Difference between revisions of "An introduction to head and neck pathology"

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An introduction to head and neck pathology (view source)

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→‎Pyogenic granuloma
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==Pyogenic granuloma==
==Pyogenic granuloma==
*[[AKA]] ''lobular capillary hemangioma''.<ref name=pmid21839350>{{Cite journal  | last1 = Baglin | first1 = AC. | title = [Vascular tumors and pseudotumors. Pyogenic granuloma (lobular capillary hemangioma)]. | journal = Ann Pathol | volume = 31 | issue = 4 | pages = 266-70 | month = Aug | year = 2011 | doi = 10.1016/j.annpat.2011.05.014 | PMID = 21839350 }}</ref>
*[[AKA]] ''lobular capillary hemangioma''.<ref name=pmid21839350>{{Cite journal  | last1 = Baglin | first1 = AC. | title = [Vascular tumors and pseudotumors. Pyogenic granuloma (lobular capillary hemangioma)]. | journal = Ann Pathol | volume = 31 | issue = 4 | pages = 266-70 | month = Aug | year = 2011 | doi = 10.1016/j.annpat.2011.05.014 | PMID = 21839350 }}</ref>
===General===
{{Main|Lobular capillary hemangioma}}
*Sometimes ''pregnancy tumour''.
*Seen in children, young adults, pregnant women.
 
Clinical:
*May grow quickly - clinically suspicious for a malignancy.
 
Notes:
*[[no truth in names|Name of entity is a misnomer]]:
**Not pyogenic, i.e. infectious.
**Not [[granuloma|granulomatous]].
*The WMSP advocates the name ''lobular capillary hemangioma''.<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
 
===Gross===
Features:<ref name=Ref_PBoD776>{{Ref PBoD|776}}</ref>
*Erythematous.
*Hemorrhagic.
 
Usually location:<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
*Lips.
*[[Tongue]].
*Gingiva.
 
===Microscopic===
Features:<ref name=Ref_PBoD775>{{Ref PBoD|775}}</ref>
*Polypoid ''or'' peduculated.
*Vascular, i.e. many blood vessels, with plump endothelium.
*Usu. thinned epithelium<ref>URL: [http://basicpathology-histopathology.blogspot.com/2009/10/head-and-neck-oral-cavity-reactive_3282.html http://basicpathology-histopathology.blogspot.com/2009/10/head-and-neck-oral-cavity-reactive_3282.html]. Accessed on: 2 February 2011.</ref> or ulcerated.<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
*Lobular arrangement of vascular (seen at low power).<ref>S. Sade. 8 September 2011.</ref>
 
DDx:
*[[Capillary hemangioma]].
*[[Myopericytoma]] (???).
*[[Bacillary angiomatosis]].<ref name=pmid16310070>{{Cite journal  | last1 = Levy | first1 = I. | last2 = Rolain | first2 = JM. | last3 = Lepidi | first3 = H. | last4 = Raoult | first4 = D. | last5 = Feinmesser | first5 = M. | last6 = Lapidoth | first6 = M. | last7 = Ben-Amitai | first7 = D. | title = Is pyogenic granuloma associated with Bartonella infection? | journal = J Am Acad Dermatol | volume = 53 | issue = 6 | pages = 1065-6 | month = Dec | year = 2005 | doi = 10.1016/j.jaad.2005.08.046 | PMID = 16310070 }}</ref>
 
Why it is not...
*[[Glomus tumour]] - cookie cutter arrangement of cells.
 
====Image====
<gallery>
Image:SkinTumors-PB061062.JPG | Pyogenic granuloma. (WC)
</gallery>
www:
*[http://www.sciencephoto.com/images/download_lo_res.html?id=670066054 Pyogenic granuloma (sciencephoto.com)].
 
===IHC===
Features - positive for vascular markers:<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
*CD34 +ve.
*CD31 +ve.
*Factor VIII +ve.
 
===Sign out===
<pre>
TONGUE, LEFT LATERAL, BIOPSY:
- LOBULAR CAPILLARY HEMANGIOMA (PYOGENIC GRANULOMA).</pre>
 
====Micro====
The sections shows a pendunculated vascular lesion with small capillaries arranged in a lobular fashion. The endothelial cells of the lesion show no atypia.  The overlying acanthotic epidermis has hyperkeratosis and hypergranulosis, and is focally ulcerated and impetiginized. There is no significant keratocyte atypia. No melanocytic nests are seen. The dermis has a mild perivascular lymphoplasmacytic infiltrate. The lesion is excised in the plane of section.


==Plummer-Vinson syndrome==
==Plummer-Vinson syndrome==
Michael
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