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Head and Neck Pathology

of

the

 Head and Neck

An Overview of

Head & Neck Topics...

Squamous Lesions

Salivary

Glands

Nasal Cavity & Sinuses

Thyroid & Parathyroid 

Oral Cavity & Oropharynx

Ear &

Temporal Bone

Pharynx & Larynx

Mandible & Maxilla

Squamous Lesions

Benign

  • Candidiasis

  • Leuko/Erythroplakia

  • Lichen Planus

  • Vesiculobullous Dz

  • Epulis

  • Granular Cell Tumor

  • Pyogenic Granuloma

Dysplastic

  • Reactive changes

  • Low grade dysplasia

  • High grade dysplasia

Malignant

  • Squamous Cell Carcinoma

    • Keratinizing​

      • Traditional SCC​

    • Non-Keratinizing

      • HPV (Oropharynx)​

      • EBV (Nasopharynx)

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Candidiasis

  • aka "Oral Thrush"

  • Most common oral fungal infection, often by Candida albicans

  • Commonly described as being a  plaque in the oral cavity (tongue, mouth, esophagus) that can be "wiped off" with scraping

    • Hence the "pseudomembrane" descriptor​ often used

High Yield Factoids...

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  • Thickened epithelium

  • Broad rete

  • Neutrophils on surface

  • Yeast & Pseudohyphae piercing the squamous epithelium

  • Flaking/Flakey squamous "tufts"

  • "Shish-ka-bob" of fungal pseudophyphae "spearing" the squamous epithelium

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Click on an image to open and view full size...

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Leuko/Erythro- plakia

  • These are clinical terms to describe the appearance of a plaque

    • LEUKOplakia= WHITE plaque

    • ERYTHROplakia= RED plaque

    • Leukoerythroplakia= Red & White

  • Usually present on the lateral tongue​

  • Can represent infection, hyperkeratosis, hyperplasia, dysplasia, or even cancer

  • Oral hairy leukoplakia (shown right) occurs in HIV patients and is associated with EBV (Epstein Barr Virus)

High Yield Factoids...

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​ORAL HAIRY LEUKOPLAKIA

  • Hyperkeratosis & Hyperplasia of squamous mucosa

  • Balloon cells in spinous layer (clear cytoplasm, large, marginated chromatin)

  • Little inflammation 

  • Decreased langerhans cells

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Click any image below to view this example of Oral Hairy Leukoplakia

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Lichen Planus

  • Autoimmune mucositis

  • Commonly presents in a young (middle-aged) female

  • Often asymptomatic, but clinically the lesion is termed "Wickham's striae"

    • Raised white streaks/lesions (hyperkeratotic portion)​ on a red (erythematous) background

High Yield Factoids...

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  • Sawtooth rete ridges

  • Subepithelial "Band-like" infiltrate with chronic inflammation

  • Clinically, this presents as "Wickham's striae" 

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MORE COMING SOON...

(when I find the time to post and whatnot)

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