ENT: Salivary Glands

Question 0

Describe the bicellular theory.

Answer 0

Hypothesis trying to explain the variety of pathology that occurs in the salivary gland stating that there is contribution of transformation in both the excretory duct and intercalated duct cells.
The excretory portion contributes to squamous cell carcinoma and mucoepidermoid carcinoma.

The intercalated portion contributes to Warthin’s Tumors

Question 1

Salivary gland that most commonly develops tumors.

Answer 1

Parotid

Question 2

Describe the multicellular theory.

Answer 2

Hypothesis trying to explain the variety of pathology that occurs in the salivary glands. It states that multiple portions of the glands contribute neoplasms due to differentiated cells within the salivary gland unit.

Question 3

What are some differences between parotid tumors and pleomorphic adenomas?

Answer 3

Parotid:
-painful, facial nerve paralysis or numbness, trismus

PA:
-painless, no facial nerve paralysis, recur often due to the many processes that extend and are often missed in surgical excision

Question 4

Treatment for a pleomorphic adenoma.

Answer 4

Superficial Parotidectomy with facial nerve preservation.

Question 5

Only neoplasm of salivary glands associated with tobacco and EtOH.

Answer 5

Warthin’s Tumor

Question 6

What are 2 unique characteristics of Warthin Tumors?

Answer 6

Aspiration of straw colored fluid

Epithelium is a double cell layer

Question 7

Treatment for a Warthin Tumor.

Answer 7

Superficial Parotidectomy with facial nerve preservation

Question 8

What is a unique histological characteristic seen in a biopsy of an oncocytoma?

Answer 8

Large number of mitochondria in the cytoplasm.

Question 9

Most common Parotid Malignancy.

Answer 9

Mucoepidermoid Carcinoma

Question 10

What differentiates a low grade mucoepidermoid carcinoma from a high grade on biopsy or Physical Exam?

Answer 10

Low Grade:

• mobile on palpation
• more mucous cells that epithelial cells on biopsy

High Grade:

• fixed to underlying tissues on palpation
• more epithelial cells than mucous cells on biopsy

Question 11

What are two characteristics unique to adenoid cystic carcinoma?

Answer 11

1. Perineural Invasion leading to facial weakness

2. Swiss Cheese pattern on biopsy

Question 12

Where do adenoid cystic carcinomas often spread?

Answer 12

Lungs