Salivary gland disorders

Question 1

Fluctuant lower lip swellings with a blue translucent hue caused by repeated trauma

Answer 1

Mucocele/pseudocysts

Question 2

Microscopy of lip swelling shows inflammatory granulation tissue of fibrous CT filled with mucin and inflammatory cells

Answer 2

Mucocele/pseudocyst

Question 3

Systemic autoimmune disease affecting the salivary glands and lacrimal glands

Answer 3

Sjogren syndrome

Question 4

Most common association of secondary Sjogren syndrome

Answer 4

RA

Question 5

Primary forms of Sjogren syndrome

Answer 5

Sicca syndrome
Isolated disorder

Question 6

Lymphatic infiltration and fibrosis of the lacrimal and salivary glands resulting in dysfunction

Answer 6

Sjogren syndrome

Question 7

Autoimmunity markers commonly seen in Sjogren syndrome

Answer 7

RF (75%)
ANA (50-80%)
SS-A (Ro) and SS-B (La) –> 90%

Question 8

Diseases that can cause Sjogren syndrome like presentation

Answer 8

Human T lymphotropic virus (HTLV)
HIV
HCV

Question 9

Microscopy of salivary gland shows intense lymphocytic and plasma cell (mononuclear) infiltration, germinal center formation, and ductal epithelial hyperplasia

Answer 9

Sjogren syndrome

Question 10

Other non-salivary and non-lacrimal manifestations of Sjogren syndrome

Answer 10

Tubulointerstitial nephritis
Synovitis
Diffuse pulmonary fibrosis
Neuropathy

Question 11

Essential for diagnosis of Sjogren syndrome

Answer 11

Biopsy of lip

Question 12

Complication of Sjogren syndrome

Answer 12

Extra-nodal marginal zone B cell lymphoma

Question 13

Benign neoplasm of salivary gland that consists of a mixture of ductal, myoepithelial, and mesenchymal cells. Most common salivary gland neoplasm.

Answer 13

Pleomorphic adenoma

Question 14

Risk factor of pleomorphic adenoma

Answer 14

Radiation exposure leading to overexpression of PLAG1 and mutations in HMGA2

Question 15

Encapsulated, rounded, well-demarcated, <6 cm salivary gland growth with protrusions. Cut surface is gray-white with myxoid and blue translucent areas of chondroid stroma.

Answer 15

Pleomorphic adenoma

Question 16

Microscopy of salivary gland growth shows ductal or myoepithelial cells on a background of loose myxoid and hyaline tissue with islands of cartilage

Answer 16

Pleomorphic adenoma

Question 17

Benign neoplasm found exclusively in the parotid gland. Appears as a round to oval encapsulated mass. Cut surface is pale gray to brown and punctuated by cystic or cleft-like spaces filled with mucinous or eosinophilic secretions.

Answer 17

Warthin tumor/papillary cystadenoma lymphmatosum

Question 18

Microscopy of parotid gland growth shows papillary projections into the cystic spaces, granular eosinophilic luminal secretion, dense lymphoid stroma with germinal center, and a double layer of neoplastic epithelial cells.

Answer 18

Warthin tumor/papillary cystadenoma lymphmatosum

Question 19

Most common malignant tumor of the salivary gland

Answer 19

Mucoepidermoid carcinoma

Question 20

Translocation associated with mucoepidermoid carcinoma

Answer 20

(11;19)(q21;p13)

CRTC1-MAML2 fusion protein

Question 21

Circumscribed lesion of the salivary gland that lacks a definitive capsule, often with infiltrative margins. Cut surface is pale gray-white with small mucin containing cysts. Microscopy shows epidermoid cells, intermediate cells, and mucinous cells.

Answer 21

Mucoepidermoid carcinoma

Question 22

Common, small, poorly encapsulated, infiltrative, gray-pink tumor of the minor salivary gland. Microscopy shows cribriform spaces filled with basophilic material, small tumor cells, and both tubular and solid growth patterns.

Answer 22

Adenoid cystic carcinoma

Question 23

Gene rearrangements present in a subset of adenoid cystic carcinoma

Answer 23

MYB-NFIB

Question 24

Associated with poorer prognosis in adenoid cystic carcinoma

Answer 24

> 30% solid growth pattern
Arising in minor salivary glands instead of parotid