and Maxillofacial Surgery
FIG. 7.27 Le Fort midfacial fractures. A, Le Fort I fracture separating inferior portion of maxilla in horizontal fashion, extending from piriform aperture of nose to pterygoid maxillary suture area. B,…
(Otorhinolaryngologic) Surgeries
FIG. 7.6 Caldwell-Luc operation. (From Ignatavicius DD, Workman ML: Medical surgical nursing: critical thinking for collaborative care, ed 5, St Louis, 2006, Mosby.) Surgical Mapping Myringotomy Instruments Important Anatomy Involved Pathophysiology…
Soft Tissue Chondroma
Range: 0.3-6.5 cm Microscopic • Well circumscribed and lobulated • Mostly composed of mature hyaline cartilage • Variable amounts of calcification • Ossification common • Granulomatous inflammation in 15% of cases • Rare tumors with extensive…
Glomus Tumors
Considered to fall on morphologic spectrum with myopericytoma, myofibroma, and angioleiomyoma Clinical Issues • Most common in young adults (20-40 years) • Female predilection in subungual tumors • Most common in distal extremities…
Melanoma In Situ, Not Otherwise Specified
Cells are markedly enlarged and atypical to bizarre-appearing Top Differential Diagnoses • Melanoma in situ, superficial spreading type • Melanoma in situ, lentigo maligna type • Atypical (dysplastic) junctional melanocytic nevus • Irritated/traumatized nevi…
Spitz (Spindle and Epithelioid Cell) Nevi
Spindle cells much more common Epithelioid cells usually dispersed individually throughout lesion • Melanocytes “mature” by becoming smaller from superficial to deep • Kamino bodies: Eosinophilic globules at dermal-epidermal junction • Artifactual clefting…
Branchial Cleft Cyst
Enlarges after upper respiratory tract infection • Along anterior border of sternocleidomastoid muscle • Initial work-up of suspected branchial cleft anomaly (in order) Intravenous or oral antibiotics (if infected), FNA, endoscopy &/or…
Spindle Cell/Pleomorphic Lipoma
Variable admixture of bland spindle cells, ropey collagen, mature adipose tissue, myxoid stroma, and mast cells • PL contains multinucleated tumor cells • Morphologic variants: Fat-free, fat-poor, angiomatous Ancillary Tests • CD34(+); loss…
