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An introduction to head and neck pathology (view source)
Revision as of 05:18, 14 November 2010
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Cytopathology of the head and neck is dealt with in a separate article called ''[[head and neck cytopathology]]''. | Cytopathology of the head and neck is dealt with in a separate article called ''[[head and neck cytopathology]]''. | ||
==Oral lesions== | ==Clinical== | ||
===Oral lesions=== | |||
DDx:<ref name=Ref_PBoD780>{{Ref PBoD|780}}</ref> | |||
*Leukoplakia. | *Leukoplakia. | ||
**Unidentified white lesion. | **Unidentified white lesion. | ||
| Line 12: | Line 13: | ||
**Unidentified red lesion. | **Unidentified red lesion. | ||
**Often erosion. | **Often erosion. | ||
=Benign= | |||
==Rathke cleft cyst== | |||
===Microscopic=== | |||
Features: | |||
*Lined by cuboidal or columnar epithelial +occasional goblet cells.<ref>URL: [http://www.endotext.org/neuroendo/neuroendo3/neuroendo3.html http://www.endotext.org/neuroendo/neuroendo3/neuroendo3.html]. Accessed on: 27 May 2010.</ref> | |||
*+/-Squamous metaplasia. | |||
Image: [http://www.endotext.org/neuroendo/neuroendo3/figures/figure11.jpg Rathke's cleft cyst (endotext.org)]. | |||
==Pemphigus vulgaris== | |||
*See the ''[[bullous disease]]'' article. | |||
===General=== | |||
*[[AKA]] ''pemphigus''. | |||
**Should not be confused with ''bullous pemphigoid'' (which is less serious). | |||
*May lead to blindness. | |||
*Oral lesion is classically: ''first to show & last to go''. | |||
**Oral lesions usually precede the skin lesions. | |||
===Etiology=== | |||
*Autoimmune disease | |||
*Antibodies: desmoglein 1, desmoglein 3. | |||
==Pyogenic granuloma== | ==Pyogenic granuloma== | ||
| Line 54: | Line 78: | ||
==Oral candidiasis== | ==Oral candidiasis== | ||
*Fungus. | *Fungus. | ||
*May be associated with immunodeficiency, e.g. AIDS, organ transplant/immunosuppression. | *May be associated with immunodeficiency, e.g. [[AIDS]], organ transplant/immunosuppression. | ||
Forms:<ref name=Ref_PBoD777>{{Ref PBoD|777}}</ref> | Forms:<ref name=Ref_PBoD777>{{Ref PBoD|777}}</ref> | ||
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*Hyperplastic. | *Hyperplastic. | ||
== | =Neoplasms= | ||
==Odontogenic tumours and cysts== | |||
* | {{main|Odontogenic tumours and cysts}} | ||
This is a rather large topic and dealt with in a separate article. | |||
It includes: | |||
*Keratocystic odontogenic tumour. | |||
*Radicular cyst. | |||
*Dentigerous cyst. | |||
*Ameloblastoma. | |||
*Adenomatoid odontogenic tumour. | |||
*Ameloblastic fibroma. | |||
*Odontogenic myxoma. | |||
==Pharyngeal carcinoma/nasopharyngeal carcinoma== | ==Pharyngeal carcinoma/nasopharyngeal carcinoma== | ||
| Line 138: | Line 173: | ||
*Lymphoepithelial, rare. | *Lymphoepithelial, rare. | ||
*Spindle cell, a common spindle cell lesion of the H&N. | *Spindle cell, a common spindle cell lesion of the H&N. | ||
===Verrucous squamous cell carcinoma=== | ===Verrucous squamous cell carcinoma=== | ||
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==Olfactory neuroblastoma== | ==Olfactory neuroblastoma== | ||
*AKA ''esthesioneuroblastoma''. | ===General=== | ||
*[[AKA]] ''esthesioneuroblastoma''. | |||
*Prognosis: poor. (???) | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
*Small round (blue) cell tumour. | *Small round (blue) cell tumour. | ||
==Craniopharyngioma== | ==Craniopharyngioma== | ||
| Line 225: | Line 253: | ||
Image: [http://www.lmp.ualberta.ca/resources/pathoimages/Images-C/000p039r.jpg Craniopharyngioma - micrograph (lmp.ualbera.ca)]. | Image: [http://www.lmp.ualberta.ca/resources/pathoimages/Images-C/000p039r.jpg Craniopharyngioma - micrograph (lmp.ualbera.ca)]. | ||
== | ==Nasopharyngeal angiofibroma== | ||
===General=== | |||
*[[AKA]] ''juvenile nasopharyngeal angiofibroma''. | |||
*Classical adolescent males with recurrent nose bleeds. | |||
===Microscopic=== | |||
Features:<ref name=Ref_Klatt144>{{Ref Klatt|144}}</ref> | |||
*Fibroblastic cells with plump (near cuboidal) nuclei. | |||
*Fibrous stroma. | |||
*Abundant capillaries. | |||
Image: [http://en.wikipedia.org/wiki/File:Angiofibroma.jpg Angiofibroma (WP)]. | |||
=Polyps= | |||
==Nasal polyps== | ==Nasal polyps== | ||
DDx (benign - multiple):<ref name=emedicine994274>[http://emedicine.medscape.com/article/994274-overview http://emedicine.medscape.com/article/994274-overview]</ref> | DDx (benign - multiple):<ref name=emedicine994274>[http://emedicine.medscape.com/article/994274-overview http://emedicine.medscape.com/article/994274-overview]</ref> | ||
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*Recurrent polyps: Functional endoscopic sinus surgery (FESS). | *Recurrent polyps: Functional endoscopic sinus surgery (FESS). | ||
== | ==Tonsillar lymphangiomatous polyp== | ||
Features:<ref>http://www.nature.com/modpathol/journal/v13/n10/full/3880208a.html</ref> | |||
*Polyp with lymph channels. | |||
Features:< | |||
* | |||
=See also= | |||
*[[Salivary gland]]. | *[[Salivary gland]]. | ||
*[[Thyroid gland]]. | *[[Thyroid gland]]. | ||
*[[Breast]]. | *[[Breast]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
=External links= | |||
*[http://education.vetmed.vt.edu/curriculum/vm8054/labs/Lab17/Lab17.htm Oral cavity histology (vetmed.vt.edu)]. | *[http://education.vetmed.vt.edu/curriculum/vm8054/labs/Lab17/Lab17.htm Oral cavity histology (vetmed.vt.edu)]. | ||
*[http://www.endotext.org/neuroendo/neuroendo3/neuroendo3.html Endocrine pathology - pituitary (endotext.org)]. | *[http://www.endotext.org/neuroendo/neuroendo3/neuroendo3.html Endocrine pathology - pituitary (endotext.org)]. | ||
[[Category:Head and neck pathology]] | [[Category:Head and neck pathology]] | ||