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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→‎Squamous papilloma
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==Squamous papilloma==
==Squamous papilloma==
:''Laryngeal papilloma'' redirects here.
:Caruncle lesion is dealt with in ''[[papilloma of the caruncle]]''.
:Caruncle lesion is dealt with in ''[[papilloma of the caruncle]]''.
:The lesion in the [[esophagus]] is dealt with in ''[[squamous papilloma of the esophagus]]''.
:The lesion in the [[esophagus]] is dealt with in ''[[squamous papilloma of the esophagus]]''.
===General===
{{Main|Squamous papilloma}}
*Benign.
*Typically related to [[HPV]] 6 and HPV 11.
 
===Gross===
Features:<ref name=Ref_HaNP33>{{Ref HaNP|33}}</ref>
*Exophytic mass.
 
===Microscopic===
Features:<ref name=Ref_HaNP33>{{Ref HaNP|33}}</ref>
*Branching papillae.
**Papilla = nipple-like projection with a fibrovascular core.
*Basal cell hyperplasia.
*Koilocytes.
 
Note:
*The threshold for dysplasia is somewhat higher in the [[head and neck pathology|head and neck]] than in the [[uterine cervix]].
 
DDx:
*[[Squamous cell carcinoma of the head and neck]] - verrucous, papillary and exophytic subtypes.
*[[Verruca vulgaris]] - have granular layer, hyperkeratosis and parakeratosis.<ref name=Ref_HaNP246>{{Ref HaNP|426}}</ref>
*[[Oral condyloma]] - broader projections with a blunted appearance.<ref name=Ref_HaNP246>{{Ref HaNP|426}}</ref>
 
Images:
*[http://www.webpathology.com/image.asp?case=170&n=1 Laryngeal papilloma - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=170&n=2 Laryngeal papilloma - high mag. (webpathology.com)].
*[http://ars.els-cdn.com/content/image/1-s2.0-S1875918111001450-gr2a.jpg Low-grade squamous dysplasia (els-cdn.com)].<ref name=pmid10502732>{{Cite journal  | last1 = Hedström | first1 = J. | last2 = Grenman | first2 = R. | last3 = Ramsay | first3 = H. | last4 = Finne | first4 = P. | last5 = Lundin | first5 = J. | last6 = Haglund | first6 = C. | last7 = Alfthan | first7 = H. | last8 = Stenman | first8 = UH. | title = Concentration of free hCGbeta subunit in serum as a prognostic marker for squamous-cell carcinoma of the oral cavity and oropharynx. | journal = Int J Cancer | volume = 84 | issue = 5 | pages = 525-8 | month = Oct | year = 1999 | doi =  | PMID = 10502732 | URL = http://www.sciencedirect.com/science/article/pii/S1875918111001450 }}</ref>
 
===Sign out===
<pre>
LARYNGEAL LESION ("LARYNGEAL PAPILLOMA"), RIGHT, BIOPSY:
- SQUAMOUS PAPILLOMA.
</pre>
 
====Not definite====
<pre>
TONGUE PAPULE, RIGHT, BIOPSY:
- SQUAMOUS EPITHELIUM WITH PARAKERATOSIS AND VERY SCANT STROMA WITH FEATURES
SUGGESTIVE OF A SQUAMOUS PAPILLOMA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
</pre>
 
====Dysplastic====
<pre>
LARYNGEAL LESION ("LARYNGEAL PAPILLOMA"), LEFT, BIOPSY:
- SQUAMOUS PAPILLOMA WITH LOW-GRADE DYSPLASIA.
- NEGATIVE FOR HIGH-GRADE DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
- CLOSE FOLLOW-UP IS RECOMMENDED.
</pre>
 
====Micro====
The sections show fibrovascular cores covered by stratified squamous epithelium with basal cell hyperplasia and edema.  Scattered lymphocytes are present in the epithelium.  No mitotic activity is appreciated.  There is no significant nuclear atypia.
Dyskeratotic cells are seen focally. Parakeratosis is present. Koilocytes are not apparent.
 
====Low-grade dysplasia====
The sections show fibrovascular cores covered by stratified squamous epithelium.  Scattered lymphocytes are present in the epithelium.  Rare mitotic activity is appreciated in the lower third of the epithelium.  Mild nuclear atypia (hyperchromasia and mild nuclear enlargement in the lower third of the epithelium) is present.
Dyskeratotic cells are seen focally. Parakeratosis is present. Koilocytes are seen focally.


==Pemphigus vulgaris==
==Pemphigus vulgaris==
Michael
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