Classification of Neoplasms of The Thyroid Gland See Box 28-1 . Box 28-1 Classification of Thyroid Gland Neoplasms Follicular Epithelial Origin Benign Follicular adenoma and variants Malignant Follicular carcinoma and variants Papillary carcinoma and variants Poorly differentiated carcinoma Undifferentiated (anaplastic) carcinoma Others: – Squamous cell carcinoma – Mucoepidermoid carcinoma – Tumors with thymic-like differentiation C-Cell Origin Medullary thyroid carcinoma Mixed Follicular and C-Cell Origin Mixed medullary…

Classification of Non-Neoplastic Lesions of the Thyroid Gland See Box 27-1 . Box 27-1 Classification of Non-Neoplastic Lesions of the Thyroid Gland Developmental Heterotopia/ectopia of thyroid tissues Lingual thyroid Thyroglossal duct cyst Lateral aberrant thyroid, parasitic nodule, and mechanical implantation Mediastinal thyroid and other sites of thyroid tissue Intranodal thyroid inclusions Struma ovarii and associated lesions Follicular epithelial metaplasia: squamous; oncocytic Others “Inclusions” in the Thyroid…

Embryology of the Thyroid ( Fig. 26-1 ) Thyroid gland is the first endocrine gland to appear during embryonic development. Thyroid gland derives from three primordium, median anlage, and lateral anlagen: Median anlage develops around the twenty-fourth day of gestation as a small, median endodermal thickening on primitive pharynx. – This thickening forms a diverticulum, which attaches to tongue by a narrow tube referred to as…

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Classification of Neoplasms of the Ear And Temporal Bone Box 24-1 Classification of Neoplasms of the Ear and Temporal Bone I External Ear A Benign Epithelial/neuroectodermal/mesenchymal – Keratoacanthoma – Ceruminal gland neoplasms – Seborrheic keratoses – Squamous papilloma – Melanocytic nevi – Dermal adnexal neoplasms – Pilomatrixoma (calcifying epithelioma of Malherbe) – Neurilemmoma/neurofibroma – Osteoma; chondroma – Hemangioma – Others B Malignant Epithelial/neuroectodermal/mesenchymal – Basal cell…

Classification of Non-Neoplastic Lesions of the Ear Box 23-1 Classification of Non-Neoplastic Lesions of the Ear and Temporal Bone External Ear Developmental (accessory tragi; first branchial cleft anomalies, others) Infectious and inflammatory Keloid Epidermal and sebaceous cysts Idiopathic cystic chondromalacia Chondrodermatitis nodularis helicis chronicus Autoimmune systemic diseases: – Relapsing polychondritis – Gout – Granulomatosis with polyangiitis (formerly Wegener granulomatosis) – Others Exostosis Synovial chondromatosis Middle and…

Embryology External Ear External ear develops from the first brachial groove. Auricle (pinna) develops from the auricular hillocks, a group of six mesenchymal swellings, from the first and second branchial arches lying around the first branchial groove. Mesenchymal structures of the auricle arise from the mesoderm of the first and second branchial arches. Epithelium of the external auditory canal develops from the ectoderm at the dorsal…

Intraoperative Consultation in Salivary Glands General Considerations ( Figs. 21-1 through 21-12 ) Intraoperative consultation (i.e., frozen section) in salivary gland pathology presents unique diagnostic challenges. Majority of salivary gland neoplasms (approximately 80%) originate in parotid and submandibular glands: Approximately 20% to 25% of neoplasms occurring in major salivary glands are malignant. In parotid gland, most neoplasms arise in superficial lobe Majority of minor salivary gland…

Classification of Neoplasms of Salivary Glands Box 20-1 contains the classification of neoplasms of the salivary glands. Box 20-1 Classification of Neoplasms of the Salivary Glands Benign Neoplasms Epithelial Pleomorphic adenoma Basal cell adenoma Canalicular adenoma Warthin tumor Myoepithelioma Oncocytoma Sclerosing polycystic adenosis Cystadenoma Ductal papillomas: Sialadenoma papilliferum Inverted ductal papilloma Intraductal papilloma Other uncommon adenomas Striated duct adenoma Intercalated duct adenoma Lymphadenoma (nonsebaceous) Keratocystoma Lipoadenoma…

Classification of Non-Neoplastic Salivary Gland Lesions Box 19-1 Classification of Non-Neoplastic Salivary Gland Lesions Developmental Lesions Heterotopias Hyperplasia and Metaplasia Adenomatoid hyperplasia Squamous metaplasia Necrotizing sialometaplasia Oncocytic changes (oncocytic metaplasia, oncocytosis) Intercalated duct lesions (intercalated duct hyperplasia; [intercalated duct adenoma]) True Cysts Lymphoepithelial cyst Salivary duct cyst Polycystic (dysgenetic) disease Nondevelopmental Cysts Mucus extravasation phenomenon Mucus retention cyst Ranulas Infectious, Inflammatory, and Autoimmune Disease Bacterial sialadenitis…

Salivary gland system composed of exocrine glanular tissue that include major salivary glands and minor salivary glands: Major salivary glands include: – Parotid gland – Submandibular (submaxillary) gland – Sublingual gland Minor salivary (seromucous) glands include: – Small aggregations within the submucosa of the upper aerodigestive tract All salivary glands share basic structure but vary per site in their function, secretions, gross and microscopic features: Major…

Issues relative to intraoperative consultation of laryngeal mucosal margins are similar to those discussed for intraoperative consultation of oral cavity mucosal lesions. The reader is referred to Section 2 for more detailed discussion, including illustrations. This section is an overview of the overlapping issues with the intraoperative consultation of laryngeal mucosal lesions and those of the oral cavity previously discussed in Section 2, Oral Cavity. Indications…

Classification of Neoplastic Lesions of the Larynx and Trachea ( Box 16-1 ) General Considerations Similar to tumors of other upper aerodigestive tract sites, most common tumors of the larynx are of epithelial origin: Most common benign neoplasm is a (squamous) papilloma Most common malignant neoplasm is squamous cell carcinoma or variant thereof, accounting for greater than 95% of all malignant neoplasms of the larynx Primary…

Classification of Non-Neoplastic Lesions of the Larynx and Trachea ( Box 15-1 ) Box 15-1 Classification of Laryngeal and Tracheal Non-Neoplastic Lesions Vocal cord nodules/polyps Laryngocele and laryngeal cysts Contact ulcer Amyloidosis Subglottic stenosis Teflon granuloma Tracheopathia osteoplastica Infectious diseases Necrotizing sialometaplasia Radiation-induced changes Benign epithelial changes Others Acquired and Congenital Lesions of the Larynx and Trachea Vocal Cord Nodules and Polyps ( Figs. 15-1 through…

Larynx Embryology Epithelium and glands of the larynx arise from the endoderm lining the laryngotracheal groove. Supraglottic larynx arises from the third and fourth branchial arches. Glottis and subglottic larynx arise from the sixth branchial arch. Cartilage, muscle, and other connective tissue elements develop from the mesenchyme around the foregut: Thyroid, cricoid, arytenoid, corniculate, and cuneiform cartilages derived from the fourth and sixth branchial arch Greater…

Classification of Neoplasms of the Neck Box 13-1 Classification of Neoplastic Lesions of the Neck Benign Mesenchymal/Neuroectodermal Fibromatosis Nodular fasciitis Paraganglioma Lipomas Nerve sheath tumors Rhabdomyoma Vascular neoplasms (e.g., angiofibroma, hemangioma, lymphangioma) Lymphatic malformation (lymphangiomas) Others Malignant Hematolymphoid Malignant Neoplasms Non-Hodgkin lymphomas Hodgkin lymphoma Others Sarcomas Malignant peripheral nerve sheath tumors Rhabdomyosarcoma Leiomyosarcoma Liposarcoma Angiosarcoma Synovial sarcoma Others Metastatic Cervical Carcinoma with an Unknown Primary Tumor…

Classification of Non-Neoplastic Lesions of the Neck ( Box 12-1 ) Box 12-1 Classification of Non-neoplastic Lesions of the Neck Developmental Cystic Anomalies Branchial cleft anomalies Thyroglossal duct cyst Cervical thymic cyst Bronchogenic cyst Dermoid cyst Others Infectious and Related Diseases/Lesions Bacterial and mycobacterial Fungal Viral Protozoal Sarcoidosis Others Reactive, Inflammatory, and Tumor-like Lesions Mesenchymal lesions Others Benign Cystic Lesions of the Cervical Neck Cystic lesions…

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Classification of Pharyngeal Neoplasms ( Box 10-1 ) General Considerations Similar to tumors of other upper aerodigestive tract sites, the most common tumors of the pharynx are of epithelial origin: The most common benign neoplasm is a (squamous) papilloma. The most common malignant neoplasm is squamous cell carcinoma or variant thereof. Unique carcinoma types identified in pharyngeal sites are the viral-associated head and neck squamous cell…

Classification of Non-Neoplastic Lesions of the Pharynx ( Box 9-1 ) Box 9-1 Classification of Non-Neoplastic Lesions of the Pharynx, Including Naso-, Oro-, and Hypopharynx Nasopharyngeal Cysts Rathke pouch cyst Tornwaldt cyst Dermoid cyst Retention cysts Others Hamartomas, Choristomas, and Teratomatous Lesions Nasopharyngeal hamartoma Heterotopic CNS tissue Nasopharyngeal dermoid Lymphangiomatous polyp Salivary gland anlage tumor Infectious and Related Diseases and Lesions Viral (HPV, EBV, HIV, CMV,…