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Questions and Answers
What are the characteristics of nasopharyngeal carcinomas?
Distinctive geographic distribution, close anatomic relationship to lymphoid tissue, and an association with EBV infection.
What is the most radiosensitive type of nasopharyngeal carcinoma?
Inverted papillomas are considered malignant tumors.
False
The primary risk factor for laryngeal carcinoma is _____ smoke.
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What types of cells do undifferentiated nasopharyngeal carcinoma consist of?
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What are the three patterns that nasopharyngeal carcinomas take?
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What is the most common form of sinonasal papilloma?
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HPV is present in about 50% of nasopharyngeal carcinoma cases.
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What is the typical clinical manifestation of carcinoma of the larynx?
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Match the following features to the type of nasopharyngeal carcinoma:
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Study Notes
Respiratory System Pathology for Medical Students
- Understanding key tumor types, risk factors, and clinical features in the respiratory system is essential for pathology students.
Tumors of the Nose, Sinuses, and Nasopharynx
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These tumors are rare and include mesenchymal and epithelial neoplasms.
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Nasopharyngeal Angiofibroma
- Highly vascular tumor primarily affecting adolescent males.
- Despite being benign, poses serious risks due to potential massive bleeding during surgery.
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Sinonasal Papillomas
- Benign tumors originating from sinonasal mucosa, categorized into three forms:
- Septal (most common)
- Inverted (biologically significant)
- Cylindrical
- Relation to HPV types 6 and 11; high recurrence rates particularly in inverted forms.
- Potential for invasion into adjacent structures including the orbit and cranial vault.
- Benign tumors originating from sinonasal mucosa, categorized into three forms:
Nasopharyngeal Carcinomas
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Characterized by unique geographic distribution and strong association with lymphoid tissue and Epstein-Barr virus (EBV) infection.
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Three histologic patterns:
- Keratinizing squamous cell carcinoma
- Nonkeratinizing squamous cell carcinoma
- Undifferentiated carcinoma
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Influencing factors include heredity, age, and EBV infection.
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Tends to progress without symptoms until advanced stages, often with metastasis to cervical nodes.
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Treatment typically involves radiotherapy, with a 3-year survival rate between 50% to 70%.
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The undifferentiated variant is the most radiosensitive; keratinizing variant shows the least sensitivity.
Morphological Characteristics
- Keratinizing and nonkeratinizing carcinoma resemble squamous cell carcinomas found in other regions.
- Undifferentiated carcinoma: characterized by large epithelial cells with vesicular nuclei, prominent nucleoli, and syncytium-like appearance, interspersed with lymphocytes (lymphoepithelioma type).
Carcinoma of the Larynx
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Development follows sequence: hyperplasia → atypical hyperplasia → dysplasia → carcinoma in situ → invasive carcinoma.
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Macroscopic presentation: varied, including smooth or roughened lesions, and potential ulceration.
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Risk Factors
- Tobacco smoke exposure: risk correlates with exposure levels; changes may regress with cessation.
- Alcohol consumption and other factors like nutritional deficiencies, asbestos exposure, and irradiation also increase risk.
- HPV identified in approximately 5% of laryngeal carcinoma cases.
Clinical Manifestation and Morphology
- Persistent hoarseness is a common symptom of laryngeal carcinoma.
- About 95% of these carcinomas are squamous cell tumors; adenocarcinomas may arise from mucous glands.
- Growth patterns and classification:
- Tumors can be intrinsic (confined to the larynx) or extrinsic (extending beyond the larynx).
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Description
This quiz focuses on the pathology of the respiratory system, specifically targeting nasopharyngeal, laryngeal tumors, and tumors of the nose and sinuses. It covers their risk factors, morphology, clinical features, and staging. Ideal for 3rd-year medical students in the Histopathology department.
