Pathology Notes

Practice questions Oral cavity pathology Updated: 02/28/2019 © Jun Wang, MD, PhD 1. A 35-year-old man presents with a firm left gum nodule for 3 months. His past medical history is unremarkable. He has a 15 pack-year history of cigarette smoking. He does not drink alcohol. Physical examination reveals a 0.7 cm firm polypoid mass with focal erosion and exudates. The mass is removed. Microscopically it has a fibrous core with slightly hyperplastic smooth squamous lining. The squamous epithelium has parakeratosis and mild cytological atypia. What is the diagnosis? A. Erythroplakia B. Irritation fibroma C. Pyogenic granuloma D. Squamous cell carcinoma E. Squamous papilloma 2. A 15-year-old boy presents with painful lesion of his left lateral tongue. He has a history of infectious mononucleosis a year ago. Physical examination reveals an isolated 0.2 cm shallow ulcer at the left anterolateral tongue. The ulcer has well-defined erythematous edge. No other abnormalities

Practice questions Salivary gland pathology Updated: 02/21/2019 © Jun Wang, MD, PhD 1. A 67-year-old man presents with pain and swelling of left neck for 2 days. He does not have fever. He was diagnosed with squamous cell carcinoma of lung 3 years ago. Other past medical history including diabetes and hypertension. He has a 45 pack year history of cigarette smoking, and drinks wines 2 glasses a day for 30 years. Physical examination reveals a 4 cm mobile firm lesion at his left submandibular area. Sonographic examination reveals an enlarged submandibular glands. Biopsy reveals mixed serous and mucinous glands with neutrophilic infiltrate and focal abscess formation. No cytological atypia is noted. What is the diagnosis? A. Acute sialadenitis B. Mucinous carcinoma C. Mucoepidermoid carcinoma D. Sjogren syndrome E. Squamous cell carcinoma 2. Use this case for the next two questions . A 64-year-old man presents with a slowly growing firm mass at his right upper ne

Xerotic eczema   Updated: 02/11/2021 © Jun Wang, MD, PhD General features AKA Asteatotic eczema, winter itch, etc Most common in winter months, especially with decreased indoor humidity More common in men older than 60 years Associated with dehydration of skin Clinical features Pruritic, dry, cracked and polygonally fissured skin with irregular scaling Management Rehydration of the skin: Short bath with lower water temperature, avoid harsh skin cleansers, etc Topical steroid ointments may be considered Back to acute inflammatory dermatitis Back to contents

Urticaria   Updated: 02/11/2021 © Jun Wang, MD, PhD General features Both acute (< 6 weeks) or chronic (> 6 weeks) Commonly at pressure point  Acute urticaria usually associated with infections, caterpillars and moths, foods and other allergens  Chronic urticaria may be associated with autoimmune disorders, thyroid dysfunctions, underlying malignancy etc Pathogenesis Localized mast cell degranulation Dermal microvascular hyperpermeability Contraction of endothelial cells Retraction of endothelial cells Direct injury of endothelial cells Endothelial injury mediated by leukocytes Transcytosis or vesiculovacuolar pathway Clinical features Pruritic, edematous plaques (wheals) Pathological findings Dermal edema (widely spaced collagen bundles), Mild eosinophilic infiltrate Dilated lymphatics Management Antihistamine, glucocorticoids, etc. Epinephrine if laryngeal angioedema suspected Prognosis Acute urticarial Usually resolve i

Nummular eczema   Updated: 02/11/2021 © Jun Wang, MD, PhD General features “ Coin-shaped ” lesions confined to skin Patients tend to have very dry skin Most commonly on arms and legs No specific pathological features Clinical diagnosis Pathogenesis Unclear, e nvironmental allergens may be involved Clinical features Start as pruritic papules , then form dry plaques with scales Vesicles may form Frequently accompanied with xerosis Management Rehydration of the skin Repair of the epidermal lipid barrier Reduction of inflammation Treatment of any infection Back to acute inflammatory dermatitis Back to contents