Non-Neoplastic Salivary Gland Disease Flashcards
Which glands are major salivary glands?
Parotid
Submandibular
Sublingual
What glads are minor salivary glands?
Throughout the mouth e.g on palate and lips
Where is partoid gland and what type of saliva?
Preauricular
Serous secretions
How much saliva does parotid contribute?
20-40%
What type of saliva does submandibular gland produce?
Mixed - mucous and serous
How much saliva does submandibular gland contribute?
60-70%
Where is sublingual gland and what type of saliva?
Located floor of mouth
Mucous secretion
Which major salivary gland is biggest?
Parotid
What saliva do minor salivary glands produce?
Mucus
Exception of mucus producing minor salivary gland?
Serous gland of von ebner - posterior-lateral of tongue
What are 3 types of non-neoplastic lesions?
Developmental
Inflammatory
Obstructive/ trauma
Example of developmental non-neoplastic lesion?
Stafne bone cavity
What is stafne bone cavity
Heterotropic salivary tissue - push into mandible = indentation
How does starfne bone cavity present?
Unilocular, corticated well defined radiolucency at angle of mandible
Always under ID canal
Example inflammatory non-neoplastic disease?
Sialodenitis - can be chronic or acute
Example of acute sialodenoitis
Bacterial
Viral
Examples chronic sialodenitis?
Bacterial
Post-irradiation
Sjogrens
Example of bacterial sialodenitis?
Acute parotitis
What is acute parotitis?
Ascending infection - travel from mouth into parotid duct then gland
Causes actue swelling and pain
Pus exudes from duct
What cause acute parotitis?
Oral bacteria e.g staph aurus
How does recurrent parotitis vary in children and adults?
Adults - recurrent to dry mouth
Children - recurrent from childhood
How does recurrent parotitis present in adults?
40-60 yrs F>M Unilateral Secondary xerostomia : sjogrens, drug-induced, radiattion damage Ascending infection
How does recurrent parotits present in children?
up to 15yrs M = F Bilateral No obvious cause/ predisposing factors Suddent onset Weeks duration w/ periods of quiescence Not suppurative
How does reccurent parotitis in children present sialogram?
Snow storm appearnace
Punctate sialectasis - gradular destruction acinar elements = reduced flow
What see in histology of recurrent parotitis?
Non-specific
Dilation of epithelial lines salivary ducts w/ prominent fibrosis around duct (replace salivary tissue)
Acini and duct damaged
Blue dots = lymphocytes
Most common type of viral sialodenitis?
Mumps
What causes mumps?
Mumps virus = paramyxovirus
How does mumps presnet clinically?
Acute bilateral parotid swelling
Pain, fever and malaise
Can spread to other glands/organs
How long does mumps last?
Self limiting 10-14 days
Incubation period 2-3 wweeks
Complications of mumops?
Orchitis
Meningitis
Oophoritis
Pancreitis
What is chronic sialodenitis usually secondary to?
Duct obstruction - often due calculi
When does radiation sialodentitis occur?
Doses over 20Gy
High risk above 30Gy
Severe damage 50Gy
What types of acini are most sensitive to radiation?
Serous
What does radiation sialodenitis cause?
Inflammation and fibrosis of glands = loss of function
What is salivary calculi?
Accumulation of calcium and phosphate salts which deposit in salivary duct/ gland
Where is most common gland for salivary calculi?
Submandibular gland
Why is most common gland for calculi submandibular gland?
Only major gland pushing saliva up against gravity - ascending duct
Duct - bend (mylohyoid) can cause obstruction
How does salivary calculus present on radiograph?
Opaque
What does obstruction of calculi cause?
Obstruction –> saliva retnetion –> inflammation –> fibrosis –> loss of function –> further swelling and fibrosis
What see histology of salivary calculi?
Fibrosis and inflammation
Destruction of architecture
Loss acini
Examples of non-neoplastic disease caused by obstruction/ trauma?
Salivary calculi
Mucous cysts
Necrotising sialometaplasia
Types of mucoceles?
Mucous retention
Mucous extravasation
Where is most common site of mucocele?
Lower tip - most common site for trauma
How do mucoceles present?
Usually in children
Painless swellings - rupture and recur
What is most common mucoele?
Mucous extravasation
What is mucous extravasation cyst?
Caused by ruptured duct - mucous spills into adjacent connective tissue
Histology of mucous extravasation cyst?
Lining of fibrous and granulation tissue
Lumen of cyst filled w/ mucous
Macrophage filled with mucous
No epithelial lining
Where is most common to see mucous retention cyst?
Floor of mouth/ buccal mucosa
Often older age groups
What cause mucous retention cyst?
Blocked duct - collection mucous
No ruptured duct
What see histology mucous retention cyst?
Blocked duct - duct dilation
Lumen filled with mucous
Lined w/ ductal epithelium
Cyst wall - fibrous tissue w/ glands
What is a ranula?
Mucocele in the floor of the mouth - arise from sublingual gland
How does necrotising sialometaplasia present?
Indurated, ulcerated swelling, often on palate - often mistaken for malignancy
What is necrotising sialometaplasia?
Benign inflammatory disease
What histology of necrotising sialometaplasia?
Squamous metaplasia of salivary ducts - islands of epithelium deep connective tissue
Necrosis of acini