Pathology of Salivary Gland Tumours

Question 1

What causes changes in gland size?

Answer 1

Secretion retention (mucocele, duct obstruction)
Chronic sialadenitis
Gland hyperplasia (increase in size of the gland)
–sialosis
–sjogren’s syndrome
Salivary neoplasma
Inflammation in glands

Question 2

What are the diagnosis techniques used for salivary gland pathologies?

Answer 2

Ultrasound guided fine needle aspirate
Core biopsy
Incisional biopsy

Question 3

What is immunohistochemistry?

Answer 3

Use of special antibodies with dyes and have affinity for certain structures present within the cells, and produce a pattern which is of different colours and can identify what the structure is and aids diagnosis

Question 4

Pleomorphic adenoma
-commonality?
-growth?
-histology?
-capsule?

Answer 4

75% of all salivary tumours
Most common in parotid
Slow growth
Varied histology- mixed tumour
–duct epithelium
–myoepithelial cells (pushes saliva out of gland)
–Myxoid and chondroid areas
Capsule variable (may not be complete)

Question 5

What is the recurrence of pleomorphic adenoma?

Answer 5

High
At least 5 years of follow up is required
May contain a lot of loose myxoid tissue - esaily left behind
Can be multifocal, where more than 1 tumour occurs in the area

Question 6

What is the treatment of pleomorphic adenoma?

Answer 6

Wide local excision

Question 7

Warthrin’s Tumour
-commonality?
-growth?
-histology?
-capsule?

Answer 7

15% of tumours (most in the parotid)
Can be multifocal- more than one tumour developing
Histology
–cystic spaces (lined by 2 layers of pink epithelium)
–distinctive epithelium
–lymphoid tissue
–connective tissue capsule surrounding it

Question 8

How are Warthrin’s Tumours treated?

Answer 8

Excision
Simple to remove
Recurrence is low
Malignancy potential is low

Question 9

What are the 2 main types of salivary gland carcinomas?

Answer 9

Adenoid Cystic Carcinoma
Mucoepidermoid Carcinoma

Question 10

What are the symptoms of an adenoid cystic carcinoma?

Answer 10

Painless in the beginning but as it begins to spread (slow growing) becomes painful (dull, continuous pain)

Question 11

What are the 2 cell types involved in mucoepidermoid carcinomas?

Answer 11

Squamous (epidermoid)
Glandular (mucous)

Question 12

What type of spread can sometimes occur with mucoepidermoid carcinoma?

Answer 12

Intraosseous
Occurs from ectopic salivary gland tissue