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4 Oral Medicine and Pathology > Salivary Gland Disorders > Flashcards

Salivary Gland Disorders Flashcards

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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
what is the histopathology of a retention mucocoele?
Mucin retained in dilated duct
26
is a retention mucocoele a true cyst?
yes as lining is epithelial lining of the duct
27
which type mucocoele has less inflammation, extravasion or retention? why?
retention mucocoele as saliva is retained within the duct and not in connective tissue
28
what is the treatment for a retention mucocoele?
excision
29
what is sialadenitis?
Inflammation of the salivary glands
30
sialadenitis can be caused by what two things?
bacteria and viruses
31
what bacteria are associates with sialadenitis?
Staph. Aureus, Streptococci and oral anaerobes
32
what are the two types of bacterial sianadenitis?
acute bacterial sialadenitis chronic bacterial sialadenitis
33
what gland is most often affected in acute bacterial sialadenitis?
parotid gland
34
what are the clinical features of acute bacterial sialadenitis?
Pain, swelling, tenderness, puss, redness Decreased salivary flow
35
what is the treatment for acute bacterial sialadenitis?
Antibiotics after culture/sensitivity testing
36
what is this painfull, tender, red swelling of the parotid?
acute bacterial sialadenitis
37
what is this infection of the parotid with puss from the duct?
acute bacterial sialadenitis
38
what gland is most often affected in chronic bacterial sialadenitis?
submandibular gland
39
what causes chronic bacterial sialadenitis?
Obstruction of duct by stone, salivary calculi or mucous plugs
40
what are the clinical features of chronic bacterial sialadenitis?
Asymptomatic or intermittent pain at meal times Firm mass that may be mistaken for neoplasm (cancer)
41
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
acini atrophic fibrous scar tissue duct dilated hyperplasia epithelium plasma cells lymphocytes
42
treatment for chronic bacterial sialadenitis if mild
remove obstruction and it will heal
43
treatment for chronic bacterial sialadenitis if extensive
remove obstruction and gland
44
look at this VM presentation of chronic bacterial sialadenitis
45
what viruses are associated with viral sialadenitis?
mumps and HIV
46
what is mumps?
Acute contagious infection caused by paramyxovirus
47
clinical features of mumps
Painful swelling of glands (parotid), fever, headache and malaise
48
mumps is typically seen in ?
children and young adults
49
prevention for mumps
MMR vaccine
50
name three significant implications of mumps
orchitis - inflammation of testicles oophoritis - inflammation of ovaries nephritis - inflammation of kidneys
51
what is this Painful swelling of glands (parotid), fever, headache and malaise?
mumps
52
clinical presentation of HIV
Swelling and occasional pain of major glands (parotid) Cysts
53
what is another name for salivary calculi?
salivary sialoliths or stones
54
what gland is most often affected by salivary calculi?
submandibular gland
55
salivary calculi are seen mainly in?
adults
56
what is the cause of salivary calculi?
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
clinical presentation of salivary calculi
Asymptomatic until obstruction then pain at meal times
58
treatment of salivary calculi
Remove or breakdown stones Remove gland
59
this shows a salivary calculi
60
cause of necrotising sialometaplasia
Trauma causing ischaemia (reduced blood flow) or infarction (death of tissue from lack of blood supply)
61
clinical presentation of necrotising sialometaplasia
Large, deep, painful ulcer that’s slow to heal
62
necrotising sialometaplasia is most common in
males older patient smokers
63
histopathology of necrotising sialometaplasia
Necrosis of salivary acini Inflammation and hyperplasia/metaplasia of salivary ducts (often mistaken for cancer
64
treatment of necrotising sialometaplasia
Not required as heals itself but biopsy taken if mistaken for cancer
65
what is this Large, deep, painful ulcer that’s slow to heal?
necrotising sialometaplasia
66
what is Sjogren's syndrome?
Autoimmune disease with lymphocytic infiltration and acinar destruction of lacrimal and salivary glands
67
sjogren's syndrome affects mainly
females and middle aged
68
what is primary Sjogren's syndrome?
Dry eyes and mouth with no connective tissue disease
69
patients with primary Sjogren's syndrome are at increased risk of developing what?
lymphoma (cancer in lymph system) in affected glands
70
what is secondary Sjogren's syndrome?
Dry eyes and mouth and a connective tissue disease e.g. rheumatoid arthritis
71
clinical features of Sjogren's syndrome
Fatigue, joint pain, peripheral neuropathy Complications of dry mouth and eyes Swelling of salivary glands Connective tissue disease in secondary Sjögren's syndrome
72
how is Sjogren's syndrome diagnosed?
Lower lip biopsy, examined for collections of lymphocytes
73
how is Sjogren's syndrome treated/managed?
Rheumatology to treat systemic symptoms Ophthalmology for eyes Stimulate saliva production Caries prevention
74
what is the cause of sialadenosis?
Salivary gland innervation problem secondary to peripheral autonomic neuropathy
75
sialadenosis clinical features
Bilateral non-inflammatory swelling of the salivary glands Painless
76
what gland does sialadenosis commonly affect?
parotid
77
histopathology of sialadenosis
Hypertrophy of serous acini
78
sialadenosis is associated with?
malnutrition, anorexia, bulimia, alcoholism, diabetes mellitus, drugs and hormonal disturbances
79
what is this painless bilateral non-inflammatory swelling of the salivary glands (parotid)
sialadenosis
80
what gland do salivary gland tumours mainly affect?
major salivary glands -> parotid
81
how are salivary gland tumours diagnosed?
clinical and radiological findings tissue sample
82
what is Fine needle aspiration FNA tissue sampling method?
uses needle to aspirate cells
83
what is core biopsy tissue sampling method?
hollow needle used to remove a core of tissue
84
what is open biopsy tissue sampling method?
surgical incision then an initial biopsy
85
what is excision tissue sampling?
all of the tumour is removed for diagnosis and treatment
86
what are the 5 who classifications of salivary gland tumours?
malignant tumours benign tumours non-neoplastic epithelial tumours benign soft tissue lesions haematolymphoid tumours
87
what does non-neoplastic epithelial lesion mean?
uncontrolled cell proliferation in the epithelium resulting in a lesion (damaged tissue) not associated with abnormal tissue growth
88
what does haematolymphoid tumour mean?
haematopoietic (associated with fromation of red blood cells) and lymphoid neoplasms
89
what is the most common malignant salivary gland tumour?
Mucoepidermoid carcinoma
90
what is an mucoepidermoid carcinoma?
Epithelial salivary gland malignant tumour
91
what is the cause of mucoepidermoid carcinoma?
MAML2 gene fusions
92
mucoepidermoid carcinoma contains what 3 types of tumour cell?
mucous-secreting cells, epidermoid (squamoid) cells, intermediate cells
93
treatment for mucoepidermoid carcinoma
complete excision
94
what is the most common benign tumour?
pleomorphic adenoma
95
clinical presentation of pleomorphic adenoma
Painless, slow growing, rubbery lump
96
cause of pleomorphic adenoma
Gene rearrangements: PLAG1 or HMGA2
97
histopathology of pleomorphic adenoma Incomplete fibrous capsule, may be ? Intermingling of ? and ? cells. Epithelial cells can ? to ?? type Can undergo ??
cystic epithelial myoepithelial differentiate connective tissue malignant transformation
98
treatment for pleomorphic adenoma
Complete excision
99
what is this Painless, slow growing, rubbery lump
pleomorphic adenoma
100
what is this?
mucoepidermoid carcinoma
101
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4 Oral Medicine and Pathology (1 decks)

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