Diseases of Salivary Glands Flashcards
what are the major salivary glands
- parotid
- submandibular
- sublingual
what are the minor salivary glands
- palate
- buccal mucosa
- tongue
- floor of mouth
- labial mucosa
- retromolar pad
- oropharynx
what glands make up the parotid gland
100% serous
what do serous glands contain
zymogen granules
what type of gland is the submandibular galnd
serous and mucous but more serous
what type of gland is the sublingual gland
serous and mucous but more mucous
what is the distribution of minor salivary glands
- palate - 60%
- tongue - 10%
- lips - 10%
- cheeks - 10%
- retromolar -10%
what are the minor salivary glands of the tongue
- glands of von ebner
- glands of blandin and nuhn
- glands of weber
where are the glands of von ebner located and what type of gland is it
- circumvalate papillae
- serous
where are the glands of blandin and nuhn located and what type of gland is it
anterior ventral
- mucous
where are the glands of weber located and what type of gland is it
posterior lateral border
- mucous
what is a mucocele
disruption in ductal system and gets stuck in soft tissue
what are mucoceles caused by
trauma
what does a mucocele feel like on palapation
fluid
what is a mucocele also known as
mucous extravasation reaction
what can superficial mucoceles on the palate be confused with
chronic disorders that form multiple bullas
what is a ranula
mucocel associated with the sublingual gland
what is a plunging ranula
mucin dissects through mylohyoid muscle presenting as a neck mass
what is a sialolith
salivary stone
how does a salivary stone occur
mucin gets trapped in duct and becomes calcified and normal salivary flow gets blocked
where is a sialolith most common and why
whartons duct because of the bends and turns
what does a sialolith feel like on palpation
hard
what is the best radiograph to take to see a sialolith
occlusal
how does necrotizing sialometaplasia appear
- on palate
- often bilateral
- ulcerating
- unknown etiology
what is the histo of necrotizing sialometaplasia
- pseudoepitheliomatous hyperplasia
- sialometaplasia
- coagulative necrosis of the glands
describe sjogren syndrom
- autoimmune disorder
- dry mouth and dry eyes
- bilateral enlargement of parotid gland
what is primary sjogren syndrom
no other autoimmune diseases
what lab values dx sjogrens
- anti-SS- A (anti-Ro)
- anti-SS-B (anti-La)
- RF
- ANA
what glands does sjogrens affect
major but effects are mimicked in minor glands too
what do you look for in the histo of sjogrens
lymphoid aggregates
what is the tumor distribution of parotid gland
- benign 50%
- malignant 50%wha
what is the tumor distribution of submandibular gland
- benign 40%
- malignant 60%
what is the tumor distribution of sublingual gland
- benign 20%
- malignant 80%
what is the tumor distribution of the palate
benign 50%
malignant 50%
what is the tumor distribution of the buccal mucosa
benign 50%
malignant 50%
what is the tumor disribution of the upper labial mucosa
- benign 80%
- malignant 20%
what is the tumor distribution of the lower labial mucosa
- benign 15%
- malignant 85%
what is the tumor distribution of the tongue
up to 90% malignant
what is the tumor distribution of the floor of the mouth
up to 90% malignant
what is the tumor distribution of the retromolar pad
up to 90% malignant
what is the growth rate induration, symtomatology, and ulceration of benign tumors
- slow growth
- movable
- asymptomatic
- intact mucosa
what is the growth rate, induration, symtomatology, ulceration of malignant tumors
- rapid growth
- fixed
- symptomatic
- ulcerated
what are the benign salivary gland tumors
-bengin mixed tumor (pleomorphic adenoma)
- monomorphic adenoma
- warthin’s tumor (papillary cystadenoma lymphomatosum)
- oncocytoma
- ductal papillomas
describe pleomorphic adenoma and who is it common in
- most common salivary gland neoplasm
- benign
- middle aged females
- painless slow growing mass
what is the histo for pleomorphic adenoma
- variable
- mixture of ductal and myoepithelial elements
- encapsulated
describe monomorphic adenoma and who is affects
- benign
- tumor with prediliction for upper lip
- middle aged females
- painless slow growing mass
what is the histo for monomorphic adenoma
- uniform pattern
- single layered cords of columnar or cuboidal epithelium
- may demonstrate papillary projections
- loose CT stroma, with prominent vascularity
- thin fibrous capsuel
describe papillary cystadenoma lymphomatosum
- benign
- 2nd most common benign salivary gland neoplasm
- parotid gland
- bilateral
- middle aged males - lower in blakcs
- smoking
- painless slowly growing nodular mass
what is the only salivary gland tumor with smoking etiology
papillary cystadenoma lymphomatosum
what is the histo for papillary cystadenoma lymphomatosum
- oncocytic ductal epithelium - uniform double rows
- lymphoid aggregate
- papillary cystic configuration
describe oncocytoma
- benign
- rare salivary gland neoplasm
- large epithelial cells, oncocytes
- females- 8th decade
- parotid
- painless slow growing mass- multifocal
what is the histo for oncocytoma
- large polyhedral cells abundant in granular eosinophilic cytoplasm- mitochondria
- limited stroma- thin fibrovascular septa
- lymphoid infiltrate
what are the malignant tumors of salivary glands
- mucoepidermoid carcinoma
- adenoid cystic carcinoma
- polymorphous low grade adenocarcinoma
- acinic cell carcinoma
- carcinoma ex- mixede tumor
- adenocarcinoma NOS
describe mucoepidermoid carcinoma
- most common malignant salivary gland neoplasm
- middle aged females
what is a mucoepidermoid carcinoma clinically mistaken for
mucocele
what is the histo for mucoepidermoid carcinoma
- mucous producing cell s
- epidermoid cells (squamous cells)
- may be cystic or solid
what are high grade mucoepidermoid carcinomas confused for histologically and how do you tell difference
squamous cell carcinoma
- look for mucocele and that is the high grade mucoepidermois carcinoma
describe adenoid cystic carcinoma
- best recognized salivary gland tumor
- middle aged females
- slowly, growing mass and painful
what is the histo for adenoid cystic carcinoma
- myoepithelial and ductal cells
- perineural and perivascular invasion
- cribriform pattern
- SWISS CHEESE pattern
what is the prognosis for adeoid cystic carcinoma and why
- poor
- because of perineural and perivascular invasion
describe polymorphous low grade adenocarcinoma
- common malignant minor salivary gland neoplasm
- middle aged females
- favors palate
where are mucoepidermoid carcinomas likely to be
on retromolar pad
what is the histo for polymorphous low grade adenocarcinoma
- deceptive uniform apperance
- different growth patterns
- perineural and perivascular invasion
- indian filing
what is the prognosis for polymorphous low grade adenocarcinoma
relatively good
describe acinic cell carcinoma
- parotid
- serous acinar differentiation
- middle aged females
- slow growing
- low grade malignancy
what is the histo for acinic cell carcinoma
- well circumscribed
- may be infiltrative
- serous acinar cell with abundant granular basophilic cytoplasm and a round, stained eccentric nucleus
describe carcinoma ex-pleomorphic adenoma
- long standing pleomorphic adenoma
- older adults
- rapid growth
- pain and ulceration
what is the histo for carcinoma ex-pleomorphic adenoma
- typical benign mixed tumor
- malignant degeneration - cellular pleomorphism , abnormal mitotic activity, capsular invasion
describe adenocarcinoma NOS
- uncommon salivary gland neoplasm because usually we cant categorize it
- middle aged females
what is the histo for adenocarcinoma NOS
variable
