Salivary gland disease Flashcards
What is labeled A, B and C?
A - Striated ducts
B - Serous acini cells (purple)
C - Intercalated ducts
Parotid gland as mainly serous
What is circled in this image?
Mucous acini cells (paler blue)
Sublingual as mainly mucous
What are the major salivary glands found in the mouth and what cells do they contain?
Parotid - mainly serous
Submandibular - mixed mucous and serous
Sublingual - mainly mucous
What structure is labeled?
Serous demilune when a mucous cell displaces a serous cell
Submandibular gland as mixed cells
What virus causes mumps?
Paramyxovirus
What is the clinical presentation of mumps?
Early and later presentations
Early - fever & malaise
Later - painful swelling of one or more salivary glands (mainly bilateral parotid gland swelling)
How would serology results confirm a diagnosis of mumps?
IgM antibodies & rise in serum antibody titre to mump antigens
What is this image showing and what condition could this be?
Viral inclusions seen in the nucleus and cytoplasm of ductal epithelial cells
Viral sialadenitis with the infection being cytomegalovirus
What is Sarcoidosis?
Systemic Chronic Granulomatous disorder which may affect parotid & minor SGs
This is an image of sarcoidosis, what pathological features are consistent with this?
Non-necrotising granulomatous inflammation (no necrosis present)
What conditions are associated with sarcoidosis?
Leukopenia (low white blood cell count)
Hyperproteinaemia (High blood protein)
What is the managment of sarcoidosis?
Medications such as steroids, methotrexate, azathioprine
In many patients sarcoidosis can either remain stable or spontaneously resolves
What is tuberculosis?
How may it present?
Intra/peri-parotid lymph nodes become infected as a result of lymphatic drainage from an infection originating in the oral cavity or dissemination of pulmonary disease
Usually manifests as a painless, discrete, solid nodule in the gland and may be mistaken for a neoplasm
This is an image of tuberculosis, what pathological features are consistent with this?
Necrotising granulomatous inflammation as can be seen in the centre of the image
What is labelled on this image?
What condition is this?
Lymphocytic-rich focus
Sjogrens syndrome
Mixed cells so submandibular gland
What is IgG4-related sialadenitis?
How does this present?
AKA Kuttner Tumour
Systemic disease where IgG4 levels are elevated
Non-tender, firm, hard swelling of affected gland (often parotid)
Where should a patient presenting with IgG4-related sialadenitis be refered?
Submandibular gland involvement may be manifestation of IgG4-related systemic sclerosing disease, so pts diagnosed with Küttner tumour should be referred to immunologist to exclude an AI disorder & systemic disease
What is the treatment for IgG4-related sialdenitis?
Generally surgically excised
What is this how can you tell?
Pleomorphic adenoma
Can see parotid gland with purple serous cells, with well circumscribed neoplasm ontop of it.
There is also the presence of ductal structures containing mucin
What is this how can you tell?
Warthins tumour
(check picture)
What is this how can you tell?
Mucoepidermoid carcinoma
Presence of mucous cells (lower grade has more mucous cells)
What is this how can you tell?
Adenoid cystic carcinoma
Cribriform ‘swiss cheese’ pattern
What is this how can you tell?
Adenoid cystic carcinoma
Presence of nerve fibres this is called perineural spread
What is this how can you tell?
Acinic cell carcinoma
Random proliferation of acinar cells (purple looking cells)
