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Oral Pathology > Chapter 11 > Flashcards

Chapter 11 Flashcards

1
Q

What does a non-neoplastic growth mean?

A

Meaning that the growth is limited.

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2
Q

What is the term for spillage of mucin into the soft tissue due to rupture of a salivary gland duct, usually caused by trauma?

A

Mucocele.

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3
Q

Where is the most common site for a mucocele?

A

Lower lip (81%), FOM, Anterior ventral tongue, buccal mucosa.

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4
Q

What is the treatment for a mucocele?

A

Sugrical excision with removal of the adjacent minor salivary gland.

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5
Q

What are mucoceles of the upper lip most likely to be?

A

Salivary gland tumor.

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6
Q

Mucoceles of the retromolar region are usually Dx as what?

A

Mucoepidermoid carcinoma.

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7
Q

What is the likely Dx?

A

Mucocele.

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8
Q

What is the term for a mucocele that is in the floor of the mouth, usually lateral to the midline and much larger in size?

A

Ranula. NOTE that is often has to come out with sublingual gland.

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9
Q

What is the term for a ranula that has passed through the mylohyoid muscle?

A

Plunging ranula.

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10
Q

What is the likely Dx?

A

Ranula.

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11
Q

What is the term for an epithelium-lined cavity that arises from salivary gland tissue?

In what population will it mostly occur?

A

Salivary duct cyst AKA mucus retention cyst.

Adults.

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12
Q

Where is the most common location for a salivary duct cyst to occur?

A

Parotid gland, FOM, Buccal mucosa, lips.

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13
Q

What is the likely Dx?

A

Salivary duct cyst.

NOTE this will usually appear bluish and would not have a history of recurrance.

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14
Q

What is the likely Dx of a mass on the hard palate?

A

Salivary gland neoplasm.

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15
Q

What is the term for calcifications developed in the salivary duct?

A

Sialolith and chronic is sialolithiasis.

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16
Q

Where do sialoliths usually occur?

A

Submandibular gland, upper lip, and buccal mucosa.

They will happen most often in the submandibular gland because of the long and tortuous duct that has thick, slow-flowing saliva.

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17
Q

What is the treatment for a sialolith?

A

Gentle message, increase fluid intake, moist heat, sialagogue, surgery.

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18
Q

What are some of the things that may predispose someone to development of sialoliths?

A

Mucous plug, bacterial colonies, chronic duct blockage, xerostomia.

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19
Q

What is the term for inflammation of the salivary gland?

What is it caused by?

A

Sialadenitis.

Infection: Viral mumps, bacterial. Non-infectious: Sjogren syndrome, sarcoidosis glanulomatous inflammation, radiation.

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20
Q

A paramyxovirus infection primarly affecting the salivary glands is called what?

A

Mumps or epidemic parotitis.

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21
Q

What are the three presentations of sjogrens syndrome?

A

Lack of salivary secretions, lack of lacrimal secretions and arthritis.

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22
Q

What are the complications of mumps?

A

Epididymoorchitis, oophpritis, mastitis.

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23
Q

What is the term for non-inflammatory, asymptomatic salivary gland enlargement?

Where does it usually occur and why?

A

Sialadenosis.
Will usually occur in the parotid gland due to hypertrophy of acini that is uaually bilateral and slow evolving.

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24
Q

What is the likely Dx?

A

Sialadenosis.

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25
Q

What is a localized, sessile, painless swelling that mimics a neoplasm of the minor salivary glands?

A

Adenomatoid hyperplasia of the minor salivary glands.

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26
Q

What is the term for a locally destructive inflammatory condition of the salivary glands?

A

Necrotizing sialometaplasia.

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27
Q

What is the cause of necrotizing sialometaplasia and what are the predisposing factors?

A

Caused by ischemia and predisposing factors are traumatic injuries, dental injections, ill-fitting dentures, tumors.

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28
Q

What is the likely Dx?

A

Necrotizing sialometaplasia.

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29
Q

What are the underlying systemic conditions of sialadenosis?

A

Endocrine disorders: Diabetes, hypothyroidism, pregnancy.

Malnutrition: Alcoholism, bulimia, anorexia

Drugs: Anti-hypertensive drugs and psychotropic drugs.

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30
Q

What is the definition for anaplasia, prosoplasia, and metaplasia?

A

Anaplasia: Reverting back in lineage to original stem cell.

Prosoplasia: Progresses futher to more differentiated cell than originally programmed.

Metaplasia: Abnormal change in condition of tissue.

31
Q

What is a swelling and eversion of the lower lip as a result of hypertrophy and inflammation of the minor salivary glands?

A

Cheilitis glandularis.

32
Q

What is the likely Dx?

A

Cheilitis glandularis.

33
Q

What are the causes of cheilitis glandularis?

A

Cause is not exactly known, possibly due to sun damage, tobacco, syphilis, or poor hygeine.

34
Q

What is the definition of excessive salivation?

A

Sialorrhea.

35
Q

What are some of the causes of sialorrhea?

A

GERD, rabies, heavy metal poisoning, cholinergic agents.

36
Q

How do you treat sialorrhea?

A

Anticholinergic agents.

37
Q

What percent of older adults experience xerostomia?

A

25%

38
Q

What are some of the complications of xerostomia?

A

Candidiasis, cervical root caires, alteration of taste, angular cheilitis, fissured tongue.

39
Q

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

A

Sjogren’s syndrome.

40
Q

What is the difference between primary and secondary sjogren’s syndrome?

A

Primary is there are no onther autoimmune diseases, secondary is when it is associated with other autoimmune diseases.

41
Q

What is the diagnostic criteria for primary Sjogren’s?

A

Must have 2 out of the following 3:

1- Positive serum anti-SSA and/or anti-SSB

2- Ocular staining score equal to or greater than 3.

3- Presence of focal lymphocytic sialadenitis with a focus score of greater than or equal to 1 focus for every 4mm2 in labial salivary glands.

42
Q

What are two sialogauges that can be used for sjogren’s?

A

Pilocarpine and cevimeline.

43
Q

What is the incidence rate of salivary neoplasms?

A

4 cases/100,000 people.

44
Q

Where are the most common sites of salivary neoplasms?

A

Parotid gland(70%), minor glands(9-23%), sublingual(<1%).

45
Q

Where is the most common site for MINOR salivary gland neoplasm?

A

Palate.

46
Q

For major salivary glands, what is the benign vs malignant occurance rates?

A

Parotid: 70% & 30%.

Submand: 60% and 40%.

Subling: 30% and 70%.

47
Q

For minor salivary glands, what is the occurance rate of benign vs malignant?

A

Minor gland: 50/50

Upper lip: 80/20

Lower lip: 40/60

Palate: 50/50

Tongue: 15/85

Cheek: 50/50

Retromolar pad: 10/90

48
Q

REVIEW CARD FOR SALIVARY GLAND NEOPLASMS

A

More common in upper lip than lower.

Upper lip are mostly benign, mostly malignant in lower.

Salivary gland neoplasms in retromolar area mostly malignant.

Most common neoplasm is pleomorphic adenoma.

Most common malignant neoplasm is mucoepidermoid carcinoma.

49
Q

What are the benign neoplasms covered in lecture?

A

Canalicular adenoma, pleomorphic adenoma, warthin tumor, oncocytoma.

50
Q

The following image is most likely from what type of neoplasm?

A

Canalicular adenoma.

51
Q

What are the locations for canalicular adenoma?

A

Upper lip(75%), buccal mucosa, exclusively in minor glands.

52
Q

What are the age guidelines for upper lip location of pleomorphic adenoma vs canalicular adenoma?

A

If patient is younger than 50 than it will likely be a pleomorphic adenoma, if they are over 60, it will likely be canalicular adenoma.

53
Q

What is the most common salivary neopplasm?

A

Pleomorphic adenoma.

54
Q

What causes the granular cytoplasm of ococytes?

A

Excessive accumulation of mitochondria.

55
Q

What is the second most common benign parotid tumor?

What are both the names given?

A

Warthin’s Tumor

Papillary Cystadenoma Lyphomatosum.

56
Q

What is the risk to smokers with Warthin’s Tumor?

A

8x greater risk.

57
Q

What are the malignant salivary neoplasms covered in class?

A

Mucoepidermoid carcinoma, acinic cell adenocarcinoma, adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, malignant mixed tumor.

58
Q

What is the most common malignant salivary neoplasm, and the most common malignant salivary gland tumor in children?

A

Mucoepidermoid carcinoma.

59
Q

How is the treatment and prognosis of mucoepidermoid carcinoma decided?

A

Treatment decided by clinical stagin and prognosis decided by the grade and staging.

60
Q

What are the survival rates between low grade and high grade mucoepidermoid carcinomas?

A

Low grade is 90-95% survival while high grade is 30-54%.

61
Q

How does and intraosseous mucoepidermoid Carcinoma form?

A

Ectopic salivary gland tissue that was developmentally entrapped within the jaw.

62
Q

What is the likely Dx?

A

Pleomorphic adenoma.

63
Q

What is the likely Dx?

A

Warthin tumor.

64
Q

What is the likely Dx?

A

Mucoepidermoid carcinoma.

65
Q

What is the second most common malignant salivary gland carcinoma in adults and children?

Where is the most common site of occurance?

A

Acinic cell adenocarcinoma.

Parotid is more common site followed by minor salivary glands.

66
Q

What is the likely Dx?

A

Intraosseous mucoepidermoid carcinoma.

67
Q

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

A

Adenoid cystic carcinoma.

68
Q

What is the likely Dx?

Hint: look at the location

A

Acinic Cell Adenocarcinoma.

most common site is parotid gland.

69
Q

What type of carcinoma has a tendancy for perineural spread?

A

Adenoid cystic carcinoma.

70
Q

What is the 5 and 20 year survival rates for adenoid cystic carcinoma?

A

5 yr is 70% and 20 yr is 20%.

71
Q

What is the type of malignant carcinoma that occurs almost exclusively in the minor saliary glands with most cases in the hard and soft palate?

A

polymorphous low-grade adenocarcinoma.

72
Q

What is a neoplasm that has both Carcinomatous and sarcomatous components )Epithelial which is carcinoma and mesenchymal which is sarcoma)?

A

Carcinosarcoma.

73
Q

What are the three types of malignant mixed tumors?

A

Carcinoma ex pleomorphic adenoma.

Carcinosarcoma.

Metastasizing mixed tumor.

74
Q

What is the type of malignant mixed tumor that is most common in major glands and is malignant transformation of epithelial cells?

A

Carcinoma ex pleomorphic adenoma.

Oral Pathology (17 decks)

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