Salivary gland disease Flashcards

1
Q

What is labeled A, B and C?

A

A - Striated ducts
B - Serous acini cells (purple)
C - Intercalated ducts

Parotid gland as mainly serous

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2
Q

What is circled in this image?

A

Mucous acini cells (paler blue)

Sublingual as mainly mucous

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3
Q

What are the major salivary glands found in the mouth and what cells do they contain?

A

Parotid - mainly serous
Submandibular - mixed mucous and serous
Sublingual - mainly mucous

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4
Q

What structure is labeled?

A

Serous demilune when a mucous cell displaces a serous cell

Submandibular gland as mixed cells

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5
Q

What virus causes mumps?

A

Paramyxovirus

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6
Q

What is the clinical presentation of mumps?

Early and later presentations

A

Early - fever & malaise
Later - painful swelling of one or more salivary glands (mainly bilateral parotid gland swelling)

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7
Q

How would serology results confirm a diagnosis of mumps?

A

IgM antibodies & rise in serum antibody titre to mump antigens

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8
Q

What is this image showing and what condition could this be?

A

Viral inclusions seen in the nucleus and cytoplasm of ductal epithelial cells

Viral sialadenitis with the infection being cytomegalovirus

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9
Q

What is Sarcoidosis?

A

Systemic Chronic Granulomatous disorder which may affect parotid & minor SGs

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10
Q

This is an image of sarcoidosis, what pathological features are consistent with this?

A

Non-necrotising granulomatous inflammation (no necrosis present)

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11
Q

What conditions are associated with sarcoidosis?

A

Leukopenia (low white blood cell count)
Hyperproteinaemia (High blood protein)

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12
Q

What is the managment of sarcoidosis?

A

Medications such as steroids, methotrexate, azathioprine
In many patients sarcoidosis can either remain stable or spontaneously resolves

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13
Q

What is tuberculosis?

How may it present?

A

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

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14
Q

This is an image of tuberculosis, what pathological features are consistent with this?

A

Necrotising granulomatous inflammation as can be seen in the centre of the image

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15
Q

What is labelled on this image?

What condition is this?

A

Lymphocytic-rich focus

Sjogrens syndrome

Mixed cells so submandibular gland

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16
Q

What is IgG4-related sialadenitis?

How does this present?

AKA Kuttner Tumour

A

Systemic disease where IgG4 levels are elevated

Non-tender, firm, hard swelling of affected gland (often parotid)

17
Q

Where should a patient presenting with IgG4-related sialadenitis be refered?

A

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

18
Q

What is the treatment for IgG4-related sialdenitis?

A

Generally surgically excised

19
Q

What is this how can you tell?

A

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

20
Q

What is this how can you tell?

A

Warthins tumour
(check picture)

21
Q

What is this how can you tell?

A

Mucoepidermoid carcinoma

Presence of mucous cells (lower grade has more mucous cells)

22
Q

What is this how can you tell?

A

Adenoid cystic carcinoma
Cribriform ‘swiss cheese’ pattern

23
Q

What is this how can you tell?

A

Adenoid cystic carcinoma
Presence of nerve fibres this is called perineural spread

24
Q

What is this how can you tell?

A

Acinic cell carcinoma

Random proliferation of acinar cells (purple looking cells)