Salivary Gland lesions

Question 1

what is a mucocele

Answer 1

local trauma

to salivary gland duct to

spillage of mucin

Question 2

tf

mucocele is not a true cyst [epi lined] waht is then?

Answer 2

true

salivary duct cyst

Question 3

2 clinical features of mucocele

Answer 3

1) dome shaped

mucosal swelling

2) 1 - 2 mm in size to few cm
3) NEVER on the upper lip

Question 4

3 histofeatures of mucocele

Answer 4

1. mucin filled cyst like cavity

beneath the mucsoal surface

2. area of spillage is surrounded by granulation tissue
3. mucin associated with the granulation tissue
   w. the foamy histiocytes

Question 5

2 TX FOR mucocele

Answer 5

1. short lived, rupture, self resolving
2. chronic need surgical excision, remove the entire minor salivary gland prevent reoccurance

Question 6

what is a ranula

Answer 6

• mucocele on the floor of the mouth
• spillage from:
  1. sublingual gland [most common]
  2. submandibular duct
  3. minor salivary duct on the floor of the mouth

Question 7

minor lesions can show up on the

**sublingual plica **

on the SUPERFICIAL DUCTS OF

________ of sublingual gland

Answer 7

RIVINI of sublingual gland

Question 8

3 clinical features of the ranula

Answer 8

1. BLUE dome shaped

fluctuant swelling

in the floor of the mouth

2. plunging and cervical
3. spillage through **mylohyoid muscle **to cause a swelling in the neck

Question 9

histofeatures of ranula

Answer 9

same as mucoele

1. mucin filled cyst like cavity beneath the mucosal surface
2. area of spillage surrounded by granulation tissue
3. mucin assocaited granulation has the foamy histiocytes

Question 10

2 tx for ranula

Answer 10

1. marsupialization
   - small lesions along the rivini of the sublingual gland
2. surgical excision
   - large lesions, remove the entire minor salivary gland

Question 11

what is a salivary duct cyst

Answer 11

1. true epi lined developmental cyst

seperate from the normal salivary duct

2. arises from minor and major salivary gland tissue

Question 12

waht is mucous retention cyst

Answer 12

1. cyst like dilation of salivary duct
2. may have **secondary to ductal obstruction [MUCOUS PLUG] **

Question 13

salivary duct cyst

_____ usually have it

Answer 13

adults

Question 14

3 histofeatures of salivary duct cysts

Answer 14

1. cystic cavity lined by **thin cuboidal epithelium **

**2. **adj to the cyst is **excretory salivary duct **lined by COLUMNAR EPITHELIUM

3. dilated duct:

C - columnar

E - eosinophilic

O - oncocytes

w/ papillary folds

into the ductal lumen

Question 15

tx for salivary duct cysts

Answer 15

conservative surgical excision

Question 16

what is sialolithiasis

Answer 16

1. Ca deposition around

nidus of debris

into the ductal lumen

2. cause is unknown
3. NOT from the derangment of Ca and P metabolism

Question 17

most often sialolithiasis occurs most often in

_______ gland

minor sialothialisis occurs most commonly in:

_______

_______

Answer 17

most common = submandibular gland

minor = buccal mucosa and upper lip

Question 18

what do you see radiographically with sialolithiasis

Answer 18

radioopaque mass

Question 19

TF

major sialolithiasis can cause

pain and swelling

in affected gland

Answer 19

true

pain and swelling

Question 20

3 histofeatures of sialolithiasis

Answer 20

1. intraductal calcified mass

shows concentric laminations

2. surrounding nidus of amorphous debri
3. ducts w. squamous metaplasia

Question 21

4 treatments of sialolithiasis

Answer 21

1. surgical excision
2. remove the gland
3. massage to milk out the stone
4. sialogogues

Question 22

sialogogues

Answer 22

drugs that increase salivary flow:

• moist heat
• increase intake of fluids

Question 23

waht is sialadentitis

Answer 23

inflammation of salivary gland

Question 24

4 things taht can use sialadentitis

Answer 24

1. virus [mumps]
2. bacteria
   - staphylococcus aureus
   - streptococcus
3. blockage of the duct:
   - abdominal surgery
   - congenital stricture
   - sialolithiasis
   - compression from adj tumor
4. meds for these things that doesnt cause infeciton
   - xerostomia, sjorgen syndrome, allergens, radiotherapy, sarcoidosis