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Oral Path 2, Exam 2 > Salivary Gland Disorders > Flashcards

Salivary Gland Disorders Flashcards

1
Q

8 salivary gland disorders

A
  1. Mucocele/Ranula
  2. Sialolithiasis
  3. Acute/Chronic Sialadenitis
  4. Sialadenosis
  5. Xerostomia
  6. Benign Lymphoepithelial Lesion (BLEL)
  7. Sjogren Syndrome
  8. Necrotizing Sialometaplasia
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2
Q

Disorder: Common cause of oral mucosal swelling

A

Mucocele

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3
Q

Mucoceles are caused by rupture of the salivary gland ___ and spillage of ____

A

Duct, mucin

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4
Q

Most common region for mucocele

A

Lower lip

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5
Q

A type of mucocele seen on the FOM

A

Ranula

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6
Q

A ranula arises from the ___ gland

A

Sublingual

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7
Q

Where are ranulas seen?

A

FOM, right or left of midline

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8
Q

Histologically: you see ___ and ____ tissue in a mucocele and ranula

A

Mucin and granulation tissue

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9
Q

What must you rule out in a mucocele?

A

Neoplasm

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10
Q

What must you excise with a mucocele?

A

The involved gland

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11
Q

Treating a ranula may include ____

A

Marsupialization

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12
Q

Disorder: Calcified structures which develop within the salivary ducts

A

Sialolithiasis

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13
Q

Sialolithiasis have deposition of ___ salts around nidus of ____ in lumen

A

Calcium, debris

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14
Q

2 potential causes of sialolithiasis

A

Chronic sialadenitis (viral/bacterial), Partial duct obstruction

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15
Q

Are sialolithiasis hard or soft?

A

Hard

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16
Q

___% of sialolithiasis come from the ____ gland

A

80%, submandibular

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17
Q

Radiographic sialolithiasis feature

A

Opaque, lamellated structure

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18
Q

Histologically: sialolithiasis shows concentric ____ surrounding ____

A

Laminations, debris

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19
Q

Sialolithiasis may demonstrate ____ ____ if the duct is removed

A

Squamous metaplasia

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20
Q

Treatment for sialolithiasis

A

Increase saliva, moist heat, massage, removal of gland

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21
Q

Prognosis for sialolithiasis

A

Good for minor glands. Morbidity if major gland requires removal

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22
Q

Disorder: Inflammation of the salivary gland

A

Acute/Chronic Sialadenitis

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23
Q

Causes of Sialadenitis

A

Bacterial, Viral, Ductal obstruction/retrograde infection

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24
Q

Cause of bacterial Sialadenitis

A

Penicillinase-producing staph

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25
Q

Cause of viral Sialadenitis

A

Mumps

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26
Q

Cause of ductal obstruction/retrograde infection leading to Sialadenitis

A

Xerostomia, may follow general anesthesia

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27
Q

Chronic Sialadenitis may follow acute Sialadenitis due to ___ damage

A

Ductal

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28
Q

Difference in Sialadenitis in Sialolithiasis

A

Sialadenitis is diffuse and sialolithiasis is localized

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29
Q

Is Sialadenitis painful?

A

Yes (note: it’s INFLAMMATION)

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30
Q

Gland mostly involved in acute Sialadenitis

31
Q

Gland mostly involved in chronic Sialadenitis

A

Submandibular

32
Q

What used to be used radiographically for Sialadenitis

A

Sialography

33
Q

4 things seen in Sialadenitis, histologically

A

Inflammatory cells, dilated ducts, acinar atrophy, fibrosis

34
Q

Prognosis for acute Sialadenitis

A

Higher mortality due to spread of infection

35
Q

Disorder: associated with underlying systemic conditions

A

Sialadenosis

36
Q

Sialadenosis treatment

A

Control of underlying condition, pilocarpine (saliva stimulator) use

37
Q

Sialadenosis prognosis

A

Fair, depending on underlying disease

38
Q

1 cause of xerostomia

A

Medications, especially polypharmacy

39
Q

Disorder: Autoimmune condition with a proliferation of epithelial cells and lymphocytes

A

Benign Lymphoepithelial Lesion

40
Q

BLEL is mainly ___ and ___ glands

A

Parotid and lacrimal

41
Q

BLEL alone may represent an isolated form of ___ ___

A

Sjogren syndrome

42
Q

BLEL has a ____ predilection

43
Q

What does sialography show for BLEL

A

“Blossoms on a tree”: Puctate sialectasis

44
Q

For the histology of BLEL, what replaces normal parotid parenchyma

A

Diffuse lymphocytic infiltrate

45
Q

What might you see occasionally in the histology of BLEL

A

Germinal centers

46
Q

What must be IDed in BLEL histology? Where else can they be seen?

A

Epimyoepithelial islands, lymphoma

47
Q

Prognosis for BLEL

A

Good - but malignant transformation has been reported

48
Q

2 forms of Sjogren’s Syndrome

A

Primary (sicca syndrome - xerostomia and dry eyes)

Secondary (sicca syndrome & any other autoimmune disease)

49
Q

Sjogrens has a huge ___ predilection

A

Female (9:1)

50
Q

____ swelling (BLEL) may be seen in Sjogren syndrome

51
Q

What do Sjogren patients complain of?

A

Dry, gritty eyes and dry mouth

52
Q

Serology for Sjogren syndrome is relatively ______

A

Non-specific

53
Q

Patients with Sjogren syndrome tend to have elevated _____ _____ _____ and _____, especially ____

A

Erythrocute Sedimentation Rate (ESR), polyhypergammaglobulinema, IgG

54
Q

Sjogren syndrome patients have positive ____ and ____ antibodies

A

RF, Anti-nuclear

55
Q

2 ANAs (Anti-nuclear Antibodies) in Sjogren syndrome

A

Anti-SS-A (anti-Rho) and Anti-SS-B (anti-La)

56
Q

Biopsy to diagnose Sjogren syndrome

A

Labial salivary gland biopsy

57
Q

How many minor glands must you remove in a labial salivary gland biopsy for Sjogren syndrome?

A

5 minor glands

58
Q

Which parts of the gland are excluded from a Sjogren diagnosis and why?

A

Lobules exhibiting acinar atrophy and interstitial fibrosis. They are non-specific features related to aging

59
Q

Histologically, what supports the diagnosis of Sjogren

A

1 or more foci of 50 or more cells per 4 mm^2 of glandular tissue

60
Q

Treatment of Sjogren

A

Artificial tears and increased saliva

61
Q

Patients with Sjogren syndrome are more at risk for ___

62
Q

Disorder: thought to be due to ischemic necrosis

A

Necrotizing Sialometaplasia

63
Q

Necrotizing Sialometaplasia has a ____ predilection

64
Q

Most common location for Necrotizing Sialometaplasia

A

Posterior hard palate/anterior soft palate

65
Q

After 2 weeks, patients with Necrotizing Sialometaplasia will say:

A

“A piece of my palate fell out”

66
Q

Necrotizing Sialometaplasia heals in __-___ weeks

67
Q

Necrotizing Sialometaplasia can be mistaken for ___ or ____ carcinoma

A

SCC, mucoepidermoid

68
Q

What do you see in the surface epithelium of Necrotizing Sialometaplasia

A

Pseudoepitheliomatous hyperplasia (PEH)

69
Q

Histologically, what mimics SCC in Necrotizing Sialometaplasia

A

Nonspecific reactive hyperplasia stratified mucocutaneous epithelia

70
Q

Constant hypersalivation

A

Sialorrhea

71
Q

2 causes of sialorrhea

A

Increased salivary flow (primary) and impaired swallowing (secondary)

72
Q

Most common reason for impaired swallowing

A

neuromuscular dysfunction

73
Q

Treatments for sialorrhea

A

Surgery and Botox

Oral Path 2, Exam 2 (6 decks)

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