Salivary Gland Disorders Flashcards
List the 8 non-neoplastic disorders of salivary gland origin.
- Mucocele/Ranula
- Sialothiasis
- Acute/chronic sialadenitis
- Sialadenosis
- Xerostomia
- Benign lymphoepithelial lesion (BLEL)
- Sjögren syndrome
- Necrotizing sialometaplasia
What causes a mucocele?
Rupture of salivary gland duct -> spillage of mucin
In what age group and at what location are mucoceles the most common?
Children/young adults; lower lip
What is a distinctive clinical feature of a mucocele?
Translucent to bluish hue
A __________ is a type of mucocele seen on the floor of the mouth, and arises from the sublingual gland.
Ranula
T/F: All mucoceles are treated with marsupialization.
False
Just Ranulas - making incision into the lesion and suturing the edges
Which gland is most often affected with sialolithiasis?
Submandibular gland (80%)
What is a lithotripsy?
A way to retrieve some sialolithiasis in major glands
What is acute/chronic sialadenitis?
Inflammation of salivary gland
What common microorganisms cause sialadenitis?
Bacteria - staph
Viral - mumps
Which glands are most often associated with sialadenitis?
Acute - parotid (pus coming from duct)
Chronic - submandibular
What allows you to differentiate between sialadenitis and a sialolith?
Radiograph
T/F: Sialadenosis is due to an infection.
False
Associated with underlying condition - diabetes, malnutrition, alcoholism, bulimia
What conditions does xerostomia predispose a patient to?
- Mucosal injury due to lack of lubrication
- Candidiasis
- Increased cervical caries
T/F: A patient on several different drugs is at more risk for xerostomia.
True
Esp. Antihistamines, antidepressants, sedatives, antihypertensives
T/F: Frothy saliva is a sign of xerostomia.
True
Which lesion can be characterized by “blossoms on a tree” look in a radiograph?
BLEL
In which disorder do you see remnants of ductal epithelium in the form of epimyoepithelial islands?
BLEL
T/F: Sjögren syndrome is sometimes thought of as a continuation of BLEL.
True
What is the difference between primary and secondary Sjögren syndrome?
Primary (sicca) - xerostomia and keratoconjunctivitis
Secondary - sicca plus another autoimmune disease
T/F: Sjögren syndrome has a male predilection.
False
More common in females
T/F: Serology is a specific test for Sjögren syndrome.
False
Is often used as diagnostic tool but is non-specific
Which antibodies can help diagnose Sjögren syndrome?
Elevated IgG, rheumatoid factor, anti-nuclear autoantibodies, anti-SS-A, anti-SS-B
What histopathogical features can be used to diagnose Sjögren syndrome?
Labial salivary gland biopsy
Looking for aggregates of >50 lymphocytes and plasma cells in a gland
T/F: Patients with Sjögren syndrome have a 44x increase in lymphoma.
True
What is thought to be the cause of Necrotizing sialometaplasia?
Due to ischemic necrosis from a variety of causes (traumatic injury, dental injection, ill fitting dentures)
T/F: Necrotizing sialometaplasia is often seen in children.
False
Rare in children
What is the most common location for necrotizing sialometaplasia?
Hard/soft palate
How does necrotizing sialometaplasia typically present?
Sharply demarcated ulcer on the palate
Patient may say “piece of my palate fell out”
Which salivary gland disorder can be easily mistaken for SCC histopathologically?
Necrotizing sialometaplasia
Pseudoepitheliomatous hyperplasia (PEH) of surface epithelium is a characteristic of which salivary gland disorder?
Necrotizing sialometaplasia
