11: Salivary pathology Flashcards

1
Q

von ebner salivary glands – where, what secretions

A

tongue beneath circumvallate and foliate papillae; primarily serous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

salivary glands in tongue beneath circumvalate and foliate papillae and their secretions

A

von ebner, primarily serous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ventral tongue salivary glands and secretions

A

blandin-nuhn, serous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

blandin-nuhn salivary glands – where, what secretions

A

ventral tongue, serous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

salivary gland aplasia syndromes

A

treacher collins, hemifacial microsomia, lacrimo-auriculo-dento-digital syndrome (LADD)
can also be isolated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

LADD genetics and clinical

A

FGF10 mutation

salivary and lacrimal gland aplasia, cup shaped ears, dental/digital anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

salivary and lacrimal gland aplasia, cup shaped ears, dental/digital anomalies

what is and genetics

A

LADD

FGF10 mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

superficial mucoceles location

A

soft palate and retromolar pad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

superficial mucoceles which conditions

A

lichen planus, lichenoid drug reactions, GVHD, tartar control toothpaste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

connective tissue reaction to extravasated mucus

A

granulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

origin of ranula

A

sublingual gland (body or ducts of Rivini)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CT/MRI sign of submandibular ranula

A

tail sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

plunging ranula dissects though

A

mylohyoid muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

salivary duct cyst location

A

upper lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

systemic treatment for multifocal ductal ectasia

A

erythromycin and chlorhexidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common sialolithiasis and histo look

A

submandibular

tortuous duct and mucoid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

types of sialadenitis and causes

A

infections - viral-mumpsm bacterial - S aureus

non-infectious – Sjogrens, RT, sarcoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

chronic sclerosing sialadenitis in submandibular leading to gland enlargement – evaluate for what

A

Kuttner tumor (IgG4) – eval for sclerosing pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do bacteria cause sialadenitis

A

retrograde spread from reduced flow (dehydration, medication) or block (sialolith, tumor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sialadenitis most commonly where and presentation

A

fever and pus, usually parotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

surgical mumps

A

after abdominal surgery, when patient is kept without food/fluids and receives atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

after abdominal surgery, when patient is kept without food/fluids and receives atropine

A

surgical mumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

sausaging of stensen’s duct – what is, what modality, what diagnosis

A

dilation and strictures from scar tissue in sialadenitis on sialography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

subacute necrotizing sialadenitis histo, demographic, ulceration

A

no squamous metaplasia, mixed acute and chronic inflammation, younger patients, does not ulcerate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cheilitis glandularis what is

A

swelling and eversion of lower lip due to hypertrophy and inflammation of glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

swelling and eversion of lower lip due to hypertrophy and inflammation of glands

A

cheilitis glandularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

cheilitis glandularis etiologues

A

UV damage, tobacco, syphilis, poor hygiene, hereditary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

forms of cheilitis glandularis

A

simple, superficial suppurative (Baelz’s disease)m deep suppurative (cheilitis glandularis apostematosa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Baelz’s disease

A

superficial suppurative cheilitis glandularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

cheilitis glandularis apostematosa aka

A

deep suppurative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

true sialorrhea causes

A

aphthae, new dentures, GERD (water brash), rabies, heavy metal poisoning, medications for alzheimers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

relative sialorrhea what is and causes

A

can’t keep saliva in mouth: Down’s, cerebral palsy, Parkinson’s, prior surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

idiopathic paroxysmal sialorrhea presentation

A

short episodes 2-5min, prodrome of nausea and epigastric pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

xerostomia how ofetn

A

25% of adult population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

xerostomia causes

A

developmental (SG aplasia)
water/metabolite (reduced intake, vomit, hemorrhage)
iatrogenic (drugs, RT, CT), systemic disorders (SS, sarcoidosis, diabetes, HIV, HCV, GVHD) and local (reduced mastication, smoking, mouth breathing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

benign lymphoepithelial lesion aka

A

lymphoepithelial sialadenitis, Mikulicz disease

painless enlargement of salivary glands, usually unilateral
pts may or may not have clinical sjogren

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

mikulicz syndrome what is

A

salivary gland enlargement from other causes (eg sarcoidosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

benign lymphoepithelial lesion histo

A

lymphocytic sialadenitis + epimyoepithelial islands (ductal preservation with epithelial proliferation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

malignant lymphoepithelial lesion aka, histo, cause

A

aka lymphoepithelial carcinoma

poorly differentiated salivary ca with prominent lymphoid stroma, EBV, de novo or from BLEL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

primary sjogrens =

A

sicca syndrome = dry eyes + mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

secondary sjogrens

A

sicca syndrome + RA, SLE, biliary cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

dry eyes in sjogrens aka

A

keratoconjunctivitis sicca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

HLA in sjogrens (primary vs secondary)

A

HLA-DRw52 both

HLA-DR3 and B8 primary only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

fruit laden branchless tree

A

sialography for sjogrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

rose bengal dye

A

shows defects on ocular surface epithelium in sjogrens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

dye to show ocular surface epithelium defects in sjogrens

A

rose bengal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

test to confirm dry eyes and what’s the metric in sjogrens

A

schirmer test - <5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

labs in sjogrens

A

ANAs, anti-SSA (Ro), anti-SSB (La0, ESR, OgG, RF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

sjogrens histo

A

multifocal lymphocytic sialadenitis (T cells)–> acini destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

sjogrens biopsy criteria

A

2+ foci of 50+ lymphocytes within 4mm squared; smokers have fewer foci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

risk with sjogrens

A

40x MALT lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

HIV related parotid cysts presentation

A

usually bilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

bilateral parotid cysts consider

A

HIV related parotid cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

HIV related parotid cysts histo

A

cystic spaces lined with squamous epithelium; abundant reactive lymphoid stroma
epimyoepithelial islands and Warthin-Finkeldey giant cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Warthin-Finkeldey cells

A

giant cells in HIV related parotid cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

giant cells in HIV related parotid cysts name

A

Warthin Finkeldey

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Sialadenosis aka, what is and why

A

sialosis

accumulation of secretory zymogen granules due to innervation disruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

accumulation of secretory zymogen granules due to innervation disruption

A

Sialadenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

sialadenosis risk factors

A

diabetes, malnutrition, alcoholism, bulimia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

sialadenosis sialgraphy

A

leafless tree (compression of finer ducts by hypertrophic acinar cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

leafless tree sialography why and what

A

sialadenosis (compression of finer ducts by hypertrophic acinar cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

adenomatoid hyperplasia of minor salivary glands where and why

A

mostly on palate (pseudotumor); poss 2/2 chronic trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

adenomatoid hyperplasia of minor salivary glands histo

A

coalescing lobules of normal mucinous acini in lamina propria and submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

coalescing lobules of normal mucinous acini in lamina propria and submucosa; say, palate

A

adenomatoid hyperplasia of minor salivary glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

polycystic (dysgenetic) parotid disease where and who

A

almost always in parotid, bilateral, usually childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

polycystic (dysgenetic) parotid disease histo

A

parenchyma diffusely replaced by varying degrees of honeycombed cystic change, lined with a thin layer of flattened epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

polycystic (dysgenetic) parotid disease ddx

A

cystadenoma/carcinoma but they are localized masses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

juxtaoral organ of chievitz what, where, function

A

vestigial organ of the developing parotid gland
bilateral in soft tissue overlying angle of mandible in buccotemporal space
poss mechanosensor in lateral wall of oral cavity – avoid removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

juxtaoral organ of chievitz histo and ddx

A

2-10 islands of squamoid cells but no keratin
dark stained cells on periphery and clear cells in center
glandular/organoid pattern
ddx: well-diff SCC, MEC, met

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

necrotizing sialometaplasia causes

A

local ischemia and infarction

factors: trauma, surgery, infection, dental injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

sclerosing polycystic adenosis where and why

A

pseudoneoplastic reactive inflammatory process, usually parotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

sclerosing polycystic adenosis histo

A

multiple densely sclerotic lobules composed of hyalinized collagen around multiple ducts with prominent cystic change
cells: apocrine, sebaceous-like, and paneth-like

has intraluminal rounded projections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

salivary gland tumors = where most common, what’s most common

A

66-75% of all tumors in parotid

66-75% are benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

salivary gland tumor occurrence by location

A

parotid (66) > minor (palate>upper lip> cheek) > submandibular > sublingual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q
what percentage of tumors are benign in
parotid
submandibular
minor salivary (overall)
sublingual
A

parotid 66 benign
submandibular 60 benign
minor salivary 50 benign
sublingual 10 benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

minor salivary glands, what percentage of tumors are benign:
upper lip
palate and buccal mucosa
retromolar pad, FOM, tongue, lower lip

A

upper lip 75 benign
palate and buccal mucosa 50 benign
retromolar pad, FOM, tongue, lower lip 10 benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

most common benign tumor in parotid

A

pleomorphic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

most common malignant tumor in parotid

A

mucoep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

most common benign tumor in submandibular

A

pleomorphic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

most common malignant tumor in submandibular

A

adenoid cystic carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

most common tumor of sublingual

A

mucoep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

most common benign tumor of minor salivary glands overall

A

pleomorphic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

most common malignant tumorS (list multiple) of minor salivary glands overall

A

PLGA/mucoep/ACC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

most common salivary gland tumor

A

pleeomorphic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

most common salivary gland tumor in children

A

pleomorphic adnoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

pleomorphic adenoma old aka and why; IHC?

A

myoepithelioma
composed of myoepithelial cells
calponin, p63+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

which pleomorphic adenomas higher recurrence

A

myxoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

string of pearls on skin

A

recurrent pleomorphic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

special histo finding in a small subset of pleomorphic adenomas and how common

A

tyrosinde crystals in 6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

tyrosine crystals which salivary gland tumor

A

pleomorphic adenoma, 6%

91
Q

oncocytoma look of cells

A

oncocytes: swollen granular cytoplasm 2/2 increased mitochondria

92
Q

oncocytoma location and origin

A

90% in parotid

poss from striated duct

93
Q

oncocytoma special stains

A

PAS+ diastase sensitive (glycogen)

PTAH can show granules

94
Q
oncocytosis aka (what kind of lesion?)
histo
A

multinodular oncocytic hyperplasia (not neoplastic)
small multiple nodules without tumor stroma
nested zellballen-like oncocytes with vascular spaces and numerous connective tissue septa

95
Q

small multiple nodules without tumor stroma

nested zellballen-like oncocytes with vascular spaces and numerous connective tissue septa

A

oncocytosis

aka multinodular oncocytic hyperplasia

96
Q

warthin tumor location, demographic, other name

A
tail of parotid
8x more common in smokers
10:1 M:F
5-17% bilateral (metachronous)
aka papillary cystadenoma lymphomatosum
97
Q

papillary cystadenoma lymphomatosum what is?

A

warthin tumor

98
Q

malignant warthin

A

carcinoma ex-papillary cystadenoma lymphomatosum

99
Q

canalicular adenoma location

A

75% upper lip, then cheek

can be multifocal

100
Q

basal cell adenoma location

A

75% parotid

then upper lip and cheek

101
Q

basal cell adenoma histo types

A

solid, trabecular, tubular, membranous

102
Q

membranous basal cell adenoma aka and histo findings

A

aka dermal anlage tumor

jigsaw puzzle and thick hyaline material

103
Q

distinctive histo pattern of basal cell adenomas

A

basosquamous whorls

104
Q

brooke-spiegler syndrome components

A

hereditary membranous basal cell adenoma, dermal cylindromas, trichoepitheliomas

105
Q

hereditary membranous basal cell adenoma, dermal cylindromas, trichoepitheliomas

A

brooke-spiegler syndrome

106
Q

basal cell adenoma with worst prognosis

A

membranous basal cell adenoma

30% recurrence

107
Q

sialadenoma papilliferum look, location, histo

A

ductal papilloma on palate, histo like papilloma

108
Q

intraductal papilloma look, location, histo

A

submucosal swelling, mostly minor salivary glands

unicystic structure with cuboidal/columnar epithelium

109
Q

inverted ductal papilloma look, location, histo

A

nodule of lower lip and mandibular vestibule

unicystic with squamous, bulbous epithelium

110
Q

sialadenoma papillefreum of skin

A

syringocystadenoma papilliferum

111
Q

sialoblastoma aka and what is

A

lymphadenoma

congenital basaloid tumor

112
Q

most common malignant ssalivary gland tumor in adults and children of the uS

A

mucoep

113
Q

mucoep locations

A

parotid, then minor salivary glans

114
Q

most common salivary gland tumor of lower lip, FOM, tongue, retromolar pad

A

mucoep

115
Q

most common etiologic factor for mucoep

A

radiation

116
Q

compare grade and prognosis for mucoeps in minor, submandibular, patorid

A

minor – lower grade, better prognosis

sub-MD worse prognosis than parotid

117
Q

intraosseous mucoeps how?

A

ectopic salivary tissue, sinus lining, or odontogenic epithelium from cyst lining

118
Q

acininc cell adenocarcinoma location, gender, prognosis

A

85% parotid
F>M
childhood, most commonly bilateral
prognosis good, better in minor glands

119
Q

second most common malignant salivary tumor of childhood (what’s first)

A

2 - acinic cell adenocarcinoma

1 - mucoep

120
Q

acinic cell adenocarcinoma special stain and histo

A

PAS, diastase resistant (not glycogen)
can be solid, cystic, microcystic, papillary-cystic
well-diff, dediff, follicular

has tumor associated lymphocytes

121
Q

types of malignant mixed tumors of salivary glands and locations. which most common?

A

carcinoma ex-PA (95%; most parotid, then minor)
carcinosarcoma (parotid, sub-MD, minor)
metastasizing PA (lungs or bones)

122
Q

malignant mixed tumors of salivary glands what’s the histo

A

usually poorly diff adenoca or salivary duct ca

123
Q

grades of invasion and worse prognosis for malignant mixed tumors of salivary glands

A

non-invasive (in situ), minimally invasive (<1.5mm), invasive (>1.5mm – worse prognosis obvi)

124
Q

salivary carcinosarcoma components usually

A

adenocarcinoma + chondrosarcoma

125
Q

basal cell adenocarcinoma arises from; location

A

de novo (most) or basal cell adenoma – 90% parotid

126
Q

types of basal cell adenocarcinoma

A

solid, membranous, tubular, trabecular

127
Q

ddx basal cell adenoma from basal cell adenocarcinoma

A

invasive growth and/or perineural or vascular invasion

128
Q

adenoid cystic carcinoma location

A

most in palate; then parotid in sub-MD

129
Q

adenoid cystic carcinoma histo patterns, IHC, special stain

A

classic (cribiform swiss cheese), tubular, solid, and de-differentiated
IHC CD43+ and CD117+
Giemsa – metachromatic staining myxoid material

130
Q

adenoid cystic pattern with best prognosis

A

tubular

131
Q

adenoid cystic pattern and location with worst prognosis

A

solid

mx sinus and subMD gland

132
Q

most common malignancy of subMD salivary gland

A

adenoid cystic carcinoma

133
Q

polymorphous low grade adenocarcinoma location

A

almost exclusively minor salivary glands of palate

134
Q

polymoprhous low grade adenocarcinoma IHC (helps to distinguish from?)

A

weak CD43, CD117 (strong in adenoid cystic) and GFAP (strong in PA)

135
Q

epithelial-myoepithelial carcinoma histo, variants

A

biphasic:
inner layer epithelial cells; outer layer myoepithelial (clear cells)

variants: oncocytic, double clear

136
Q

epithelial-myoepithelial carcinoma locations

A

60-80% parotid

remaining in sub-MD, sinonasal tract, minor

137
Q

epithelial-myoepithelial carcinoma IHC

A

inner cells: AE1/3 and CAM5.2
outer: PAS, SMA, calponin, p63+ (p63 is best – participates in epidermal-mesenchymal interactions during embryonic development)

138
Q

hyalinizing clear cell carcinoma histo and IHC

A

low-grade, monomorphic, glycogen rich (PAS+, diastase sensitive) carcinoma
dense fibrous stroma around chords/nests/sheets/trabeculae of tumor cells
myoepithelial markers negative

139
Q

low-grade, monomorphic, glycogen rich (PAS+, diastase sensitive) carcinoma; negative myoepithelial markers

A

hyalinizing clear cell carcinoma

140
Q

salivary duct carcinoma histo, location

A
aggressive adenocarcinoma ( similar to high grade breast ductal carcinoma)
comedonecrosis in ducts; Roman bridge formation

most in parotid
90% are high grade

141
Q

comedonecrosis in ducts; Roman bridge formation

A

salivary duct carcinoma

142
Q

sebaceous carcinoma aka; age

A

lymphadenocarcinoma (malignant of sebaceous lymphadenoma – RAREST (6 cases))

30s and 80s

143
Q

lymphadenocarcinoma aka; age

A

sebaceous carcinoma (malignant of sebaceous lymphadenoma – RAREST (6 cases))

30s and 80s

144
Q

mammary analogue secretory carcinoma histo

A

macro and microcysts; secretion in cysts PAS+
prominent hobnailing
cells with granular pink vacuolated cytoplasm

145
Q

macro and microcysts; secretion in cysts PAS+
prominent hobnailing
cells with granular pink vacuolated cytoplasm

in salivary

A

mammary analogue secretory carcinoma

146
Q

mammary analogue secretory carcinoma IHC and genetics

A

IHC: vimentin, S100+
FISH: ETV6-NTRK3

147
Q

ETV6-NTRK3

A

mammary analogue secretory carcinoma

148
Q

mucinous adenocarcinoma aka and histo

A

colloid carcinoma

epithelial clusters with large pools of extracellular mucin

149
Q

epithelial clusters with large pools of extracellular mucin in salivary

A

mucinous adenocarcinoma

150
Q

mucinous adenocarcinoma IHC

A

CD20+
breast colloid carcinoma markers?

CK7 neg, CDX2 neg, TTF1 neg

151
Q

salivary gland aplasia syndromes

A

mandibulofacial dysostosis (treacher collins); hemifacial microsomia; lacrimo-auriculo-dento-digital syndrome (LADD)

152
Q

LADD syndrome genetics and clinical

A

Lacrimo-auriculo-dento-digital (LADD) syndrome

AD / FGF10
Aplasia or hypoplasia of SG, LG
Cup shaped ears
Hearing loss
Dental and digital anomalies
153
Q

plunging (cervical) ranula what happens, where

sublingual looks like?

A

mucin dissects through mylohyoid muscle
 Sublingual space known as “tail sign”
 Lateral to midline (vs dermoid cyst )

154
Q

tail sign in ranulas

A

plunging ranula

Sublingual space known as “tail sign”

155
Q

Most common inflammatory salivary gland disorder in children in the states; what happens to it

A

Juvenile recurrent parotitis; regresses at puberty

156
Q

salivary gland inflammation in teenagers /young adults

where and what happens to it

A

Subacute necrotizing sialadenitis:

Resolves in 2 weeks
 Hard and soft palate

157
Q

inflammation of minor salivary glands of lower lip

A

cheilitis glandularis

158
Q

types of cheilitis galndularis

A
  1. Simple
  2. Superficial suppurative (Baelz disease)
  3. Deep suppurative (Cheilitis glandularis apostematosa)
159
Q

treatment of sialorrhea

A

Anti-emetic

Anti-cholinergic

160
Q

sialorrhea underlying conditions

A

Rabies , metal poisoning, meds (cholinergic agonist / clozapine), acid from GERD, dentures

161
Q

super salivation of unknown cause (2-5 min /short episodes)

A

Idiopathic paroxysmal sialorrhea:

162
Q

Idiopathic paroxysmal sialorrhea:

A

super salivation of unknown cause (2-5 min /short episodes)

163
Q

IgG4 disease IgG4 levels

A

Normal IgG4 levels = 8-40 mg/l / IgG4 disease 25 x > than normal levels of IgG

164
Q

mikulicz aphthae

A

minor aphthous ulcers

165
Q

mikulicz disease vs mikulicz syndrome

A
disease = SG + LG swelling
syndrome = that but due to TB, sarcoid, lymphoma
166
Q

locations for IgG4 disease

A

Pancreas > H&N ( submandibular)

167
Q

Location for IgG-4 sialadenitis and special name

A

submandibular glands - Kuttner tumor

168
Q

complications of IgG4 disease

A

 Abdominal aortitis
 Inflammatory pseudo tumors of the kidney
 Thyroid inflammation ( Riedel thyroiditis )
 lymphadenopathy

169
Q

Kuttner tumor what is and histo

A

IgG4 sclerosing sialadenitis of submandibular gland
 hyperplastic lymphoid follicle
 acinar atrophy

170
Q

clerosing sialadenitis of submandibular gland
 hyperplastic lymphoid follicle
 acinar atrophy

eval for what

A

Kuttner tumor, eval for IgG4 disease

171
Q

malignancy in Sjogrens

A

Higher risk for MALT; Lymphoma extra nodal marginal zone B-cell lymphoma (20 X)

172
Q

dry eyes in sjogrens special name

A

keratoconjunctivitis sicca

173
Q

fruit laden branchless tree

A

Sjogren punctate sialectasia

174
Q

what kind of dz is sjogren

A

autoimmune

175
Q

special autoantibodies in Sjogrens and how often

A

 SS-A (50-70%) SS-B ( 30-60%)

176
Q

Sjogrens with other autoimmune, how often?

A

 15% RA

 30 % SLE

177
Q

Sjogrens criteria

A

Patient must have at last 2 of the 3

1) + Anti-Ro ( SS-A) and /or Anti-La (SS-B) antigen or + RF and ANA titer ≥ 1:320
2) ≥ 1 focus / 4mm3
3) Keratoconjuctiva sicca with ocular score ≥ 3

178
Q

pleomorphic adenoma genetics

A

PLGA1 gene

179
Q

PLGA1 gene

A

pleomorphic adenoma

180
Q

Warthin tumor aka

A

Papillary cystadenoma lymphomatosum

181
Q

Papillary cystadenoma lymphomatosum aka

A

Warthin tumor

182
Q

Niesse-Nicholson rests:

A

SG tissue trapped within LN seen in oncocytic change of Warthin tumor

183
Q

SG tissue trapped within LN seen in oncocytic change of Warthin tumor

A

Niesse-Nicholson rests:

184
Q

which basal cell adenoma is associated with hereditary disease

A

membranous basal cell adenoma:

eg Brooke Spiegler syndrome

185
Q

Brooke Spiegler syndrome

A

 Membranous BCAC
 Dermal Cylindroma
 Spiroadenoma
 Trichoepithelioma

186
Q

oncocytoma staining and what exactly

A

m/ch; PTAH

187
Q

mucoepidermoid carcinoma genetics

A

t(11:19) CRTC1-MAML2

188
Q

t(11:19)

A

CRTC1-MAML2 mucoepidermoid

189
Q

CRTC1-MAML2

A

t(11:19) mucoepidermoid

190
Q

special cells in acinic cell carcinoma

A

zymogen cells

191
Q

zymogen cells which salivary tumor

A

acinic cell carcinoma

192
Q

which mucoeps have better prognosis

A

with genetic mutation

193
Q

MASC translocation

A

t(12:15) ETV6-NTRK3

194
Q

t(12:15)

A

MASC ETV6-NTRK3

195
Q

ETV6-NTRK3

A

t(12:15) MASC

196
Q

causes of sialosis

A

non-inflammatory

1) Endocrine : DI, DM, pregnancy, acromegaly, hypothyroidism
2) Nutritional: Bulimia, anorexia, cirrhosis
3) Neurogenic : medication

197
Q

sialosis medical treatment

A

pilocarpine

198
Q

pleomorphic adenoma IHC

A

+ GFAP

199
Q

adenoid cystic IHC

A

+ CD117, CD43

200
Q

polymorphous low grade adenocarinoma IHC – ddx from what?

A

PLGA = - GFAP (vs PA), weak + CD117, CD43 (vs ACC)

201
Q

von ebner glands where

A

in tongue beneath circumvalate and foliate papillae

202
Q

minor glands in tongue beneath circumvalate and foliate papillae

A

von ebner

203
Q

blandin-nuhn glands

A

ventral tongue

204
Q

ventral tongue salivary glands

A

blandin-nuhn

205
Q

superficial mucoceles seen in what

A

lichen planus, lichenoid drig reactions, GVHD

206
Q

causes of sialadenitits

A

infections (viral-mumps, bacterial-staph aureus) and non-infections (Sjogrens, RT, sarcoid)

207
Q

schirmer’s test to confirm dry eyes measurement

A

<5mm

208
Q

test to confirm dry eyes

A

Schirmer’s, <5mm

209
Q

dye to show defects on ocular surface epithelium and for what

A

sjogrens dry eyes, rose bengal

210
Q

why is c/pl swollen in salivary oncocytoma

A

increased m/ch

211
Q

increased m/ch in cells which tumor

A

oncocytoma

212
Q

oncocytoma with stains

A

PAS+, diastase sensisitive glycogen

PTAH for m/ch

213
Q

oncocytosis aka

neoplastic?

A

multinodular oncocytic hyperplasia

non-neoplastic

214
Q

membranous basal cell adenoma, dermal cylindromas, trichoepitheliomas what is

A

Brooke-Spiegler syndrom

215
Q

most common subtype of basal cell adenoma

A

solid

216
Q

worst prognosis for basal cell adenoma which subtype

A

membranous, 30% recurrence

217
Q

types of ductal papillomas

A

sialadenoma papilliferum (papilloma-like); intraductal papilloma (submucosal swelling); inverted ductal papilloma (nodule)

218
Q

clinical look of intraductal papilloma

A

submucosal swelling

219
Q

clinical look of inverted ductal papilloma

A

nodule

220
Q

best prognosis location for mucoep

A

minor salivary glands

221
Q

adenoid cystic carcinoma IHC

A

CD43+ and CD117+

222
Q

worst histo type prognosis of adenoid cystic

A

solid

223
Q

worst location prognosis for adenoid cystic

A

mx sinus and subMD gland