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Oral Pathology, Stephen > ch 11 Salivary Gland Pathology > Flashcards

ch 11 Salivary Gland Pathology Flashcards

1
Q

Parotid gives watery or thicker saliva

A

Watery (serrous)

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2
Q

Common lesion of the oral mucosa from rupture of salivary gland duct and spillage of mucin into surrounding soft tissue, lower lip 60%, can be fluctuant to firm

A

Mucocelle

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3
Q

Mucocele on the floor of the mouth that will appear bluish

A

Ranula

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4
Q

Epithelium-lined cavity that arises from salivary gland tissue that can be mistaken for ranula if in floor of mouth

A

Salivary duct cyst/mucous retention cyst

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5
Q

Treatment for mucocele, ranula, or salivary duct cyst

A

Surgical excision w/adjacent gland or marsupialization

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6
Q

A ranula can be on the midline, what other pathology can cross the midline

A

epidermoid cyst

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7
Q

This is a ranula that occurs when the spilled mucin dissects the mylohyoid

A

plunging ranula

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8
Q

How would a hemangioma look, feel different from a ranula

A

hemangioma more pebbly and irregular

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9
Q

Calcified structures that develop within the salivary ductal system, common in the submandibular gland because of its tortuous route and its more sebaceous excretions

A

Sialolithiasis

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10
Q

Common duct for Sialolithiasis

A

Wharton’s duct

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11
Q

inflammation of the salivary glands

A

Sialadenitis

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12
Q

What is reactive obstructive diseases

A

pain w/ salivation, obstructive means there’ s an obstruction, reactive means it’s not a neoplasm

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13
Q

What are non-infectious causes of Sialadenitis

A

Sjogrens syndrome, Sarcoidosis (granuloma disease), radiation therapy

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14
Q

Acute Sialadenitis character

A

Common in parotid w/ swelling and erythema

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15
Q

Chronic sialadenitis of submandibualr gland can lead to what persistent enlargement

A

Kuttner tumor

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16
Q

This form of sialadenitis occurs most commonly in teens and young adults

A

Subacute Necrotizing Sialadenitis

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17
Q

How differentiate sialadenitis from salivary gland tumore

A

Sialdenitis will have pain

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18
Q

Treatment of acute sialadenitis

A

Antibiotics and rehydration

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19
Q

rare inflammatory condition of minor glands causing lower lip swelling and subsequent eversion caused by hypertrophy and inflammation. Common in middle aged to older men

A

Cheilitis Glandularis

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20
Q

3 levels of Cheilitis Glandularis

A

Simple
Superficial Supurative (Baeltz’s Disease)
Deep supurative

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21
Q

Superficial supurative Cheilitis Glandularis and Deep Supurative Cheilitis Glandularis have what involvement and symptoms

A

Bacterial involvement w/ inflammation, swelling, suppuration, ulceration

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22
Q

Treatment for Cheilitis Glandularis

A

Vermillionectomy (lip shave)

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23
Q

Excess Salivation

A

Sialorrhea

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24
Q

Episodes of excess salivation for 2-5 min associated with prodrome of nausea and epigastric pain

A

Idiopathic Paroxysmal Sialorrhea

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25
Q

Treatments for Sailorrhea

A

anticholinergics

Transdermal scopolamine Surgery if muscular involvement GERD meds if a factor

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26
Q

Subjective sensation of dry mouth

A

Xerostomia

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27
Q

First, Second, and Third leading cause of Xerostomia

A

Drugs

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28
Q

What’s the anti rule for xerostomia

A

if it’s an anti drug (e.g. antidepressant) it causes xerostomia

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29
Q

Treatments for Xerostomia

A

Biotene
Prevident 5000
Pilocarpine 5 mg tabs

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30
Q

What infection is seen with Xerostomia

A

candidiasis

Cervical and root caries

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31
Q

This is a cause of Xerostomia that is normally a unilateral swelling of the parotid gland

A

Benign lymphoepithelial lesion

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32
Q

What is the characteristic histo associated with Benign Lymphepithelial Lesion

A

epimyoepithelial islands

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33
Q

Chronic, systemic autoimmune disease that principally involves the salivary and lacrimal glands resulting in xerostomia, xeropthalmia (dry eyes)

A

Sjogren Syndrome

34
Q

What is dry eyes and dry mouth without another autoimmune disorder called

A

Sicca syndrome (primary Sjogren)

35
Q

Xeropthalmia of Sjogren Syndrome called

A

eratoconjunctivitis sicca

36
Q

Secondary Sjogren Syndrome means what

A

There’s another autoimmune component

37
Q

What is the other autoimmune component commonly associated with Sjogren Syndrome

A

Rheumatoid Arthritis

38
Q

Gender predilection of Sjogren Syndrome

A

Women (80-90%), middle aged

39
Q

Symptoms associated with Sjogren syndrome or any xerostomia

A 
red tender oral mucosa
Angular cheilitis
Candidiasis
Cervical Decay
Difficulty swallowing
Altered taste
Retrograde bacterial sialadenitis
40
Q

Sialographic look or Sjogren syndrome

A

Fruit laden branchless tree

41
Q

What is the tear test for Sjogren Syndrome

A

Schirmer test (<5mm tears for 5 min = Keratoconjuctivitis sicca)

42
Q

noninflammatory disorder characterized by salivary gland enlargement, especially parotid, usually do to some underlying systemic problem

A

Sialadenosis/Sialosis

43
Q

Systemic conditions associated with Sialadenosis

A

Diabetes melitis Malnutrition
Alcoholism
Bulimia

44
Q

Locally destructive inflammatory condition of salivary glands caused by ischemia that leads to local infarction. The problem is it mimics a malignant process clinically and microscopically

A

Necrotizing Sialometaplasia

45
Q

What is one way to differentiate Necrotizing Sialometaplasia from Oral Cancer

A

Cleaner borders around the lesion (cancer has ragged borders)

46
Q

Where is Necrotizing Sialometaplasia commonly found

A

Palate salivary glands (squamous cell carcinoma rare on palate)

47
Q

Treatment for Necrotizing Sialometaplasia

A

Biopsy and no treatment, will resolve in 5-6 weeks

48
Q

Most common site for salivary gland tumors

A

Parotid gland

49
Q

What is the most common parotid gland tumor

A

Pleomorphic Adenoma

50
Q

What gland tumor has the highest rate of malignancy

A

Sublingual

51
Q

Benign vs Malignant for Salivary Gland tumors

A

Parotid: 80% benign, 20% malignant Submand/palatal/Buccal: 50/50
Sublingual: 20% Benign, 80% malignant Upper lip glands: 80% benign, 20% malignant Lower lip glands: 20% benign, 80% malignant

52
Q

Most common site for minor salivary gland tumors

53
Q

Common location for Pleomorphic adenoma

A

Superficial lobe parotid with swelling over ramus in front of ear

54
Q

What is the exception about the Pleomorphic Adenoma

A

exception where tumor is immobile, but benign

55
Q

What is the radiographic character of the Pleomorphic Adenoma

A

regular circumscribed border (malignant would have no clear border or moth eaten)

56
Q

Treatment of Pleomorphic Adenoma

A

Surgical excision, 95% cure

57
Q

Tumor that is exclusive to Parotid Gland

A

Warthin Tumor

58
Q

Character of Warthin Tumor

A

Huge male predilection
Does not occur in minor salivary glands Smokers at huge risk
Parotid only

59
Q

What is the histology associated with the Warthin Tumor

A

double row of oncocytes with adjacent lymphoid stroma

60
Q

Where does the Warhtin tumor grow

A

Tail of parotid near angle of the mandible

61
Q

Monomorphic adenoma found almost exclusively in the minor glands of the upper lip

A

Canalicular adenoma

62
Q

Treatment for canalicular adenoma

A

Surgical excision

63
Q

Difference between a Warthin tumor and an Oncocytoma (benign salivary gland tumor in 8th decade)

A

no lymphoid stroma around the double row of oncocytes

64
Q

3 most common malignant salivary gland tumors

A

mucoepidermoid carcinoma Adenoid cystic carcinoma

Low Grade carcinoma

65
Q

Most common malignant salivary gland neoplasm

A

mucoepidermoid carcinoma

66
Q

Most common salivary gland tumor in childre

A

mucoepidermoid carcinoma

67
Q

What gland is the Mucoepidermoid carcinoma common in

68
Q

Where is the second most common site for Mucoepirdermoid carcinoma

A

minor glands of palate

69
Q

If there is a lesion, not tooth related, that is elevated on the palate, what is it until proven otherwise

A

salivary gland tumor

70
Q

Histo of mucoepidermoid carcinoma

A

mucous producing cells and epidermoid cells

71
Q

Mucoepidermoid carcinoma is the salivary gland tumor that most commonly

A

goes into bone

72
Q

The higher the grade tumor of Mucoepidermoid carcinoma

A

the less prominent the cyst and the fewer mucous cells

73
Q

Low grade mucoepidermoid carcinoma treatment

A

surgical resection with modest margin of surrounding normal tissue w/ good prognosis. Hige grade requires more resection and possible radiation with a more guarded prognosis.

74
Q

Slow growing mass with pain early in the swelling common in minor salivary glands, meaning most common on palate

A

Adenoid Cystic Carcinoma

75
Q

Most important clinical feature of Adenoid Cystic Carcinoma

A

Perineural invasion

76
Q

What is the classic histology of Adenoid Cystic Carcinoma (Good exam question and picture)

A

Swiss cheese or cylinder look

77
Q

Surgical consideration of Adenoid Cystic Carcinoma

A

relentless, hard to get rid of, doesn’t kill you quickly. Surgery w/ adjunct radiation

78
Q

Where does Adenoid Cystic Carcinoma metastasize to

A

Lungs and bones

79
Q

This is the third most common malignant salivary gland tumor and is exclusive to the minor salivary glands (which means itm most commonly occurs on the palate)

A

Polymorphous Low Grade Adenocarcinoma

80
Q

2 malignant salivary gland tumors we should be able to identify histologically

A

Mucoepidermoid (mucous and epidermal cells) Adenoid Cystic Carcinoma (Swiss cheese look)

81
Q

How is Polymorphous Low Grade Adenocarcinoma like Adenoid Cystic Carcinoma

A

both have perineural invasion, but polymorphous low grade adenocarcinoma perineural invasion does not affect prognosis

82
Q

Treatment for Polymorphous Low-Grade Adenocarcinoma

A

Wide surgical resection with good prognosis

Oral Pathology, Stephen (13 decks)

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