Pathology of Salivary Gland Tumours

Question 1

name four examples of why salivary glands may change in size

Answer 1

secretion retention - mucocele
chronic sialadenitis
sjogren’s syndrome
salivary neoplasms

Question 2

how do salivary gland neoplasias present to patients

Answer 2

painless
slow growing
well defined

Question 3

name three possible aetiologies of salivary gland tumours

Answer 3

radiation
viruses
racial susceptibilities

Question 4

name the two categories of epithelial neoplasms

Answer 4

benign - adenoma
malignant - adenocarcinoma

Question 5

name two categories of non-epithelial neoplasms

Answer 5

lymphoma
sarcoma

Question 6

name three clinical features of tumours in major salivary glands

Answer 6

asymmetry (lump)
obstruction
pain, facial palsy

Question 7

name the different techniques for taking a biopsy of a swelling

Answer 7

fine needle aspirate (only small amount of tissue collected)
core biopsy (larger amount of tissue recorded)
incisional biopsy (may require more than one depending on the tumour)

Question 8

name four problems when diagnosing salivary gland tumours

Answer 8

number of tumour type
common features between types
not all tumours fit the classification
immunohistochemistry may be required to differentiate

Question 9

what does NOS stand for

Answer 9

not otherwise specified - we just do not know what type of tumour it is

Question 10

what is the most common salivary gland tumour

Answer 10

pleomorphic adenoma

Question 11

describe a pleomorphic adenoma

Answer 11

slow growth
varied histology
capsule variable

Question 12

where is pleomorphic adenomas most common

Answer 12

parotid

Question 13

what is a common feature of most benign tumours

Answer 13

they are encapsulated

Question 14

what is the follow up regime for a pleomorphic adenoma

Answer 14

5 years

Question 15

what is the treatment of pleomorphic adenoma

Answer 15

wide local excision

Question 16

what are the two main problems of pleomorphic adenomas

Answer 16

recurrence
progression to carcinoma (rare)

Question 17

what is a malignant pleomorphic adenoma tumour called

Answer 17

malignant ex-pleomorphic adenoma

Question 18

what is Warthin’s tumour

Answer 18

adenolymphoma - related to smoking

Question 19

where is Warthin’s tumour most commonly found

Answer 19

parotid gland
can occur bilaterally

Question 20

what are the distinctive features of Warthin’s tumour

Answer 20

cystic spaces lined with epithelium
connective tissue capsule on outside
lymphoid cells present

Question 21

how is Warthin’s tumour treated

Answer 21

excision

Question 22

where are salivary gland carcinomas most commonly found

Answer 22

minor glands

Question 23

what is adenoid cystic carcinoma

Answer 23

salivary gland carcinoma that is very difficult to eradicate

Question 24

why is adenoid cystic carcinoma difficult to treat

Answer 24

grows along nerves (perineural infiltration)
late spread metastases by blood

Question 25

what is mucoepidermoid carcinoma

Answer 25

2 cell types present histologically (squamous and glandular)
can be cystic or solid

Question 26

what may cause cyst formation/ mucus formation in the jaw bones

Answer 26

odontogenic epithelium in the jaw bones

Question 27

where is acinic cell carcinoma usually found

Answer 27

parotid

Question 28

where is polymorphous adenocarcinoma usually found

Answer 28

minor glands in the palate