Path Salivary Gland Disease self study

Question 1

Sialadenitis

Answer 1

inflammation of salivary glands (many etiologies)

Question 2

Frequent infectious agent in sialadenitis

Answer 2

staph aureus

Question 3

bacterial sialadenitis (location, signs)

Answer 3

parotid glands, painful & swollen, purulent discharge drains from duct

Question 4

chronic sialadenitis cause

Answer 4

sialolith

episodic pain & swelling, usually at meals

Question 5

Kuttner tumor

Answer 5

chronic sialadenitis involving submandibular gland, persistent enlargement

Question 6

salivary gland tumors:
common?
most common location
benign or malignant?

Answer 6

uncommon (7% heent tumors)
80% involve parotid
70% benign. The smaller the gland, the more likely malignant

Question 7

Submandibular gland frequency

Answer 7

11% of salivary gland tumors, 45% malignant

Question 8

sublingual gland

Answer 8

rare, 90% malignant

Question 9

Pleomorphic adenoma

gross, epidemiology

Answer 9

benign mixed tumor
most common type of salivary gland tumor (50%)
Mixture of 2 germ layers.
more common in females (60%)
middle aged (50)
slow growing painless, moveable, firm mass

Question 10

pleomorphic adenoma (histology)

Answer 10

encapsulated
epithelial component in ductal/cystic formations
myoepithelial cells in myxoid or chondroid matrix

Question 11

Tx of pleomorphic adenoma

Answer 11

surg. low recurrence. CN-VII posible damage

Question 12

Warthin’s tumor (gross, epidemiology)

Answer 12

papillary cystadenoma lymphomatosum

2nd most common, 60% males, age 60, smoking
slow groing painless mass. firm or fluctuant in tail of parotid. 17% bilateral

Generally not actually neoplastic. Polyclonal. Low recurrence rate

Question 13

Warthin’s tumor histology (histology)

Answer 13

1 cystic spaces lined by double layer of oncocytes (epithelial cells with granular eosinophilic cytoplasm)

2 prominent lymphoid stroma (german centers possible)

Question 14

Mucoepidermoid carcinoma (gross, epidemiology)

Answer 14

uncommon (15%)
most common malignant tumor of salivary gland
highly variable behavior
middle age, slightly more females

parotid and minor glands of palate
Asymptomatic swelling. Sometimes interosseous

Question 15

Mucoepidermoid carcinoma (histology)

Answer 15

mix of mucous and squamous cells. mucicarmine stain can show mucus.

grade important in prognosis

Question 16

survival rates in high and low mucoepidermoid carcinoma

tx

Answer 16

high grade: 50%
low grade: 90%

radiation post-op. variable outcome; younger patients fare better.