Pathology Of Salivary Gland Tumours Flashcards
Why may there be changes in salivary gland size
Secretion obstruction
- mucocele
- duct obstruction
Chronic sialadenitis
Gland hyperplasia
- silosis
- sjogrens
Salivary neoplasms
Distribution %’s of salivary gland tumours?
80% parotid - 15% malignant
10% submandibular - 30% malignant
.5% sublingual - 80% malignant
10% minor glands - 45% malignant
Clinical features of major salivary gland tumour?
Lump in affected gland
- asymmetry
- obstruction of gland duct
- pain
- facial palsy (late sign)
Clinical features of minor salivary gland tumour?
Junction of hard / soft palate
Upper lip / cheek
Late ulceration
How take biopsy of salivary gland tumour to test?
Ultrasound guided fine needle aspirate
Core biopsy
Incisional biopsy
Why may there be an issue in making a diagnosis of salivary gland tumour?
Variation in tumour as tissues originate from different stem cell lines
Common features shared between tumours
Not all tumours fit classification
What is pleomorphic adenoma?
75% of all salivary gland tumours
- most common parotid
Slow growth
Varied histology with different cell appearances and variable capsule
Issues with pleomorphic adenoma?
Recurrence - it is multifocal
Progression to carcinoma - 5%
What is warthin’s tumour
15% of tumours, mostly in parotid
- occasionally bilateral
- treated by incision
- related to smoking - most pts smokers
What is adenoid cystic carcinoma?
5% of salivary gland tumours
- mainly minor glands
Varies patterned
- cribiform - Swiss cheese
- tubular / solid
Local spread
- nerves and bone
Difficult to treat with high recurrence
- poor long term prognosis @ 20 years
Late metastasis
- by blood to Lung
Histology pleomorphic adenoma?
Duct epithelium
Myoepithelial cells
Myxoid and chondroid areas
Capsule variable
Histology warthins tumour?
Cystic and cystic spaces
Distinctive epithelium
Lymphoid tissue
What is acinic cell carcinoma?
Rare carcinoma
Varied histology and behaviour
Mostly in parotid gland
What is polymorphous adenocarcinoma?
Minor glands in the palate
Locally infiltrative to nerves
Histology of adenoid cystic carcinoma?
Cribiform / Swiss cheese like
Cystic spaces
Malignant cells
