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GI 2 Pathology--Chapt 16 and 17 > Chapter 16--Salivary glands > Flashcards

Chapter 16--Salivary glands Flashcards

1
Q

Xerostomia–what is it? Cause?

A
  • dry mouth
  • due to lack of salivary secretions
  • incidence is as high as 70% of individuals over age 70
  • can occur in autoimmune inflammation and fibrosis (Sjogren syndrome) or may be complication of radiation therapy or a wide variation of pharmacologic agents
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2
Q

Presentation of xerostomia

A

-range from oral dryness to tongue fissuring and ulceration with papillary atrophy to concomitant inflammatory salivary gland enlargement (Sjogren syndrome)

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3
Q

Complications of xerostomia

A
  • increased caries
  • candidiasis
  • difficulties with swallowing and speaking
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4
Q

Inflammation of salivary gland is called? Causes?

A
  • Sialadentis

- may be traumatic, viral, bacterial or autoimmune (Sjogren syndrome)

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5
Q

Most common cause of viral sialadenitis

A

Mumps

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6
Q

2 common lesions of the salivary gland (causes of sialadentis)

A
  • Mucoceles

- Sialolithiasis

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7
Q

Mucoceles

A
  • Most common salivary gland lesion

- result from ductal blockage or rupture with saliva leakage into surrounding storm

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8
Q

Mucoceles–commonly occur where? result from?

A
  • Most often on lower lip
  • Typically result from trauma
  • Lesions fluctuate in size, especially in association with meals
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9
Q

Ranula

A

-specific mucocele of the sublingual gland

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10
Q

Sialolithiasis

A

-salivary gland ductal obstruction caused by stones (due to edema and/or impacted food debris)

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11
Q

Non-specific sialadentitis

A
  • painful salivary gland enlargement and purulent discharge

- typically follows ductal obstruction

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12
Q

In sialolithiasis, dehydration and decreased secretory function predispose to what?

A

-secondary infection by Staph aureus or strep viridans

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13
Q

Neoplasms of the salivary glands

A
  • 30 of them
  • Parotids account for 65-80%!!
  • 15-30% are malignant!!
  • 10% occur in submandibular glands (40% malignant)
  • remainder in minor salivary glands (70-90% malignant)
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14
Q

Benign tumors of the salivary glands incidences

A
  • Pleomorphic adenoma (50%)–mixed tumor
  • Warthin tumor (5-10%)
  • Oncocytoma (1%)
  • Other adenomas (5-10%)
  • Ductal papillomas
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15
Q

Malignant tumors of the salivary gland incidences

A
  • Mucoepidermoid carcinoma (15%)
  • Adenocarcinoma (NOS) (10%)
  • Acinic cell carcinoma (5%)
  • Malignant mixed tumor (3-5%)
  • SCC (1%)
  • Other carcinomas (2%)
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16
Q

Pleomorphic adenoma–what are they?

A
  • benign tumors exhibiting mixed epithelial and mesenchymal differentiation
  • constitute 60% of all parotid tumors and lesser percentages in other salivary glands
17
Q

Pleomorphic adenoma–characteristics and histology

A

-painless, slow-growing, mobile discrete masses with epithelial nests dispersed in a variable matrix of myxoid, hyaline, chondroid or osseous differentiation

18
Q

Recurrence rates and malignant transformation of pleomorphic adenoma

A
  • recurrence rate=25% if not well excised
  • Malignant transformation (usually as adenocarcinoma or undifferentiated carcinoma) occurs in 10% of tumors of >15 years duration
  • Malignant transformation associated with 30% to 50% 5-yr mortality
19
Q

Warthin Tumor

A
  • aka Papillary Cystadenoma Lymphomatous
  • benign tumor of unknown histogenesis
  • found exclusively in parotid!
  • 10% multifocal and 10% bilateral
20
Q

Warthin tumor found in what population??

A

-8x more common in smokers!!

21
Q

Wrathin tumor morphology?

A
  • well encapsulated

- consists of glandular spaces lined by a double layer of epithelial cells atop a dense lymphoid stroma

22
Q

Mucoepidermoid carcinoma

A
  • Most common primary malignant salivary tumor!!
  • up to 8cm!
  • lack well defined capsules
  • Histo: cords, sheets, or cystic arrangements of squamous, mucous or intermediate cells with mucous filled vacuoles
23
Q

Mucoepidermoid carcinoma–low vs. high grade tumors–recurrence and survival

A
  • Low grade tumors can invade locally with 15% recurrence rates
  • High grade tumors have 25% recurrence rates and 50% year survival rates
24
Q

Other salivary gland tumors–list (2)

A
  • Adenoid cystic carcinoma

- Acinic cell tumors

25
Q

Adenoid cystic carcinoma

A
  • uncommon
  • half occur in minor salivary glands
  • Histo: small cells with scant cytoplasm
  • arrayed in tubular or cribriform patterns with intercellular spaces filled with excess basement membrane like material
26
Q

Adenoid cystic carcinoma–recurrence, survival rates and invasiveness

A
  • slow growing but stubbornly recurrent and invasive, eventually becoming metastatic!
  • Fiver year survival rates=60-70%
27
Q

Acinic cell tumors

A
  • 2-3% of all salivary gland tumors
  • arise most commonly from parotid glands
  • Tumor cells resemble normal salivary serous acinar cells
28
Q

Acinic cell tumors clinical behavior

A
  • dependent on cellular pleomorphism

- 10-15% metastasize to lymph nodes and 5 year survival rate is 90%

GI 2 Pathology--Chapt 16 and 17 (14 decks)

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