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Simple, benign lymphoepithelial cyst. The cavity is lined with columnar and cuboidal cells with scattered goblet cells. The surrounding tissue contains small lymphocytes and macrophages. Beyond this is a capsule and subcapsular space resembling that of a lymph node Fig. 5.4. Simple, benign lymphoepithelial cyst. The cavity is lined with columnar and cuboidal cells with scattered goblet cells. The surrounding tissue contains small lymphocytes and macrophages. Beyond this is a capsule...

Branchial Cleft Cysts Sinuses and Fistulae

Branchial apparatus anomalies are lateral cervical lesions that result from congenital developmental defects arising from the primitive branchial arches, clefts and pouches. The branchial apparatus appears around the 4th week of gestation and gives rise to multiple structures or derivatives of the ears, face, oral cavity and neck. These structures are described in more detail in other sources 126 . Anatomically, the branchial apparatus consists of a paired series of six arches, five internal...

Chlamydia Trachomatis TRIC Agent Infection

Chlamydia trachomatis (TRIC agent TR trachoma, IC inclusion conjunctivitis) is an obligate intracellular pathogen of columnar epithelial cells 79 . In hot climates it can cause trachoma, primarily affecting the conjunctiva and corneal epithelium, ultimately causing cicatrisation of this tissue. Trachoma commonly affects children and is one of the world's major causes of blindness. Trachoma is spread from eye to eye by transfer of ocular discharges. In temperate climates chlamydial infection is...

Cervical Bronchogenic Cyst

Cervical bronchogenic cysts are uncommon congenital lesions found almost invariably in the skin or subcutaneous tissue in the vicinity of the suprasternal notch or manubrium sterni, rarely in the anterior neck or shoulder. Bronchial cysts are derived from small buds of diverticula that separate from the foregut during formation of the tracheobronchial tree. When they occur outside the thoracic cavity, the cyst presumably arises from erratic migration of sequestered primordial cells. They are...

Closure Glaucoma

In primary angle closure glaucoma, the aqueous outflow is obstructed by apposition of the iris to the inner surface of the cornea and the trabecular meshwork. The acute form of the disease occurs unilaterally in middle-aged and elderly patients and presents with a rapid and painful rise in intraocular pressure. Both in acute and chronic angle closure glaucoma, three ageing processes seem to cause the closure of the angle shrinkage of the eye, reduction in depth of the anterior chamber and...

And Chronic Otitis Media

Otitis media is one of the most common of all diseases, particularly in young children. The disease is usually caused by bacterial infection, Haemophilus influenzae and Gram-positive cocci usually being incriminated in the acute form and Gram-negative bacilli in the chronic form. The clinical forms of the acute and chronic conditions correspond to the pathological changes, but intermediate or mixed states are frequent. Perforation of the tympanic membrane may occur at any phase of otitis media,...

And Herpes Zoster

Primary herpetic stomatitis showing intercellular vacu-olation and multinucleated epithelial cells Fig. 3.1. Primary herpetic stomatitis showing intercellular vacu-olation and multinucleated epithelial cells Chickenpox is a highly contagious infection caused by the herpes virus Varicella zoster. It is typically seen in children where it causes crops of pruritic cutaneous vesicles. It is usually transmitted by direct contact and has an incubation period of 2-3 weeks. The exanthem is...

Of Neck Dissections

The American Academy of Otolaryngology-Head and Neck Surgery and the American Society of Head and Neck Surgery classified neck dissection into four categories radical, modified radical, extended and selective 99 . Neck dissection is classified primarily by the cervical lymph node groups that are removed, and secondarily on the anatomic structures that may be preserved, such as the spinal accessory nerve, the sternocleidomastoid muscle, and the internal jugular vein 71, 99 . The cervical lymph...

Inverted Papilloma

Inverted papilloma is the most common type of sch-neiderian papilloma. This lesion occurs almost exclusively in the lateral wall of the nasal cavity and in the paranasal sinuses, although on rare occasions it may also arise on the nasal septum 226 . Grossly, they frequently have a polypoid appearance, but they differ from nasal polyps of the common type by their histological features. Inverted papillomas are composed of invaginat-ing crypts, cords and nests covered by non-keratinising squamous...

Crohns Disease

Generalised fibrous hyperplasia hypertrophy of the gingiva can be familial or drug-induced. Hereditary gingival fibromatosis is a rare condition that is usually inherited as an autosomal dominant trait 20 . It can affect all of the gingiva, often in a symmetrical manner. It may be associated with hypertrichosis, coarsening of the facial features and neurological problems such as epilepsy and mental retardation. The condition usually first affects adolescents, but occasionally it can involve the...

Dermatitis Herpetiformis

Dermatitis herpetiformis is an uncommon, intensely pruritic mucocutaneous disorder related to coeliac disease that only occasionally involves the mouth 126 . Oral lesions present as areas of erythema and clusters of small, friable vesicles or superficial, painful ulcers. The lesions can involve both keratinised and non-ke-ratinised mucosa and head and neck cutaneous lesions tend to affect the scalp and periorbital regions. Dermatitis herpetiformis is seen most frequently in teenagers and young...

Malignant Melanoma

Sinonasal melanomas represent between 0.5 and 1.5 of all melanomas 25, 82, 157 and between 3 and 20 of sinonasal malignant neoplasms 25, 74 . They most frequently develop after the fifth decade of life 25, 42, 250 and seem to originate from melanocytes present in the mucosa of the respiratory tract 25, 58, 275 . In our experience, it is not uncommon to see melanomas arising in an area of squamous metaplasia . In contrast to Caucasians, black Africans often show visible pigmentation at sites...

Malignant Otitis Externa

Malignant otitis externa was first described as a severe infection of the external auditory canal 16 . It usually (but not always 101 ) affects elderly diabetics, resulting in unremitting pain, purulent discharge and invasion of cartilage, nerve, bone and adjacent soft tissue. The causative agent is usually Pseudomonas aeruginosa, but other organisms including fungi have been incriminated. The condition frequently goes on to ninth, tenth, eleventh and twelfth cranial nerve palsies and...

Addison Disease

Addison disease is rare with an estimated annual incidence of 0.8 cases per 100,000 of the population in Western societies. It is due to bilateral destruction of the adrenal cortex. Formerly, the most common cause was tuberculosis. Most cases now are due to organ-specific auto-immune destruction and opportunistic infections such as histoplasmosis in patients with AIDS. Due to this, it is likely that the number of patients with Addi-son disease will increase significantly. Addison disease may be...

Smokers Melanosis

Heavy smokers can sometimes develop areas of oral hyperpigmentation. It is more common in women than men. Although any part of the mouth can be affected the anterior gingivae are involved most frequently. The lesions vary in colour from light brown to bluish-black and the lesions may be focal or diffuse. Sometimes the overlying mucosa has a somewhat milky-white appearance, particularly in the buccal mucosa. The condition can slowly resolve if smoking is stopped or reduced 72 . Pigmentation of...

Geographic Tongue

Geographic tongue is a relatively common idiopathic condition typically characterised by migrating areas of depapillation on the dorsum of the tongue 6 . In many cases it is associated with fissuring. There is loss of filiform papillae often surrounded by a slightly raised yellowish-white and crenellated margin. These areas of depapillation tend to heal centrally and spread cen-trifugally. Occasionally, the ventrum is involved and in that site lesions consist of an area of erythema completely...

Median Rhomboid Glossitis

Median rhomboid glossitis usually presents as a painless, reddened, sharply demarcated area of depapillation in the centre of the dorsum of the tongue anterior to the foramen caecum. In some cases the area is nodular or grooved. It was originally thought to be due to the persistence of the developmental eminence called the tuberculum impar, but now most cases are believed to be candidal in origin 180, 188 . Predisposing factors include smoking, wearing dentures, diabetes and using steroid...

Viral Tonsillitis

The most common causes of upper respiratory tract infections and pharyngo-tonsillitis in the general population, including infants and young children, are viruses such as influenza virus, Coxsackie's virus (group A), adenovirus, and the ubiquitous herpes virus Ep-stein-Barr virus 205 . EBV infects epithelial cells and B-lymphocytes of Waldeyer's ring, which represent the reservoir for life-long viral persistence 104, 186 . Primary infections with EBV occur early in infancy and childhood in...

Schwannoma and Neurofibroma

About 4 of schwannomas of the head and neck region arise in the sinonasal tract 202 . They usually present as polypoid lesions involving the nasal cavity and or a paranasal sinus, with non-specific symptoms of obstruction, compression, or extension in the surrounding structures 202 . Histologically, the tumour is composed of elongated wavy-shaped monomorphic spindle cells, with eosinophilic cytoplasm and oval nucleus. Antoni type A and type B areas usually coexist within the lesion, and nuclear...

Benign and Potentially Malignant Lesions of the Squamous Epithelium and Squamous Cell Carcinoma

1.1 Squamous Cell Papilloma and Related Lesions 2 Verruca Vulgaris, Condyloma Acuminatum and Focal Epithelial Hyperplasia 2 1.1.2 Laryngeal 1.2 Squamous Intraepithelial Lesions SILS 4 1.2.1 General 1.2.2 Terminological 1.2.3.1 Oral Cavity and and Macroscopic 1.2.4.1 Oral and Oropharyngeal Leukoplakia, Proliferative Verrucous Leukoplakia and Erythroplakia 6 1.2.4.2 Laryngeal and Hypopharyngeal Leukoplakia and Chronic Laryngitis 1.2.5 Histological 1.2.5.1 WHO Dysplasia 1.2.5.2 The Ljubljana...

Microinvasive Squamous Cell Carcinoma

Microinvasive squamous cell carcinoma SCC is a SCC with invasion beyond the epithelial basement membrane, extending into the superficial stroma. There is little consensus among pathologists on the maximum depth of invasion in microinvasive SCCs, but it generally ranges from 0.5 mm 20 to 2 mm 77 . The depth of invasion must be measured from the basement membrane of the adjacent non-neoplastic surface epithelium, because of the great variations in epithelial thickness. Microinvasive SCC is a...

The Ljubljana Classification and WHO 2005 Classification

Comparing the two classifications, one should be aware that there is no simple relationship and overlapping between the WHO 2005 and the Ljubljana classifications Table 1.1 . The group of the so-called benign lesions, including squamous and basal-parabasal cell abnormal hyperplasia is comparable in both classifications. Disagreement starts with the presumption of the WHO 2005 classification 381 that each grade of the whole series of dyspla-sia is considered to be a precursor or potentially...