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OMF Pathology > 11 Salivary Gland Diseases > Flashcards

11 Salivary Gland Diseases Flashcards

1
Q

Any bump on the roof of the mouth is automatically considered to be what before exam/biopsy?

A

Salivary gland tumor

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2
Q

What is a mucocele?

A

leaking of mucin into soft tissues due to the rupturing of a salivary gland duct

(mostly caused by trauma)

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3
Q

What are common places to see a mucocele?

A
  1. Lower lip (81%)
  2. FOM
  3. anterior ventral tongue
  4. buccal mucosa
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4
Q

A clinical mucocele on the upper lip is more likely to be what?

A

A salivary gland tumor

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5
Q

A mucocele of the retromolar region is unusual and more often proven to be what?

A

Mucoepidermoid carcinoma

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6
Q

What is this?

A

Mucocele

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7
Q

How would you treat this?

A

Surgical excision of the mucocele and adjacent (minor) salivary glands

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8
Q

If left untreated, what can a mucocele eventually become?

A

A fibroma

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9
Q

What is this?

A

mucocele

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10
Q

What is this called?

A

Ranula (mucocele on FOM or sublingual)

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11
Q

What can happen if this is left untreated and it continues to grow in size?

A

Called a “Plunging Ranula” it will dissect the mylohyoid and continue into the mediastinum to slowly suffocate the patient

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12
Q

Pt says they used to have a big bump under their tongue. What happened?

A

Plunging Ranula dissected mylohyoid

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13
Q

Upon biopsy it shows an epithelium-lined cavity. What is this soft fluctuant swelling?

A

Salivary duct cyst (aka mucous retention cyst)

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14
Q

What are common places to see salivary duct cysts?

A
  1. Parotid gland
  2. FOM
  3. Buccal mucosa
  4. Lips
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15
Q

Salivary duct cysts occur mostly in ________ whereas mucoceles occur more often in __________.

A

adults, children

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16
Q

What is a sialolith?

A

A calicification (stone) in the salivary duct

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17
Q

What are the three most common places to find a sialolith?

A
  1. Submandibular gland
  2. Upper lip
  3. Buccal mucosa
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18
Q

What is this artifact seen on this CT scan?

A

A sialolith

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19
Q

Why is the submandibular gland most likely to develop a sialolith?

A

It has the longest, most tortuous duct for saliva to go through on its way to the mouth

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20
Q

What are some possible causes of sialoliths?

A
  1. Mucous plug
  2. Bacterial colonies
  3. Chronic duct blockage phenomena
  4. Normal ductal anatomy (Wharton’s duct)
  5. Xerostomia
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21
Q

What is that?

A

Sialolith

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22
Q

What is this? How do you get it out if near the surface?

A
  1. Sialolith
  2. “milk” it out of the duct or surgical excision if too deep
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23
Q

What is the definition of Sialadenitis?

A

An inflammation of the salivary gland

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24
Q

What is a viral infection that can cause sialadenitis?

A

Mumps - caused by paramyxovirus

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25
Q

What are some non-infectious causes of sialadenitis?

A
  • Sjögren syndrome
  • Sarcoidosis, granulomatous inflammation
  • Radiation induced
  • Recent surgery
  • Allergic reaction
  • Obstruction of the salivary duct
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26
Q

What is sialadenosis?

A

non-inflammatory, asymptomatic enlargement of the salivary glands (usually bilateral)

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27
Q

What are some underlying systemic conditions that can cause sialadenosis?

A

diabetes mellitus, general malnutrition, bulimia

hypothyroidism, pregnancy, alcoholism, anorexia, anti-hypertensive drugs, psychotropic drugs

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28
Q

Pt is in third trimester. What could this be?

A

Sialadenosis (salivary gland enlargement)

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29
Q

Upon palpation you find the parotid glands are enlarged but still feel soft. What is this termed?

A

Sialadenosis

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30
Q

Describe Adenomatoid Hyperplasia of the Minor Salivary Glands.

A

Localized, sessile, painless swelling of minor salivary glands (usually on hard/soft palate) that mimics a neoplasm. Typically hyperplasia of gland.

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31
Q

What are your first thoughts? (Give a differential diagnosis of two things.)

A
  1. Adenomatoid hyperplasia of minor salivary glands
  2. Salivary gland tumor
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32
Q

There are more cells in this frame than regularly seen in a salivary gland. What pathogenesis does this fall under?

A

Adenomatoid hyperplasia of minor salivary gland(s)

  • hyperplasia is seen in this histo slide
33
Q

What is necrotizing sialometaplasia?

A

Locally destructive inflammatory condition of the salivary glands believed to be due from ischemia (other causes)

34
Q

What could a dentist cause if they inject anesthetic too quickly under the periosteum of the palate?

A

Necrotizing sialometaplasia

35
Q

What is this?

A

necrotizing sialometaplasia

36
Q

How long does it take Necrotizing Sialometaplasia to resolve/heal?

A

5-6 weeks

37
Q

Person has hitory of anorexia. What is this?

A

Necrotizing sialometaplasia

38
Q

Give two possible diagnoses for this.

A
  1. necrotizing sialometaplasia (will heal in 5-6 weeks)
  2. malignancy (continues to grow)

Watch for a week. If it gets smaller then it’s #1.

39
Q

Define Cheilitis glandularis.

A

Swelling and eversion of the lower lip due to hypertrophy and inflammation of minor salivary glands

40
Q

What is this? What can give it away?

A
  1. Cheilitis Glandularis
  2. “weeping” of minor salivary glands
41
Q

What is this salivary gland pathology?

A

Cheilitis glandularis

42
Q

Someone with a sialolith will usually complain of what symptom?

A

Having pain or swelling upon eating

43
Q

What is excessive salivation called?

A

Sialorrhea

44
Q

What are some possible causes of Sialorrhea?

A
  • GERD
  • Local irritations
  • Cholenergic agonists
  • Lithium
  • etc
45
Q

Xerostomia is a common problem in ____% of adults.

A

25%

46
Q

What are clinical signs of xerostomia?

A
  • fissured tongue
  • dry lips
  • mucosal tissue is sticky after wiping dry
47
Q

What are three complications of xerostomia?

A
  1. altered taste
  2. higher risk of cervical or root caries
  3. candidiasis
48
Q

What are some known causes of xerostomia?

A

medications, radiation therapy, caffeine/alcohol, smoking, Sjögren’s syndrome, diabetes, sarcoidosis

49
Q

What is an autoimmune disease mainly affecting salivary and lacrimal glands?

A

Sjögren’s syndrome

50
Q

What are three common symptoms seen in Sjögren’s syndrome patients?

A
  1. xerostomia
  2. xerophthalmia
  3. arthralgia
51
Q

What are three criteria to meet to diagnose Sjögren’s syndrome?

A
  1. Positive autoantibodies to Ro(SS-A) and/or La(SS-B) antigens
    1. Or positive rheumatoid factor and antinuclear antibody titer
  2. labial salivary gland biopsy showing focal lymphocytic sialadenitis (≥1 focus/4mm2)
  3. Keratoconjunctivitis sicca w/ ocular staining score ≥3
52
Q

People with Sjögren’s syndrome have a 40x greater risk of getting ___________.

A

Lymphoma

53
Q

What are the most common sites to have a salivary neoplasm?

A
  1. Parotid gland (64-80%)
  2. Minor glands
  3. Submandibular
  4. Sublingual
54
Q

Of the three major salivary glands, which one is more likely to be malignant if it had a salivary neoplasm?

A

Sublingual (~70%)

55
Q

Of all minor salivary gland neoplasms, which location in the mouth has the highest rate of malignancy?

A

Retromolar pad (90% are malignant)

Tongue is close second w/ 85%

56
Q

Of all minor salivary gland neoplasms, which location is most likely to have a benign neoplasm?

A

Upper lip (80% are benign)

57
Q

Are minor salivary gland neoplasms more common in upper lip or lower lip?

A

Upper lip is more common, but lower lip is more likely to be malignant.

58
Q

What is the most common benign neoplasm overall?

A

Pleomorphic adenoma (benign) - most common in parotid

59
Q

What is the most common malignant neoplasm overall?

A

Mucoepidermoid carcinoma (parotid most common site)

60
Q

What are four benign salivary gland neoplasms to know?

A
  1. Canalicular adenoma
  2. Pleomorphic adenoma
  3. Warthin tumor (papillary cystadenoma lymphomatosum)
  4. Oncocytoma
61
Q

Canalicular adenoma occurs exclusively in _______ salivary glands.

A

Minor

62
Q

If your patient is >60 yrs old and has a benign salivary gland neoplasm, it is more likely to be what kind?

A

canalicular adenoma

63
Q

if your patient is <50 yrs old and has a benign salivary gland neoplasm, it is more likely to be what kind?

A

pleomorphic adenoma

64
Q

T or F: Benign salivary gland tumors are typically encapsulated in connective tissue.

A

True

65
Q

Pleomorphic adenomas are most commonly seen where overall?

A

parotid gland

66
Q

Pleomorphic adenomas are most commonly seen where if in a minor salivary gland?

A

Palate

67
Q

Oncocytoma occurs mainly in _______ salivary glands.

A

Major

68
Q

Oncocytoma get it’s name from what histologic feature?

A

Oncocytes: large epithelial cells

69
Q

What is the second most common benign tumor of the parotid gland?

A

Warthin’s tumor (papillary cystadenoma lymphomatosum)

70
Q

Who has an 8-fold higher risk of developing warthin’s tumor?

A

smokers

71
Q

Papillary cystadenoma lymphomatosum is almost exclusively seen in the ________ gland.

A

Parotid

72
Q

What are the two most common malignant salivary neoplasms?

A
  1. Mucoepidermoid carcinoma
  2. Acinic cell adenocarcinoma
73
Q

What is malignant ectopic salivary gland tissue that was developmentally entrapped in the jaw?

A

Intraosseous Mucoepidermoid Carcinoma

74
Q

What is a common site to see Intraosseous mucoepidermoid carcinoma?

A

The angle of the mandible

75
Q

Histologically, this acinic cell adenocarcinoma will show what taking over the salivary gland?

A

Acinar cells

76
Q

What is the most common malignant salivary gland tumor of the submandibular gland?

A

Adenoid cystic carcinoma

77
Q

Why is the long-term survival rate with adenoid cystic carcinoma so low?

A

The tumor metastesises in the neurons and spreads out through the nerves, making total removal impossible

78
Q

Not occurring on the midline and affecting minor salivary glands of the palate, what might this be?

A

Polymorphous Low-grade Adenocarcinoma

OMF Pathology (21 decks)

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