Chapter 16- Salivary Glands Flashcards
What is xerostomia
Dry mouth from a decrease in the production of saliva
How does xerostomia present
Dry mucosa
Atrophy of the tongue papillae with fissuring and ulcerations
Patients with xerostonia present with higher rates of what
- Dental caries
- Cadidiasis
- difficulty swallowing and speaking
What is the most common type of inflammatory salivary gland lesion
Mucoceles
What is the most common type of viral sialadenitis
Mumps, which affects the parotid
What is the cause of mucocele
Lesion of the salivary gland from blockage or rupture of the salivary gland duct, leading to leakage into the connective tissue stroma
What is the most common cause of mucoceles
Trauma, usually on the lower lip
What is the clinical presentation of mucocele
- Swelling of the lower lip with a blue tint to it
- Changes in size of the lesion, especially with meals
Histologically, what are mucoceles composed of
- Psedocysts which have cyst spaces lined inflammatory granulation tissue/connective tissue
- Spaces filled with mucin and macrophages
What is the treatment of the mucocele
Excision of the cyst along with the accompanying minor salivary gland
What is the it called when there is an epithelial lined cyst that has arisen due to damage to the sublingual duct
Randal
What is the term used for when there is a cyst that has dissected the connective tissue and has connected the two bellies of the myohyloid bellies
Plunging ranula
What are the common bacterial causes non-specific sialadenitis, and what is the common duct affected
Submandibular gland blocked by stones, usually as a result of S. Aureus or Sptrept viridans
Patients under which treatment can commonly develop decreased secretory function
Phenothiazines
Which patients are at an increased risk of developing bacterial suppurative parotitis
Elderly patients with recent major thoracic or abdominal surgery and are dehydrated
What is the rule for bilateral versus unilateral in obstructive or inflammatory of glands
Unilateral is the rule
Most neoplasms of the salivary glands arise in which location
Parotid gland
How common are neoplasms of the salivary glands
Not very common at all
What is the relationship between the size of the salivary gland and the risk for a neoplasm
The smaller the gland is, the more likely it is to develop a neoplasm (parotid is the lowest, sublingual the highest)
Which patient population is more likely to develop Warthin tumors
Males (higher risk of smoking, which predisposes)
What will be the prevention of all parotid neoplasms
Distinctive swelling in front of and below the ear
What are the cells the make up the pleomorphic adenomas
Mixture of ductal cells (epithelial) and myoepithelial cells (mesenchymal)
What is the most common tumor in the parotid gland and what is its prevalence in other glands
Pleomorphic adenoma, rarely found in any other than the parotid gland
What is known to increase the risk for a pleomorphic adenine
Radiation exposure
What is the chromosomal rearrangement that is commonly associated with the formation of pleomorphic adenomas
PLAG1
What is the prognosis of pleomorphic adenomas
Benign tumor
What is the histological features of the pleomorphic adenomas
Resemble ductal cells or myoepithelial cells arrange in a ductal formation
In most cases of pleomorphic adenomas, what is there no evidence of
- No epithelial dysplasia
- No mitotic activity
How will a pleomorphic adenoma present to the clinic
-Painless, slow growing, mobile, discrete masses within the parotid or submandibular areas or buccal cavity
What is the prognosis of a pleomorphic adenoma becomes a mixed malignant tumor
Not good, as it is one of the most invasive salivary tumors
What is the location that the papillary cystadenoma lymphomatosum usually arises in
Parotid gland
What is the patient group that the papillary cystadenoma lymphomatosum will arise in
Male smokers
Which condition is histologically known to contain a granular appearance of the cytoplasm of the upper layer of cells due large number of mitochondria
Aka oncytic cell see in Warthin tumors
Which cells are included in mucoepidermoid carcinoma
Mixture of squamous cells, mucus secreting cells, and intermediate cells
Which condition is associated with the translocation (11;19)(q21;p13)
Mucoepidermoid carcinoma
What is the condition associated with MECT1/MAML2 fusion genes
Mucoepidermoid carcinoma
What is the most common form of primary malignant tumor of the salivary glands
Mucoepidermoid carcinoma
Which pathway is affected by the MECT1 and MAML2 fusion gene
CAMP and Notch
What is the histological pattern seen in mucoepidermoid carcinomas
- Lack well defined capsules and infiltrating at the margins
- Contain mucin filled cysts
- Cords/sheets of squamous, mucous, and intermediate cells
What is the common location that adenoid system carcinoma is found
50% in the minor salivary glands, especially the palatine glands
What salivary gland tumor has reports of invading the nose, sinuses and upper airways, or the cribriform plate aka perineural spaces
Adenoid cystic carcinoma
Which form of adenoid cystic carcinoma have a poorer prognosis than others
Minor salivary glands have a worse prognosis when compared to parotid glands
