FRCPath Part1 Course
Head and Neck EMQ 1 Identify the special stain / immuno which would aid in diagnosis for each case. A. B. C. D. E. F. G. H. I. J.
CD1a S-100 CD68 Synaptophysin ZielNeelson CD45 DPAS p16 EBV ISH GFAP
1. A 37 year old female presents with a polyp on the tongue which is excised. The H and E stained section shows sheets of plump polygonal cells with abundant eosinophilic granular cytoplasm filling the lamina propria. 2. A 75 year old female undergoes incisional biopsy of a mixed red and white plaque on the tongue. There is some irregular pseudoepitheliomatous hyperplasia of the epithelium and mild atypia. Aggregates of neutrophils are readily detected in the surface parakeratin. 3. A 30 year old male undergoes biopsy of a white patch on the lateral border of the tongue. Histological examination shows parakeratosis and a band like layer of cells with clear cytoplasm in the upper stratum spinosum. 4. A 45 year old oriental male presents with an enlarged cervical lymph node and on panendoscopy is found to have a mass in the nasopharynx. 5. An 8 year old male presents with premature loosening of deciduous molars on the lower left side and an osteolytic lesion is seen on plain X-ray. Curettings show sheets of mononuclear cells with oval nuclei admixed with clusters of eosinophils.
EMQ 2 Many syndromes present with signs in the head and neck region. Match the syndrome to the clinical description. A. B. C. D. E. F. G. H. I. J.
Neurofibromatosis type 2 Fanconi’s anaemia Gardners syndrome Down’s syndrome Albrights syndrome (McCune-Albright) Osteogenesis imperfecta Gorlin Goltz syndrome MEN2b Cowdens syndrome Plummer-Vinson syndrome
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