(With answers)

For Section D 2016

Case 1. Inflammatory Nasal Polyp Proliferation of the stroma

Proliferation of inflammatory cells

Collagen bundles, Fibrosis

MYXOMATOUS !!!

Edema

Results from chronic allergies

Common complaint: Stuffy nose

A 25 y/o medical resident complains of stuffy nose. He has recurrent bouts of sneezing for the last six months. On consult to an ENT doctor he was subjected to rhinoscopy which showed the picture below. The microscopic section shows the representative high magnification of the lesion.

1. What is the possible pathology in this case?

2. Describe the microscopic findings.

3. Give the possible pathophysiology.

Case 2. Pleomorphic Adenoma Slow growing, usually

asymptomatic

BENIGN

Gross: encapsulated or circumscribed but irregular

margins, opaque to

translucent

Case 2. Pleomorphic Adenoma Microscopic:

Epithelial and mesenchymal (chondroid, myxoid, osteoid, hyaline) elements

Luminal cells forming ducts and glands, in turn surrounded by single or multiple layers of nonluminal cells

Luminal cells may show goblet cell, sebaceous or squamous differentiation

A 35 y/o male presented with a pre auricular mass for the past month. On surgery the mass was well circumscribed and easily excised.

This is NOT a keratin pearl. It is just a look-alike.

Squamous differentiation: Ducts Keratin

Benign

1. What is the diagnosis?

2. What are the microscopic findings?

3. Is this benign or malignant?

A 60 y/o male with 20 year history of smoking presented with hoarseness. Laryngoscopy showed a white tan fungating mass.

A 60 y/o male with 20 year history of smoking presented with hoarseness. Laryngoscopy showed a white tan fungating mass.

This is the REAL keratin pearl, as seen in squamous cell carcinoma.

It usually affects the larynx.

MALIGNANT

Common complaint: Chronic hoarseness

1. What is the diagnosis?

2. What are the microscopic findings?

3. Is this benign or malignant?