Salivary Gland Diseases (Nichols Self Study)

Question 1

Inflammation of salivary glands

Answer 1

sialadenitis

Question 2

etiologies of sialadentitis (general)

Answer 2

infectious (viral, bacterial)

noninfectious (Sjogren syndrome, sarcoidosis, radiation)

Question 3

most common pathogen causing sialadenitis

Answer 3

s. aureus

Question 4

what gland is typically invovled in acute bacterial sialadenitis? how does it present

Answer 4

parotid: it is swollen and painful with purulent discharge from the duct

Question 5

what is the common cause of chronic sialadenitis

Answer 5

2’ to recurrent or pesistant ductal obstruction due to a stone (sialolith)

Question 6

how does chronic sialadenitis present?

Answer 6

episodic pain and swelling usually at meal time

Question 7

_______ involvement in chronic sialadenitis may include persistent enlargement (Kuttner tumor)

Answer 7

Submandibular

Question 8

treatment of acute vs chronic sialadenitis

Answer 8

acute: abx and rehydration
chronic: removal of sialolith (if appropriate)–surgical removal of parotid gland if indicated

Question 9

most salivary tumors involve the ___ gland and most are (benign or malignant)

Answer 9

parotid and 70% are benign

Question 10

what is the general principle for salivary gland tumors

Answer 10

the smaller the the salivary gland, the more likely tumor in it is malignant

Question 11

sublingual glad tumors are 90% (benign or malignant)

Answer 11

malignant

Question 12

what is the most common salivary gland tumor?

Answer 12

pleomorphic adenoma

Question 13

from what tissue dies a pleomorphic adenoma arise?

Answer 13

ductal epithelium and mesenchyme (2 germ layers!!)

Question 14

presentation of pleomorphic adenoma

Answer 14

slw growing, painless, movable, firm mass

“rubbery texture”

Question 15

epidemiology of pleomorphic adenoma

Answer 15

F > M, middle age (~50)

Question 16

micropath of pleomorphic adenoma

Answer 16

encapsulated with epithelial component forming ducts or cysts and mesenchymal component (usually myoepithelial cells) in a myxoid or chondroid matrix

Question 17

treatment for pleomorphic adenoma

Answer 17

surgical excision **injury to facial N is the most common complication to surgury

Question 18

2nd most common benign tumor of the parotid

Answer 18

warthin’s tumor

Question 19

epidemiology og warthin’s tumor

Answer 19

late middle aged, male, smoker

Question 20

presentation of warthin;s tumor

Answer 20

slowly growing, painless, firm or fluctuant, in the tail of the parotid

Question 21

histology of warthins tumor

Answer 21

1. cystic spaces lined by double layer of oncocytes (epi cells with abundant cytoplasm)
2. lymphoid stroma (commonly with germinal centers)

Question 22

are warthin’s tumors poly or mono-clonal

Answer 22

polyclonal *** therefore they are not true neoplasms!!

** may be metaplastic lesion with lymphoid reaction

Question 23

most common malignant tumor of salivary gland

Answer 23

mucoepidermoid carcinoma

**BUT most commonly found in the parotid and the minor glands of the palate

Question 24

____ tumors sometimes occur with nucoepidermoid carcinoma

Answer 24

Intraosseous

Question 25

histo of nucoepidermoid carcinoma

Answer 25

squamous cells + mucous(use mucicarmine stain)

Question 26

how bad a tumor looks to a pathologist under a microscope

Answer 26

tumor grade

Question 27

anatomic extent of the tumor

Answer 27

tumor stage

Question 28

what is the most important prognostic determinant of a mucoepidermoid carcinoma

Answer 28

grade

Question 29

treatment for mucoepidermoid carcinoma

Answer 29

surgical removal + radiation