Salivary Gland Diseases (Nichols Self Study) Flashcards
Inflammation of salivary glands
sialadenitis
etiologies of sialadentitis (general)
infectious (viral, bacterial)
noninfectious (Sjogren syndrome, sarcoidosis, radiation)
most common pathogen causing sialadenitis
s. aureus
what gland is typically invovled in acute bacterial sialadenitis? how does it present
parotid: it is swollen and painful with purulent discharge from the duct
what is the common cause of chronic sialadenitis
2’ to recurrent or pesistant ductal obstruction due to a stone (sialolith)
how does chronic sialadenitis present?
episodic pain and swelling usually at meal time
_______ involvement in chronic sialadenitis may include persistent enlargement (Kuttner tumor)
Submandibular
treatment of acute vs chronic sialadenitis
acute: abx and rehydration
chronic: removal of sialolith (if appropriate)–surgical removal of parotid gland if indicated
most salivary tumors involve the ___ gland and most are (benign or malignant)
parotid and 70% are benign
what is the general principle for salivary gland tumors
the smaller the the salivary gland, the more likely tumor in it is malignant
sublingual glad tumors are 90% (benign or malignant)
malignant
what is the most common salivary gland tumor?
pleomorphic adenoma
from what tissue dies a pleomorphic adenoma arise?
ductal epithelium and mesenchyme (2 germ layers!!)
presentation of pleomorphic adenoma
slw growing, painless, movable, firm mass
“rubbery texture”
epidemiology of pleomorphic adenoma
F > M, middle age (~50)
micropath of pleomorphic adenoma
encapsulated with epithelial component forming ducts or cysts and mesenchymal component (usually myoepithelial cells) in a myxoid or chondroid matrix
treatment for pleomorphic adenoma
surgical excision **injury to facial N is the most common complication to surgury
2nd most common benign tumor of the parotid
warthin’s tumor
epidemiology og warthin’s tumor
late middle aged, male, smoker
presentation of warthin;s tumor
slowly growing, painless, firm or fluctuant, in the tail of the parotid
histology of warthins tumor
- cystic spaces lined by double layer of oncocytes (epi cells with abundant cytoplasm)
- lymphoid stroma (commonly with germinal centers)
are warthin’s tumors poly or mono-clonal
polyclonal *** therefore they are not true neoplasms!!
** may be metaplastic lesion with lymphoid reaction
most common malignant tumor of salivary gland
mucoepidermoid carcinoma
**BUT most commonly found in the parotid and the minor glands of the palate
____ tumors sometimes occur with nucoepidermoid carcinoma
Intraosseous
histo of nucoepidermoid carcinoma
squamous cells + mucous(use mucicarmine stain)
how bad a tumor looks to a pathologist under a microscope
tumor grade
anatomic extent of the tumor
tumor stage
what is the most important prognostic determinant of a mucoepidermoid carcinoma
grade
treatment for mucoepidermoid carcinoma
surgical removal + radiation