Salivary Gland Diseases

Question 1

3 sub categories of salivary gland diseases

Answer 1

Reactive

Benign

Malignant

Question 2

a lesion caused by the traumatic rupture of salivary ducts, resulting in the release of mucous into adjacent CT

Answer 2

mucous extravasation phenomenon

Question 3

most common form of mucous extravasation phenomenon, a mucous-containing cystic lesion commonly found on the lower lip

Answer 3

mucocele

Question 4

Depending on its size, mucoceles can appear blue because of 3 reasons:

Answer 4

• tissue cyanosis
• vascular congestion
• translucency of underlying fluid

*Think: CCF

Question 5

mucocele on the floor of the mouth

Answer 5

ranula (means frog’s belly)

Question 6

tx for a mucocele

Answer 6

complete excision, must remove entire affected salivary gland or risk higher chance of recurrence

Question 7

the same as the mucous extravasation phenomenon except this is a histologically true cyst (lined by epithelium)

Answer 7

mucous retention cyst

Question 8

cause of a mucocele vs mucous retention cyst

Answer 8

Mucocele- trauma

Mucous retention cyst- blockage of salivary ducts by sialolith (calcified mass)

Question 9

a rapidly expanding ulcerative lesion usually located towards the back of the hard palate, this condition is usually due to ischemic necrosis of minor salivary glands as a result of trauma or local anesthesia

Answer 9

necrotizing sialometaplasia

Question 10

cause of necrotizing sialometaplasia

Answer 10

ischemic necrosis of minor salivary glands as a result of trauma or local anesthsia

Question 11

tx for necrotizing sialometaplasia

Answer 11

self heals in 6-10 weeks

Question 12

a hyperimmune multi-systemic disease with rare oral involvement that affects salivary glands and mucosa, this condition may be triggered by mycobacteria (the primary etiology of TB) and is therefore primarily a pulmonary disease

Answer 12

sarcoidosis

Question 13

bacteria that may trigger sarcoidosis

Answer 13

mycobacteria, the primary etiology of TB

Question 14

oral manifestation of sarcoidosis

Answer 14

xerostomia

Question 15

2 conditions linked to sarcoidosis:

Answer 15

Lofgren’s syndrome- arthritis, bilateral hilar lymphadenopathy, and erythema nodosum

Heerfordt’s syndrome- anterior uveitis, parotid gland enlargement, facial nerve palsy, and fever

Question 16

tx of sarcoidosis

Answer 16

corticosteroids

Question 17

syndrome characterized by arthritis, bilateral hilar lymphadenopathy, and erythema nodosum

Answer 17

Lofgren’s syndrome

Question 18

syndrome characterized by anterior uveitis, parotid gland enlargement, facial nerve palsy, and fever

Answer 18

Heefordt’s syndrome

Question 19

cyst caused by the blockage of glands in the sinus mucosa, can only be observed radiographically, appears as a bump along the base of the sinus floor

Answer 19

sinus retention cyst (aka antral pseudocyst)

Question 20

tx for sinus retention cyst

Answer 20

none needed

Question 21

an autoimmune disease affecting salivary and tear glands, leading to dry mouth and eyes

Answer 21

Sjogren’s syndrome

Question 22

Two stages of Sjogren’s syndrome:

Answer 22

Primary- characterized by keratoconjunctivitis sicca (dry eye) and xerostomia (dry mouth)

Secondary- same as primary + another autoimmune disease (usually RA, which typically involves TMJ disorders)

Question 23

antibodies common in Sjogren’s syndrome patients

Answer 23

ANA (antinuclear antibody)
RF (rheumatoid factor)
SSA (Sjogren syndrome A)
SSB (Sjogren syndrome B)

Question 24

a benign salivary gland tumor developing in the upper lip and parotid gland

Answer 24

monomorphic adenoma

Question 25

this adenoma is composed of a single cell type, and includes basal cell adenoma, canalicular adenoma, myoepithelioma, and oncocytic tumor

Answer 25

monomorphic adenoma

Question 26

tx of monomorphic adenoma

Answer 26

surgical excision

Question 27

MC benign salivary gland tumor developing in the parotid gland (majority of cases) and submandibular gland

Answer 27

pleomorphic adenoma

Question 28

this “mixed tumor” adenoma is composed of a mixture of cell types (CT and epithelial cells)

Answer 28

pleomorphic adenoma

Question 29

clinically, this tumor can vary widely in size and has firm, rubbery swelling

Answer 29

pleomorphic adenoma

Question 30

a benign cystic tumor composed of oncocytes, or epithelial cells with excessive number of mitochondria, and lymphoid cells

Answer 30

Warthin’s tumor

Question 31

common location of Warthin’s tumor

Answer 31

parotid gland of older men

Question 32

Malignant salivary gland lesions are primarily found where?

Answer 32

palate

Question 33

a rare form of cancer that most commonly forms in salivary glands or other head/neck regions, but can also occur in other parts of the body (breast, skin, cervix)

Answer 33

adenoid cystic carcinoma

Question 34

microscopically, a cribriform or Swiss cheese pattern of cells can be observed

Answer 34

adenoid cystic carcinoma

Question 35

lethality of adenoid cystic carcinoma

Answer 35

high, 10% survival rate at 15 yrs

Question 36

the MC salivary gland malignancy

Answer 36

mucoepidermoid carcinoma

Question 37

these low-grade cancers are composed of mucosal and epithelial cells

Answer 37

mucoepidermoid carcinoma

Question 38

2nd MC salivary gland malignancy

Answer 38

polymorphous low-grade adenocarcinoma (PLGA)

Question 39

the prefix “adeno” of this malignancy refers to gland, and helps solidify the fact that this tumor is found almost exclusively in minor salivary glands

Answer 39

polymorphous low-grade adenocarcinoma (PLGA)