Pathology of salivary gland Flashcards
The inflammation of the salivary glands is known as what?
Sialadenitis
Salivary gland stones
Sialolithiasis
The infection (Acute bacterial parotitis) if the formation of what?
Calcus formaion in the submandibular gland.
The acute bacterial parotitis affect which age group
Young to middle-aged adults
Main symptoms of acute bacterial parotitis
Pain and swelling beneath the jaw
what worsen the symptoms of acute bacterial parotitis
Symptoms appear, or worsen, before and during eating
what is sialolithiasis?
Salivary duct obstruction by stones (Usually idiopathic)
What are causes of sialadenitis?
o Trauma: usually manifests as a mucocele (fluctuant bluish swelling) resulting from either blockage or rupture of a salivary gland duct with mucus extravasation
o Viral infections: especially mumps
o Bacterial infections: non-specific bacterial sialadenitis is usually caused by infection with S.aureus and Streptococcus viridans following sialolithiasis
o Autoimmune disease
One word
The autoimmune disorder characterised by destruction of lacrimal and salivary glanss resulting in inability to produce tears and saliva, commonly seen in females.
Sjogren syndrome
The primary diseases of sjogren syndrome is called what?
SICCA Syndrome
explain how the sjogren syndrome occurs
Its occurs secondary to other autoimmune disorders e.g rheumatoid arthritis
Presence of which antibodies is asscociated with sjogren syndrome
Presence of anti-ribonucleoprotein antibodies like SS-A (Ro) and SS-B (La)
Presence or SS-A (Ro) is associated with?
Early disease onset, longer disease duration and extra glandular manifestations, e.g. cutaneous vasculitis and nephritis
Clinical features of sjogren sydrome
Clinical features
Dry mouth (xerostomia)
Dry eyes (keratoconjunctivitis sicca), due to lymphocytic infiltration and destruction of the lacrimal gland..
Patients with Sjogren syndrome have an increased risk of developing lymphoid malignancies.
Where do neaoplasm of salivary glands arises?
65-80% of all salivary gland neoplasms arise in parotid, 10% in submandibular gland and rest in the minor salivary glands
Which tumours of are benign and maligannt in salivary glands
Majority of parotid tumours are benign, while higher proportions of submandibular and minor salivary gland tumours are malignant
Most common form of benign salivary gland tumpurs are?
Pleomorphic adenoma and warthin tumpur
Most common malignant tumours of salivary galns are?
Mucoepidermoid carcinoma
what is pleomorphic adenoma (Mixed tumours)?
Most common salivary gland neoplasm (Parotid gland»submandibular»Minor salivary glands)
Tje pleomorphic adenoma consists of what?
Consists of a mixture of ductal (epithelilal) and myoepithelial cells within a chondromyxoid or fibrous (mesenchymal) stroma, associated with PLAG1 or HMGA2 alterations
what are clinical features of pleomorphic adenoma?
Usually presents as painless slow-growing mobile discrete mass
Does the pleomorphic adenoma recur?
May recur, low rate of malignant tranformation (increases with age of lesion)
Explain the gross appearance of pleomorphic adenoma?
Circumscribed lobulated mass with tan, white, translucent or gelatinous cut surface
Name the tumour that consists of oncocytic epithelial cells lining ductal, papillary and cystic structures associated witha lymphoid rich stroma
Warthin tumour
Explain the clinical features of warthin tumour?
40-60yo M>F, particulary in smokers.
is warthin tumour recur?
Rarely recurs unless incompletetly excised
Gross appearance of warthin tumour
usually unifocal but can be multifocal/bilateral. well circumscibed round to oval mass with pale gray surface and cystic/cleft-like spaces +/- papillary projections filled with mucinous secretions
The microscopic appearance of the warthin tumour looking at the example
Papillary cystadenoma lymphomatosum, microscopic Papillary fronds project into cystic to cleftlike spaces filled with pale pink mucinous to serous secretions. The papillary fronds are covered by a double layer of pink (oncocytic) cuboidal to columnar epithelium
The most common primary malignant tumpur of salivary glans (mostly in parotid glands)
Mucoepidermoid carcinoma
The mucoepidermoid carcinoma consists of what?
Consists of mucous, intermediate and epidermoid (squamous) epithelium cells forming solid and cystic areas.
The mucepidermoid carcinoma is assocted with what?
MAML2 gene rearrangement
List the clinical fearures of mucoepidermoid carcinoma
Wide age range include children
The prognosis of mucoepidermoid carcinoma
depends on hostologic grade
The gross appearance of mucoepidermoid carcinoma
Pale gray-white firm to soft solid tumours +/- cystic areas, may appear circumscribed or infilrative
Where does Adenoid cystic carcinoma occur?
Approximately half occur in the minor salivary glands, can also occur in sites outside of the salivary glands e.g, nose, upper airways, lung, breast
The adenoid cystic carcinoma consits of what?
Consists of basaloid cells forming tubular, solid or cribriform growth patterns with basophilic or hyaline matrix/basement membrane material
The adenoid cystic carcunoms is associated with what?
Associated with MYB, MYBL1 or NFIB reaarangement
What are clinical features of adenoid cystic carcinoma
Usually older patients. Tends to be slow-growing but can have rapid course in the presence of high grade transformation. Frequent perineurial invasion
The gross appearance od adenoid cystic carcinoma
Poorly circumscribed tan-gray/whte firm solid mass
