pathology of salivary gland neoplasms Flashcards
What are some examples of benign neoplasms of the salivary glands?
pleomorphic adenoma
monomorphic adenoma
warthin’s tumour (adenolymphoma)
oncocytoma
What is a pleomorphic adenoma?
well-circumscribed tumour characterised microscopically by its heterogeneous appearance with clearly recognisable epithelial and myoepithelial cells intermingled with areas of mucoid, myxoid or chondroid appearance
may recur due to small outgrowths protruding through the capsule which are left behind if excision is inadequate
What are monomorphic adenomas?
tumour in which the epithelium forms a very regular usually glandular pattern and in which there is either no or minimal mesenchyme like tissue (that is characteristic of pleomorphic)
histological classification dependent upon growth and/or cellular composition e.g. warithin’s tumour or oncocytoma
What is a warthin’s tumour?
benign tumour formed of glandular and often cystic structures, sometimes with papillary cystic structure lined by characteristic eosinophilic epithelium
stoma contains variable amount of reactive lymphoid tissue with lymphoid follicles
usually occurs in older men often smokers and may be multiple and bilateral
What are oncocytomas?
tumours consisting of large cells with eosinophilic cytoplasm
very little stroma and although lymphocytes may be present lymphoid follicles are not seen
What are examples of malignant neoplasms of the salivary glands?
muco-epidermoid carcinoma acinic cell carcinoma adenoid cystic carcinoma adenocarcinoma squamous cell carcinoma squamous cell carcinoma undifferentiated carcinoma carcinoma ex-pleomorphic adenoma metastatic tumours = malignant melanoma, squamous cell carcinoma connective tissue tumours = haemangioma, lipoma
What are muco-epidermoid carcinomas?
tumour characterised by the presence of squamous cells, mucus secreting cells and cells of intermediate type
may be high or low grade and spread locally and may metastasise
What are acinic cell carcinomas?
tumour consisting of cells similar to the serous cells of salivary glands
round or polyhedral tumour cells are arranged in sheets or acini and generally have a basophilic granular cytoplasm
clear tumour cells may be present and even predominate
may spread locally and occasionally metastasise after a prolonged interval
What are adenoid cystic carcinoma?
infiltrative tumour which has a characteristic cribiform appearance, typically with conspicuous basement membrane deposits/hyaline droplets
two types of tumour cells = duct lining cells and cells of myoepithelial type
arranged as small duct like structures or large masses of myoepithelial cells around cystic spaces giving cribriform appearance
tends to infiltrate along nerves
slow growing but difficult to eradicate due to +ve resection margins
What are adenocarinoma of salivary glands like?
tumour not otherwise specified that shows some tubule or papillary/glandular formation
What are undifferentiated carcinomas of salivary glands like?
tumour of epithelial structure that is too poorly differentiated to be placed in any other group
What are carcinoma ex-pleomorphic adenomas of salivary glands like?
tumour showing definite evidence of malignancy such as invasive growth and cytological change appropriate to carcinoma and in which areas characteristic of pleomorphic adenoma or effete fibro-sclerotic remnants thereof can still be found
What are squamous cell carcinoma of salivary glands like?
tumour containing cells forming keratin or having intercellular prickles - mucus secretion is not present
What are mumps?
commonest acute inflammatory lesion of the salivary glands - main symptom is bilateral painful swelling of the parotid glands - sometimes submandibular glands may be involved
may also be orchitis, oophoritis, pancreatitis, or meningitis
What is acute suppurative parotitis?
due to infection which pyogenic cocci and occurs as a post-operative complication in dehydrated patients or elderly, debilitated patients
