Salivary Gland Dz Flashcards
What is sialadentitis?
inflammation of salivary gland, often caused by s. aureus (cluster of grapes)
What gland is frequently involved in acute bacterial sialadenitis and how so?
parotid gland, typically swollen and painful purulent discharge drains from duct
What would cause a chronic sialadenitis?
secondary to recurrent or persistent ductal obstruction due ot a stone (sialolith)
What are symptoms of chronic sialadenitis?
episodic pain and swelling, usually at mealtime. submandibular involvement may include persistent enlargement
How do you tx sialadenitis: acute and chronic?
Acute - antibiotics rehydration Chronic - remove sialolith
What gland is most often involved in salivary gland tumors?
parotid (80%)
What is the general principle with malignancy in salivary gland tumors?
the smaller, the more likely it’s malignant
List the salivary glands from largest to smallest
Parotid, submanidbular, sublingual
Submandibular gland malignany percentage
up to 45%
sublingual gland malignancy percentage
up to 90%
What is the most common type of salivary gland tumor?
pleomorphic adenoma (benign mixed tumor)
What is a pleomorphic adenoma?
a mixture of ductal epi and mesenchymal elements (2 germ layers)
what is the classic presentation of a pleomorphic adenoma?
a 50 yr old woman with a slwoly growing painless movable firm mass, typically rounded, well circumscribed and commonly rubbery texture.
What are the pathologic qualities of pleomorphic adenoma?
typically encapsulated, epithelial component usually ductal or cystic formations, mesenchymal component usually myoepithlial cells in a myxoid or chondroid matrix
how do you tx pleomorphic adenoma
surgical excision, be careful of facial nerve injury
What is warthin’s tumor
papillary cysadenoma lymphomatosum
what is the typical presentation of warthins tumor?
60 yo male smoker with painless firm slowly growing mass in the tail of the parotid, often bilateral
what is the histology of warthin’s tumor
cystic spaces lined by a double layer of oncocytes (epi cells with abundant granular eosinophilic cytoplasm) prominent lymphoid stroma (commonly in germinal centers)
T of F: warthins tumors are monoclonal and not actually neoplastic
false, they are polyclonal and not actually neoplastic
T or F: warthin’s tumors may have lymphoid reactoin
true
`What is a mucoepidermoid carcinoma?
most common malignant tumor of salivary glands, with a highly variable biologic behavior. Rare.
What is the typical presentaiton of mucoepidermoid carcinoma?
middle aged female with asymptomatic swelling of the parotid or palate
What is the histology of a mucoepidermoid carcinoma
Mixture of squamous cells and mucus
What stain can you use to see a mucoepidermoi carcinoma?
mucicarmine stain, which stains mucus red
Which is more important in mucoepidermoid carcinoma: stage or grade?
Both are very important (usually stage is more important)
What is this?
