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AU18: Oral Path 2 > Salivary Gland Neoplasms > Flashcards

Salivary Gland Neoplasms Flashcards

1
Q

T/F: Salivary gland neoplasms have a slight female predilection.

A

True

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2
Q

What is the most common site for a salivary gland neoplasm (benign or malignant)?

A

Parotid gland

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3
Q

What is the most common site for a salivary gland neoplasm in the minor glands?

A

Palate

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4
Q

Which major salivary gland has the highest percentage of malignancies per neoplasm?

A

Sublingual

Neoplasms in the sublingual glands are the most likely to be malignant

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5
Q

Which intraoral minor salivary glands are most likely to have a malignant neoplasms?

A

Retromolar region and tongue

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6
Q

______________ is the most common salivary gland neoplasm.

A

Pleomorphic adenoma

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7
Q

What percentage of pleomorphic adenomas are found in the parotid gland?

A

80% of pleomorphic adenomas are in the parotid gland

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8
Q

T/F: Pleomorphic adenomas will cause pain to the patient.

A

False

Slow-growing, painless, moveable, rubbery-firm

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9
Q

Which minor salivary gland is most likely to develop a pleomorphic adenoma?

A

Palate

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10
Q

T/F: Pleomorphic adenomas will look encapsulated histologically.

A

True

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11
Q

T/F: Pleomorphic adenomas are benign.

A

True

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12
Q

_____________ may appear plasmacytoid or spindled in pleomorphic adenomas.

A

Myoepithelial cells

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13
Q

Which gland is least likely to have a salivary gland neoplasm (benign or malignant)?

A

Sublingual

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14
Q

Which salivary gland has the lowest percentage of malignancies per neoplasm in that area?

A

Parotid

Most neoplasms in the palate are benign

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15
Q

T/F: Pleomorphic adenoma has a very specific histological appearance.

A

False

Can look very different

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16
Q

What is the second most frequent site for a pleomorphic adenoma?

A

Upper lip

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17
Q

T/F: To remove a pleomorphic adenoma in the parotid, the lesion must be removed along with the parotid gland.

A

False

Parotid - lesion and lobe involved

Submandibular - lesion and involved gland

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18
Q

What percentage of pleomorphic adenomas will become malignant if not removed?

A

5%

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19
Q

T/F: Parotid pleomorphic adenomas are more likely to recur than those in minor glands.

A

True

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20
Q

What is the second most common benign tumor of the salivary glands?

A

Papillary cystadenoma lymphomatosum - “Warthin tumor”

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21
Q

T/F: Warthin tumor has a strong association with cigarette smoking and has a male predominance.

A

True

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22
Q

Where on the parotid are Warthin tumors most commonly found?

A

Tail

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23
Q

T/F: Pleomorphic adenoma will show cystic spaces containing serous fluid histopathologically.

A

False

Papillary cystadenoma lymphomatosum

24
Q

T/F: Papillary cystadenoma lymphomatosum is encapsulated.

A

True

25
Q

Oncocytes are seen projecting into the cystic space in which type of tumor?

A

Warthin tumor (Papillary cystadenoma lymphomatosum)

26
Q

T/F: Warthin tumors have a good prognosis.

A

True

Surgical excision - low recurrence rate

27
Q

T/F: Canalicular adenoma is more common in minor salivary glands.

A

True

28
Q

Which benign salivary tumor occurs more often in much older patients (7th decade)?

A

Canalicular adenoma

29
Q

What will be seen histopathologically in a Canalicular adenoma?

A

Tubules and narrow trabecular cords appearing like channels

30
Q

What is the prognosis for a Canalicular adenoma?

A

Excellent

Enucleation - no tendency to recur

31
Q

What is the most common salivary gland malignancy?

A

Mucoepidermoid carcinoma

32
Q

T/F: Mucoepidermoid carcinoma is unlikely to be seen in people less than 40 years old.

A

False

15% in patients <15 y.o.

33
Q

T/F: Mucoepidermoid carcinoma is seen in only major glands.

A

False

Both major and minor

34
Q

What are the two most common minor salivary regions to see mucoepidermoid carcinoma?

A

Palate and retromolar region

35
Q

You see a mucocele-appearing lesion in the retromolar area. What should be #1 on you differential?

A

Mucoepidermoid carcinoma

36
Q

Why might a mucoepidermoid carcinoma have a blue tint?

A

Trapped mucin

37
Q

T/F: Mucoepidermoid carcinoma will show significant pleomorphism and increased mitotic activity.

A

False

Must show intracellular mucin and have mucous and Epidermoid cells

38
Q

What are the two distinct histopathologic features of mucoepidermoid carcinoma?

A
  1. Mucous cells

2. Epidermoid cells

39
Q

T/F: All mucoepidermoid carcinomas need excision and radiation.

A

False

Only high-grade need radiation after excision

40
Q

What is the second most common minor salivary gland malignancy?

A

Polymorphous adenocarcinoma (PAC)

41
Q

T/F: Polymorphous adenocarcinoma is more prevalent in females.

A

True

42
Q

What are the clinical features of a polymorphous adenocarcinoma?

A

Slow-growing, firm and painless

May have ulceration

Starts as well demarcated then infiltrates

43
Q

T/F: Polymorphous adenocarcinoma is almost exclusive to the parotid glands.

A

False

Exclusive to minor salivary glands

62% in palate

44
Q

What are some histopathological features of a Polymorphous adenocarcinoma?

A

Variety of growth patterns

Lobular growth pattern infiltrating surrounding tissue

Pseudocapsule

45
Q

What is the prognosis for Polymorphous adenocarcinoma?

A

Good
Wide surgical excision
20% recurrence

46
Q

Where are the majority of adenoid cystic carcinomas found?

A

Often in minor salivary glands, especially the palate

47
Q

What is the most common malignancy of the submandibular gland?

A

Adenoid cystic carcinoma

48
Q

T/F: Adenoid cystic carcinoma is typically associated with pain or tenderness.

A

True

NSAIDs and acetaminophen do not help

49
Q

What are some histopathological features of adenoid cystic carcinoma?

A

Unencapsulated

Perinueral and intraneural invasion

50
Q

What are the three possible growth patterns for adenoid cystic carcinoma?

A
  1. Tubular - well-differentiated
  2. Cribriform - “Swiss cheese”
  3. Solid - poorly-differentiated
51
Q

T/F: There is lots of pleomorphism and mitotic activity with adenoid cystic carcinoma.

A

False

52
Q

T/F: Radiation treatment is required with adenoid cystic carcinoma.

A

True

53
Q

What is the prognosis for adenoid cystic carcinoma?

A

Poor

54
Q

What is the most common path of metastasis for adenoid cystic carcinoma?

A

Blood -> lung, brain, bone, liver

55
Q

Where are the majority of acinic cell carcinomas?

A

Parotid gland

AU18: Oral Path 2 (18 decks)

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