Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral candidiasis > 20. Neoplastic salivary gland disease > Flashcards

20. Neoplastic salivary gland disease Flashcards

1
Q

What are the 5 malignant salivary gland tumours?

A

Mucoepidermoid carcinoma
Acinic cell carcinoma
Adenoid cystic carcinoma
Carcinoma ex pleomorphic adenoma
Polymorphous low grade adenocarcinoma

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

Where does mucoepidermoid carcinoma affect most?

A

Commonest SG tumour
Parotid and palate

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

What are the features of mucoepidermoid carcinoma?

A

Poorly circumscribed
Invasive
Cystic formation cell
3 cell types

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

What is the first cell type of mucoepidermoid carcinoma?

A

Squamous/epidermoid cells- intercellular bridges, keratinisation very rare, solid or cystic

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

What is the second cell type in mucoepidermoid carcinoma?

A

Mucous producing cells- PAS staining, solid or cystic, cuboidal or columnar goblet like, cyst might break down inducing a granulomatous reaction

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

What is the third cell in mucoepidermoid carcinoma?

A

Small, dark stained nuclei

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

What is low grade mucoepidermoid carcinoma?

A

Survival 5 years- 90%
More than 50% mucous cells
Cystic spaces
More circumscribed

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

What is high grade mucoepidermoid carcinoma?

A

5 year survival is 70%
More squamous and intermediate cells, necrosis and haemorrhage

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

Where does acinic cell carcinoma affect most?

A

Low grade tumour
80% affects parotid

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

What type of cells do acinic cell carcinoma contain?

A

Shows some cytological differentiation towards acinar cells, but a wide range of histological patterns.
Solid, microcystic, papillary-cystic, follicular

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

What is the histology of acinic cell carcinoma?

A

Sheets groups of large polygonal acinar cells
Granular cytoplasms- PAS positive
Vacuolated cells
Intercalated duct like cells
Lymphoid infiltrate in the stroma

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

What is the survival rate of acinar cell carcinoma?

A

Well differentiated- 80 to 100%
Poorly differentiated- 65%

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

Where does adenoid cystic carcinoma affect most?

A

Middle age/elderly patients
More common in minor salivary glands

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

What are the symptoms of adenoid cystic carcinoma?

A

Slow enlarging
Pain
Ulceration
Facial palsy in parotid

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

What are the 3 histological patterns of adenoid cystic carcinoma?

A

Cribriform- swiss cheese, basement membrane like material
Tubular- surrounded by desmoplastic stroma
Solid

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

What are the cell types in adenoid cystic carcinoma?

A

Duct lining cells- small, basophilic forming pseudo/cysts
Myoepithelial cells

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

Where can adenoid cystic carcinoma invade into?

A

Perineural and perivascular invasion without stromal reaction
In bone it spreads via marrow spaces
Recurrence is common

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

What is the survival rate of adenoid cystic carcinoma?

A

Survival 5 years- 75%
10-40%
20-20%

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

Which type of adenoid cystic carcinoma has the most perineural invasion?

A

Solid tumour type
Has large nests of cells with high nuclear to cytoplasm ratio

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

What can be used to stain in adenoid cystic carcinoma?

A

Alcian blue- highlights the pseudocystic glycosaminoglycan material

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

Where is carcinoma ex pleomorphic adenoma mostly found?

A

Arises from pleomorphic adenoma from mostly parotid which have been present a long time
They turn into adenocarcinoma or undifferentiated carcinoma

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

When is carcinoma ex pleomorphic adenoma mostly found?

A

Peak of incidence is 10 years later than peak for pleomorphic adenoma

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

Where can carcinoma ex-pleomorphic adenoma metastastise to?

A

Lymph nodes
Lungs
Bone

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

What is the prognosis of carcinoma ex pleomorphic adenoma like?

A

If still inside the capsule of pleomorphic adenoma then it is good prognosis, otherwise poor

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

Where is polymorphous low grade adenocarcinoma mostly found?

A

Almost exclusively in minor SG in palate

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

What are the growth patterns of polymorphous low grade adenocarcinoma?

A

Trabecular
Cribriform
Papillary
Lobular

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

What is the histology of polymorphous low grade adenocarcinoma?

A

Concentric neurotropism
Mucinosis in the stroma
Encasement of benign residual salivary glands

28
Q

What is the differential diagnosis for polymorphous low grade carcinoma?

A

Adenoid cystic carcinoma- hyperchromatic nuclei, more infiltrative
Pleomorphic adenoma- myochondroid/chondroid stroma

29
Q

What is the prognosis of polymorphous low grade adenocarcinoma?

A

Prognosis is somewhat unpredictable- not as low grade as other low grade tumours

30
Q

What is adenocarcinoma NOS?

A

Tumours that do not fit into recognised types
Usually in parotid

31
Q

What are the characteristics of adenocarcinoma NOS?

A

Infiltrating neoplasms, showing some glandular or ductal structures

32
Q

How are adenocarcinoma NOS graded?

A

Graded according to duct number and epithelial atypia.
Few ducts and solid is high grade

33
Q

Which major salivary glands are most commonly affected by tumours?

A

Parotid-90%
Submandibular-10%
Sublingual almost never

34
Q

Which minor salivary glands are most commonly affected?

A

Palate-55%
Upper lip-20%
Lower lip-rare
Other parts-15%

35
Q

Where does pleomorphic adenoma affect most?

A

Parotid- 60-65%
Minor-45%

36
Q

What are the symptoms of pleomorphic adenoma?

A

Slow growing
Painless
Rubbery swelling

37
Q

What is the lining of pleomorphic adenoma?

A

May be encapsulated, or incompletely
This means they can form intra or extracapsular nodules so excise through surgical margin, not through cleavage plane

38
Q

What is the histology of pleomorphic adenoma?

A
  1. Varied epithelial and stromal patterns
  2. Epithelial and myoepithelial cells form sheets, strands and ducts in a myxoid/mucoid chondroid or fibrous stroma
  3. Plamacytoid pattern
  4. Squamous metaplasia
  5. May have stromal hyalinisation
39
Q

Which types of pleomorphic adenoma are more likely to recur or transform?

A

Solid ones more likely to transform
Myxoid neoplasms more likely to recur

40
Q

What is myoepithelioma?

A

A rare benign tumour of myoepithelial cells
50 years- women

41
Q

Where does myoepithelioma affect most?

A

Minor salivary glands- primarily palate
Can affect parotid and occasionally submandibular

42
Q

What is the histology of myoepithelioma?

A

Solid
Spindle cells
Epithelioid cells and clear cells
Plasmacytoid pattern
No ductal structures
S100 protein positive

43
Q

What does a plasmacytoid pattern look like?

A

Eccentric nuclei
Abundant eosinophilic cytoplasm

44
Q

What are the 4 types of myoepithelioma?

A

Plasmacytoid
Spindle
Recticular- ribbons of ME cells
Clear- uniform sheets of cells

45
Q

Where is a Warthin tumour found?

A

Almost always in parotid
Between 60 and 70
80% multifocal- superficial parotidectomy
5-10%- bilateral or synchronous

46
Q

What is the histology of warthin tumour?

A
  1. Glandular
  2. Often multiple cystic structures (papillary)
  3. Lined by eosinophilic epithelium- 2 layers, cuboidal and columnar rich in abnormal mitochondria
  4. Stroma with lymphoid tissue
47
Q

What is the origin of warthin tumour?

A

Salivary duct epithelium entrapped in lymph nodes

48
Q

What does warthin tumour look similar to?

A

Cystadenoma but without the lymphoid elements

49
Q

What does the bilayer look like in warthins tumour?

A

Columnar cells have hyperchromatic nuclei that is aligned towards the luminal aspect.
Cuboidal cells have vesicular nuclei

50
Q

Where are basal cell adenomas found?

A

70% parotid
20% upper lip

51
Q

What is the histology of basal cell adenoma?

A

Uniform
Prominent
Basaloid cells
Basement membrane like structure
No mucoid stroma

52
Q

What is the lining of basal cell adenoma?

A

They are encapsulated

53
Q

What can basal cell adenoma transform to?

A

Basal cell adenocarcinoma

54
Q

What is basal cell adenoma often seen with?

A

Other dermal tumours such as cylindroma, tricoepithelioma, eccrine spiradenoma- may be inherited predispostion

55
Q

What are the 4 patterns of basal cell adenoma?

A

Solid- basaloid cells with peripheral palisading
Trabecular- loose fibrous stroma
Tubular
Membranous- distinct hyaline band

56
Q

What can be used for immunohistochemistry in basal cell adenoma?

A

Keratin highlights inner luminal aspect
P63- basal cells
SMA- myoepithelial cells and BM zone
CD117 luminal cells

57
Q

Where does oncocytoma affect most?

A

Parotid
Over 60

58
Q

What can oncocytoma be confused with?

A

Oncocytic hyperplasia- ageing change- difficult to distinguish

59
Q

What is the histology of oncocytoma?

A
  1. Polyhedral faintly granular eosinophilic cells
  2. Small dark nuclei
  3. Oncocytes have small dark nuclei- centrally placed with or without nucleoli
60
Q

Where is canalicular found?

A

Almost all cases in upper lip

61
Q

What is the histology of canalicular adenoma?

A

Columnar epithelial cells arranged in anastomosing bi-layer strands- beading pattern
Loose, highly vascular stroma

62
Q

What is a ductal papilloma?

A

Rare tumour from excretory ducts

63
Q

What is the endophytic ductal papilloma like?

A

Inverted ductal papilloma
Cuboidal to columnar cells seen on luminal aspect
Scattered mucous cells
Microcyst formation

64
Q

What is exophytic ductal papilloma?

A

Intraductal papilloma
Luminal papillary proliferation
Fibrovascular cores
Microcysts

65
Q

What is endophytic and exophytic ductal papilloma?

A

Sialadenoma papilliferum
Surface papillary squamous proliferation
Papillary hyperplasia
Adenomatous proliferation
Cuboidal luminal cells with spindle nuclei

Oral candidiasis (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions