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4 Oral Medicine and Pathology > Salivary Gland Disorders > Flashcards

Salivary Gland Disorders Flashcards

1
Q

Salivary gland developmental abnormalities are rare. name two salivary gland developmental abnormalities

A

aplasia

atresia

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2
Q

what is aplasia?

A

salivary gland fails to develop normally

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3
Q

what is atresia?

A

ducts fail to be tubular

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4
Q

what duct does atresia mainly affect?

A

submandibular

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5
Q

what is a mucocoele?

A

a cystic cavity filled with mucus

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6
Q

what are the two types of salivary mucocoele?

A

extravasion mucocoele/cyst

retention mucocoele/cyst

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7
Q

what is an extravasion mucocoele caused by?

A

ruptured duct which leaks saliva into surrounding connective tissue which elicits an inflammatory reaction - associated with trauma

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8
Q

what are the clinical features of an extravasion mucocoele?

A

Blue-ish or transparent swelling that’s asymptomatic

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9
Q

what gland does extravasion mucocoele mainly affect?

A

minor glands especially lips

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10
Q

extravasion mucocoele is common in ?

A

children and young adults

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11
Q

what is the histopathology of an extravasion mucocoele?

A

Cystic cavity filled with mucin surrounded by inflamed granulation tissue (macrophages) in connective tissue

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12
Q

why is an extravasion mucocoele not a true cyst?

A

no epithelial lining

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13
Q

what is the treatment for an extravasion mucocoele?

A

Remove mucocoele, ruptured duct and gland if possible to prevent recurrence

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14
Q

what is a ranula?

A

uncommon form of extravasion mucocoele from sublingual gland

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15
Q

clinical features of a ranula

A

Painless, bluish 2-3cm swelling in the floor of the mouth

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16
Q

treatment of a ranula?

A

Drainage and removal of sublingual gland

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17
Q

what is a plunging ranula?

A

Swelling in the neck as mucin passes through and develops below the mylohyoid

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18
Q

what is this Blue-ish or transparent swelling that’s asymptomatic?

A

extravasion mucocoele

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19
Q

what is this Painless, bluish 2-3cm swelling in the floor of the mouth?

A

ranula

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20
Q

what is this Swelling in the neck as mucin passes through and develops below the mylohyoid?

A

plunging ranula

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21
Q

what is a retention mucocoele?

A

Cystic dilatation of a duct due to obstruction

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22
Q

what are the clinical features of a retention mucocoele?

A

Blue-ish or transparent swelling that asymptomatic

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23
Q

what gland do retention mucocoeles affect?

A

major and minor salivary glands

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24
Q

can you get a retention mucocoele on the lower lip?

A

yes but rare

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25
Q

what is the histopathology of a retention mucocoele?

A

Mucin retained in dilated duct

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26
Q

is a retention mucocoele a true cyst?

A

yes as lining is epithelial lining of the duct

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27
Q

which type mucocoele has less inflammation, extravasion or retention? why?

A

retention mucocoele as saliva is retained within the duct and not in connective tissue

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28
Q

what is the treatment for a retention mucocoele?

A

excision

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29
Q

what is sialadenitis?

A

Inflammation of the salivary glands

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30
Q

sialadenitis can be caused by what two things?

A

bacteria and viruses

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31
Q

what bacteria are associates with sialadenitis?

A

Staph. Aureus, Streptococci and oral anaerobes

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32
Q

what are the two types of bacterial sianadenitis?

A

acute bacterial sialadenitis

chronic bacterial sialadenitis

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33
Q

what gland is most often affected in acute bacterial sialadenitis?

A

parotid gland

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34
Q

what are the clinical features of acute bacterial sialadenitis?

A

Pain, swelling, tenderness, puss, redness
Decreased salivary flow

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35
Q

what is the treatment for acute bacterial sialadenitis?

A

Antibiotics after culture/sensitivity testing

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36
Q

what is this painfull, tender, red swelling of the parotid?

A

acute bacterial sialadenitis

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37
Q

what is this infection of the parotid with puss from the duct?

A

acute bacterial sialadenitis

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38
Q

what gland is most often affected in chronic bacterial sialadenitis?

A

submandibular gland

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39
Q

what causes chronic bacterial sialadenitis?

A

Obstruction of duct by stone, salivary calculi or mucous plugs

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40
Q

what are the clinical features of chronic bacterial sialadenitis?

A

Asymptomatic or intermittent pain at meal times
Firm mass that may be mistaken for neoplasm (cancer)

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41
Q

histopathology for chronic bacterial sialadenitis

Salivary ? become ? (waisted away) and are replaced by ???

Salivary ? become ? with ? of the ?

Chronic inflammatory infiltrate (?? and ?) within the gland

A

acini
atrophic
fibrous scar tissue

duct
dilated
hyperplasia
epithelium

plasma cells
lymphocytes

42
Q

treatment for chronic bacterial sialadenitis if mild

A

remove obstruction and it will heal

43
Q

treatment for chronic bacterial sialadenitis if extensive

A

remove obstruction and gland

44
Q

look at this VM presentation of chronic bacterial sialadenitis

A
45
Q

what viruses are associated with viral sialadenitis?

A

mumps and HIV

46
Q

what is mumps?

A

Acute contagious infection caused by paramyxovirus

47
Q

clinical features of mumps

A

Painful swelling of glands (parotid), fever, headache and malaise

48
Q

mumps is typically seen in ?

A

children and young adults

49
Q

prevention for mumps

A

MMR vaccine

50
Q

name three significant implications of mumps

A

orchitis - inflammation of testicles

oophoritis - inflammation of ovaries

nephritis - inflammation of kidneys

51
Q

what is this Painful swelling of glands (parotid), fever, headache and malaise?

A

mumps

52
Q

clinical presentation of HIV

A

Swelling and occasional pain of major glands (parotid)
Cysts

53
Q

what is another name for salivary calculi?

A

salivary sialoliths or stones

54
Q

what gland is most often affected by salivary calculi?

A

submandibular gland

55
Q

salivary calculi are seen mainly in?

A

adults

56
Q

what is the cause of salivary calculi?

A

Mineralisation of phosphates from supersaturated saliva deposited around a central nidus of cell debris

Bacteria often grow on the stone surface eliciting an inflammatory response

57
Q

clinical presentation of salivary calculi

A

Asymptomatic until obstruction then pain at meal times

58
Q

treatment of salivary calculi

A

Remove or breakdown stones
Remove gland

59
Q

this shows a salivary calculi

A
60
Q

cause of necrotising sialometaplasia

A

Trauma causing ischaemia (reduced blood flow) or infarction (death of tissue from lack of blood supply)

61
Q

clinical presentation of necrotising sialometaplasia

A

Large, deep, painful ulcer that’s slow to heal

62
Q

necrotising sialometaplasia is most common in

A

males
older patient
smokers

63
Q

histopathology of necrotising sialometaplasia

A

Necrosis of salivary acini

Inflammation and hyperplasia/metaplasia of salivary ducts (often mistaken for cancer

64
Q

treatment of necrotising sialometaplasia

A

Not required as heals itself but biopsy taken if mistaken for cancer

65
Q

what is this Large, deep, painful ulcer that’s slow to heal?

A

necrotising sialometaplasia

66
Q

what is Sjogren’s syndrome?

A

Autoimmune disease with lymphocytic infiltration and acinar destruction of lacrimal and salivary glands

67
Q

sjogren’s syndrome affects mainly

A

females and middle aged

68
Q

what is primary Sjogren’s syndrome?

A

Dry eyes and mouth with no connective tissue disease

69
Q

patients with primary Sjogren’s syndrome are at increased risk of developing what?

A

lymphoma (cancer in lymph system) in affected glands

70
Q

what is secondary Sjogren’s syndrome?

A

Dry eyes and mouth and a connective tissue disease e.g. rheumatoid arthritis

71
Q

clinical features of Sjogren’s syndrome

A

Fatigue, joint pain, peripheral neuropathy

Complications of dry mouth and eyes

Swelling of salivary glands

Connective tissue disease in secondary Sjögren’s syndrome

72
Q

how is Sjogren’s syndrome diagnosed?

A

Lower lip biopsy, examined for collections of lymphocytes

73
Q

how is Sjogren’s syndrome treated/managed?

A

Rheumatology to treat systemic symptoms

Ophthalmology for eyes

Stimulate saliva production

Caries prevention

74
Q

what is the cause of sialadenosis?

A

Salivary gland innervation problem secondary to peripheral autonomic neuropathy

75
Q

sialadenosis clinical features

A

Bilateral non-inflammatory swelling of the salivary glands

Painless

76
Q

what gland does sialadenosis commonly affect?

A

parotid

77
Q

histopathology of sialadenosis

A

Hypertrophy of serous acini

78
Q

sialadenosis is associated with?

A

malnutrition, anorexia, bulimia, alcoholism, diabetes mellitus, drugs and hormonal disturbances

79
Q

what is this painless bilateral non-inflammatory swelling of the salivary glands (parotid)

A

sialadenosis

80
Q

what gland do salivary gland tumours mainly affect?

A

major salivary glands -> parotid

81
Q

how are salivary gland tumours diagnosed?

A

clinical and radiological findings

tissue sample

82
Q

what is Fine needle aspiration FNA tissue sampling method?

A

uses needle to aspirate cells

83
Q

what is core biopsy tissue sampling method?

A

hollow needle used to remove a core of tissue

84
Q

what is open biopsy tissue sampling method?

A

surgical incision then an initial biopsy

85
Q

what is excision tissue sampling?

A

all of the tumour is removed for diagnosis and treatment

86
Q

what are the 5 who classifications of salivary gland tumours?

A

malignant tumours
benign tumours
non-neoplastic epithelial tumours
benign soft tissue lesions
haematolymphoid tumours

87
Q

what does non-neoplastic epithelial lesion mean?

A

uncontrolled cell proliferation in the epithelium resulting in a lesion (damaged tissue) not associated with abnormal tissue growth

88
Q

what does haematolymphoid tumour mean?

A

haematopoietic (associated with fromation of red blood cells) and lymphoid neoplasms

89
Q

what is the most common malignant salivary gland tumour?

A

Mucoepidermoid carcinoma

90
Q

what is an mucoepidermoid carcinoma?

A

Epithelial salivary gland malignant tumour

91
Q

what is the cause of mucoepidermoid carcinoma?

A

MAML2 gene fusions

92
Q

mucoepidermoid carcinoma contains what 3 types of tumour cell?

A

mucous-secreting cells, epidermoid (squamoid) cells, intermediate cells

93
Q

treatment for mucoepidermoid carcinoma

A

complete excision

94
Q

what is the most common benign tumour?

A

pleomorphic adenoma

95
Q

clinical presentation of pleomorphic adenoma

A

Painless, slow growing, rubbery lump

96
Q

cause of pleomorphic adenoma

A

Gene rearrangements: PLAG1 or HMGA2

97
Q

histopathology of pleomorphic adenoma

Incomplete fibrous capsule, may be ?

Intermingling of ? and ? cells.

Epithelial cells can ? to ?? type

Can undergo ??

A

cystic

epithelial
myoepithelial

differentiate
connective tissue

malignant transformation

98
Q

treatment for pleomorphic adenoma

A

Complete excision

99
Q

what is this Painless, slow growing, rubbery lump

A

pleomorphic adenoma

100
Q

what is this?

A

mucoepidermoid carcinoma

101
Q
A
102
Q
A

4 Oral Medicine and Pathology (1 decks)

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