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Eczematous Dermatitis

D efinition —A constellation of inflammatory conditions caused by a reaction to exogenous or endogenous factors. Including, but not limited to, exogenous dermatitis, irritant contact dermatitis, allergic contact dermatitis, atopic dermatitis, and nummular dermatitis. Clinical Features Epidemiology Seen in all demographic groups. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log…

Guidelines for the Dissection of Head and Neck Specimens

Introduction Head and neck specimens are technically difficult because they often comprise a lot of different anatomic structures and corresponding surgical margins. In the following text, some practical guidelines are given that may be useful when confronted with these specimens. The following specimens are discussed: Oral cavity : lip, tongue, floor of the mouth, and mandibular gingiva, mandible, maxilla, and cheek Oropharynx : tonsillar area, base…

Pathology of the Conjunctiva, Orbit, Lacrimal Gland, and Intraocular Tumors

A large array of pathologies must be considered in the differential diagnosis of symptoms affecting the ocular tissues. The major causes of conjunctival, orbital, and intraocular diseases, the histopathological findings, and major differential diagnoses are described in this chapter. A discussion on the normal histopathology of the ocular tissues will allow the reader to better understand the different pathological processes. This chapter is divided into three…

Cutaneous Tumors and Pseudotumors of the Head and Neck

Introduction There are few, if any, cutaneous neoplasms of the head and neck that are unique to that topographic region. Accordingly, a consideration of skin tumors in this area of the body must be rather expansive. However, there are some dermatological lesions that are so uncommon (or unknown) in otorhinolaryngological practice that a discussion of their attributes will be understandably omitted. The following chapter addresses those…

Benign and Malignant Hematopoietic Diseases of the Head and Neck

Introduction The head and neck region may be involved by benign or malignant diseases of hematopoietic origin. In this chapter, benign and malignant processes are separately described and lesions that are common or unique to the head and neck are the focus. In general, extranodal lesions of the head and neck have the most distinctive features. The nodal diseases in this region are usually part of…

Ear: External, Middle, and Temporal Bone

Introduction Lesions of the ear reflect the composition and environmental exposures of the ear’s constituent parts: the skin, subcutaneous tissues, and cartilage of the external ear; the mucosa, ossicles and bone, nerves, muscles, and blood vessels of the middle ear and mastoid; and the specialized epithelium and nerves of the inner ear, which, encased within the temporal bone, transmute sound and position sensation to electrical impulses…

Cysts of the Neck, Unknown Primary Tumor, and Neck Dissection

The occurrence of a cervical mass is a rather common event in a wide variety of conditions, including congenital, inflammatory, and neoplastic diseases. The disease process may be located within lymph nodes or in the soft tissues of the head and neck, and it may appear as a cystic or solid tumor. Because of this diversity, a broad spectrum of possibilities must be considered in the…

Odontogenic Cysts and Tumors

Introduction Odontogenic cysts and tumors represent a surprisingly diverse group of pathologic lesions of the jaws and overlying soft tissues. Basic familiarity with the histology and embryology of tooth formation can help in understanding the development and histopathology of these lesions. Tooth formation is a complex process that involves both epithelial and connective tissues. There are three major tissue components involved in odontogenesis: the enamel organ,…

Soft-Tissue Tumors of the Head and Neck

Introduction Soft-tissue tumors of the head and neck are very rare, as compared to the far more common epithelial tumors that arise in these anatomic locations. Although benign lesions doubtless account for the great majority of head and neck soft-tissue tumors, it is essentially impossible to give any estimate as to their relative frequency. Malignant soft-tissue tumors of the head and neck comprise approximately 1% of…

Bone Lesions

Acknowledgments The authors express their appreciation to Drs. William G. Totty and Murali Sundaran, Department of Radiology, Washington University School of Medicine, for their help in interpreting the illustrated radiologic studies; and to Dr. Michael Kyriakos, Department of Pathology, Washington University School of Medicine, for allowing the use of his histologic material to illustrate some of the bone lesions in this chapter. We also acknowledge the…

Thyroid and Parathyroid Glands

Introduction Diseases of the thyroid and parathyroid glands are among the most common of all endocrine disorders. Affected patients may be relatively asymptomatic or may have evidence of hypofunction, hyperfunction, or a mass lesion. As a group, the diseases of these endocrine glands are of major importance because most are amenable to highly effective surgical or medical treatment. The purpose of this chapter is to provide…

Salivary Glands

Development and Anatomy Embryology The oropharyngeal membrane divides the primitive oral cavity from the primitive pharynx. The oral cavity structures originating external to the oropharyngeal membrane are of ectodermal derivation; those arising internal to the oropharyngeal membrane are of endodermal origin. In the adult, the boundary of this remote membrane is less than certain. It is generally accepted that the parotid gland is of ectodermal origin.…

Nonsquamous Pathologic Diseases of the Hypopharynx, Larynx, and Trachea

Anatomic Relationships and Barriers or Pathways for Tumor Spread in the Hypopharynx and Larynx Hypopharynx The hypopharynx is in continuity with the oropharynx and extends from the level of the hyoid bone to the opening of the esophagus. It is composed of the inferior aspect of the middle constrictor and the inferior pharyngeal constrictor muscles. The hypopharynx sits behind the larynx, and its lateralmost walls, the…

Lesions of the Oral Cavity

Fibrous, Fibrohistiocytic, and Fibrovascular Lesions The great majority of soft-tissue masses of the mouth are hyperplastic inflammatory responses to local, usually chronic, trauma or infection. Moreover, these reactive lesions are much more common in the mouth than in other parts of the body, presumably because of the close proximity of mucosa to hard, often sharp teeth and prosthetic appliances, as well as the inevitable low-grade inflammation…

Nonsquamous Lesions of the Nasal Cavity, Paranasal Sinuses, and Nasopharynx

Anatomy and Histology Nasal Cavity The nose is a complex organ composed of two components: the external and the internal nose. The external nose is triangular, with a wide base covering two external openings, the nares or nostrils, separated by the columella. Within the aperture of each nostril is a dilated area covered by skin known as the vestibule . The internal nose is divided by…

Squamous Cell Carcinoma of the Upper Aerodigestive System

Introduction Squamous cell carcinoma (SCC) of the upper aerodigestive tract (UADT) is the most common malignant neoplasm of the mucosal lining of the upper food and air passages. The estimated worldwide global annual burden of 630,000 new patients diagnosed resulting in 350,000 deaths worldwide. Recent changes in demographic alignments of new and traditional risk factors have greatly altered the approach to prevention, diagnosis, treatment, and prognostication…

Precursor Lesions for Squamous Carcinoma in the Upper Aerodigestive Tract

General Introduction There is considerable literature on all aspects of precursor lesions for squamous cell carcinoma of the upper aerodigestive tract (UADT). Most data are specific to oral and laryngeal lesions. A common feature of all these precursor lesions, irrespective of their site of origin, is histological evidence of progressive and cumulative epithelial genetic and epigenetic alterations induced by exposure to carcinogens, particularly tobacco and alcohol,…

Neoplasms of the Testis

Testicular cancer is the most common malignancy in men between the ages of 15 and 35 years, although this cancer accounts for less than 1% of all malignancies in men. The incidence of testicular cancer has steadily increased in recent decades and greatly varies worldwide, with the highest incidence in Northern Europe. In the United States, approximately 8590 patients are newly diagnosed with testicular cancer every…

Nonneoplastic Diseases of the Testis

Testicular specimens for non-neoplastic conditions are relative rarities in the surgical pathology laboratory. This chapter describes, illustrates, and compares the most common pathologic entities. Specimens may be obtained from patients who are newborn, prepubertal, or postpubertal. Therefore knowledge of the embryology and anatomy of the testes and paratesticular structures is important. Embryology In humans, the development of the testis (sex-specific phenotype) results from a series of…

Diseases of the Penis, Urethra, and Scrotum

Diseases of the Penis Anatomy and Histology Anatomy plays a key role in the staging and understanding of neoplasms of the penis. Certain types of tumor are more likely to occur in specific anatomic sites. The three parts to the penis are the body (shaft), which comprises the central portion; the glans, coronal sulcus, and foreskin (prepuce), which comprise the anterior end; and the root portion,…