Salivary Gland Dz

Question 1

What is sialadentitis?

Answer 1

inflammation of salivary gland, often caused by s. aureus (cluster of grapes)

Question 2

What gland is frequently involved in acute bacterial sialadenitis and how so?

Answer 2

parotid gland, typically swollen and painful purulent discharge drains from duct

Question 3

What would cause a chronic sialadenitis?

Answer 3

secondary to recurrent or persistent ductal obstruction due ot a stone (sialolith)

Question 4

What are symptoms of chronic sialadenitis?

Answer 4

episodic pain and swelling, usually at mealtime. submandibular involvement may include persistent enlargement

Question 5

How do you tx sialadenitis: acute and chronic?

Answer 5

Acute - antibiotics rehydration Chronic - remove sialolith

Question 6

What gland is most often involved in salivary gland tumors?

Answer 6

parotid (80%)

Question 7

What is the general principle with malignancy in salivary gland tumors?

Answer 7

the smaller, the more likely it’s malignant

Question 8

List the salivary glands from largest to smallest

Answer 8

Parotid, submanidbular, sublingual

Question 9

Submandibular gland malignany percentage

Answer 9

up to 45%

Question 10

sublingual gland malignancy percentage

Answer 10

up to 90%

Question 11

What is the most common type of salivary gland tumor?

Answer 11

pleomorphic adenoma (benign mixed tumor)

Question 12

What is a pleomorphic adenoma?

Answer 12

a mixture of ductal epi and mesenchymal elements (2 germ layers)

Question 13

what is the classic presentation of a pleomorphic adenoma?

Answer 13

a 50 yr old woman with a slwoly growing painless movable firm mass, typically rounded, well circumscribed and commonly rubbery texture.

Question 14

What are the pathologic qualities of pleomorphic adenoma?

Answer 14

typically encapsulated, epithelial component usually ductal or cystic formations, mesenchymal component usually myoepithlial cells in a myxoid or chondroid matrix

Question 15

how do you tx pleomorphic adenoma

Answer 15

surgical excision, be careful of facial nerve injury

Question 16

What is warthin’s tumor

Answer 16

papillary cysadenoma lymphomatosum

Question 17

what is the typical presentation of warthins tumor?

Answer 17

60 yo male smoker with painless firm slowly growing mass in the tail of the parotid, often bilateral

Question 18

what is the histology of warthin’s tumor

Answer 18

cystic spaces lined by a double layer of oncocytes (epi cells with abundant granular eosinophilic cytoplasm) prominent lymphoid stroma (commonly in germinal centers)

Question 19

T of F: warthins tumors are monoclonal and not actually neoplastic

Answer 19

false, they are polyclonal and not actually neoplastic

Question 20

T or F: warthin’s tumors may have lymphoid reactoin

Answer 20

true

Question 21

`What is a mucoepidermoid carcinoma?

Answer 21

most common malignant tumor of salivary glands, with a highly variable biologic behavior. Rare.

Question 22

What is the typical presentaiton of mucoepidermoid carcinoma?

Answer 22

middle aged female with asymptomatic swelling of the parotid or palate

Question 23

What is the histology of a mucoepidermoid carcinoma

Answer 23

Mixture of squamous cells and mucus

Question 24

What stain can you use to see a mucoepidermoi carcinoma?

Answer 24

mucicarmine stain, which stains mucus red

Question 25

Which is more important in mucoepidermoid carcinoma: stage or grade?

Answer 25

Both are very important (usually stage is more important)

Question 26

What is this?