the immunohistochemistry findings in plasmacytoma?

Answer 18

Positive for one light chain (κ, λ), IgG, IgM, CD38, CD79A, CD138, and VS38c.

Question 18

What is plasmacytoma and its localization?

Answer 18

Localized in the upper airway tract.
Most common extra-medullary site.
Can be a manifestation of multiple myeloma or primary.

Question 19

Macroscopic features of plasmacytoma

Answer 19

Sub-mucosal localisation
Airway tract obstruction
Ulceration and haemorrhage
Diffuse cellular population
Round to ovoid cells “Cart-wheel” chromatin
Basophilic cytoplasm

Question 20

Supra & subglottic carcinomas proognosis

Answer 20

Less common and worse

Question 21

Where does glotiic carcinoma originate from & whats the prognosis?

Answer 21

Origin: true vocal cords
Most common and best prognosis

Question 22

Cause of vocal cord nodule

Answer 22

Chronic irritation

Question 23

Vocal cord nodule is ass w

Answer 23

heavy smoking

Question 24

Localisation of vocal cord nodules

Answer 24

True vocal cords

Question 25

Squamous Papilloma of the larynx is ass w

Answer 25

Association with low-risk HPV-6 and -11 benign

Question 26

Squamous Papilloma of the larynx localisation

Answer 26

Centered around true vocal cords

Question 27

Risk factors of Squamous Papilloma of the larynx

Answer 27

Airway obstruction

Question 28

Epidemiology of squamous cell carcinoma of the larynx

Answer 28

Most common malignant tumour of the larynx
- Men >40 years

Question 29

Squamous cell carcinoma of the larynx predisposing factors

Answer 29

Combination of cigarette smoking and alcoholism NO association to HPV infection

Question 30

Clinical picture of Squamous cell carcinoma of the larynx

Answer 30

Persistent hoarseness

Question 31

Squamous cell carcinoma of the oropharynx is ass w

Answer 31

High risk HPV

Question 32

Localisation of Squamous cell carcinoma of the oropharynx

Answer 32

Palatine & lingual tonsils

Question 33

Histopathology of Squamous cell carcinoma of the oropharynx

Answer 33

Non-keratinising squamous cell carcinomas with basaloid
morphology

Question 34

What is Embryonal Rhabdomyosarcoma?

Answer 34

An aggressive mesenchymal malignancy of skeletal muscle origin, & the most common soft tissue sarcoma in children & adolescents.

Question 35

Epidemiology of Embryonal Rhabdomyosarcoma

Answer 35

Most common in children and adolescents (<15 years: ~87% of cases).
Annual incidence: 6 cases per 100,000 in the US.

Question 36

What are the common sites of occurrence for Embryonal Rhabdomyosarcoma?

Answer 36

Occur in any anatomic site.
Most common in the head, neck, and genitourinary tract.

Question 37

What are the microscopic findings in Embryonal Rhabdomyosarcoma?

Answer 37

Small, round blue cell tumour with high cytologic variability.
Differentiated neoplasms: Rhabdomyoblasts with eosinophilic cytoplasm and cross striations.
Poorly differentiated cells: Elongated pleomorphic tumour cells, hyperchromatic nuclei, and variable pleomorphism.
Loose, myxoid, or collagenous stroma.
High mitotic index and prominent nucleoli.

Question 38

What are the clinical features of Embryonal Rhabdomyosarcoma?

Answer 38

Expanding mass with pain and compression symptoms.
Metastases may cause:
Bone pain.
Anaemia, thrombocytopenia, and neutropenia.
Respiratory difficulty due to lung nodules or pleural effusion.

Question 39

What is the prognosis of Embryonal Rhabdomyosarcoma for metastatic and localized disease?

Answer 39

Metastatic disease: 5-year survival rate <30%.
Localized disease: 5-year survival rate >80% with combined surgery, radiation, and chemotherapy.