Salivary Gland Pathology

Question 1

What are acini?

Answer 1

Saliva producing cells

Question 2

What are lobules?

Answer 2

Several salivary acini arrange together

Question 3

How do serous and mucous acini vary on histology?

Answer 3

Serous = dark purple
Mucous = light purple

Question 4

How do mucocele present?

Answer 4

Often lower lip
Well defined raised lesions
Blue-ish tint
May have surrounding erythema
Fluctuant

Question 5

Differential of mucocele?

Answer 5

Mucocele - extravasation/ retention

Hemangioma - often darker

Question 6

Is labial mucosa keratinised?

Answer 6

No - lining tissue

Question 7

What substance expect to see in lumen of mucoele (extravasation)?

Answer 7

Mucosa

Macrophages

Question 8

What is cyst wall composed of in mucocele?

Answer 8

Fibrous tissue

Inflamed - chronic cells

Question 9

Why do mucoceles form?

Answer 9

Trauma = ruptured duct (mucous extravasation)

Question 10

Ex of mucous extravasation cyst?

Answer 10

Excision cyst and associated glands

Question 11

What substance expect to see mucous retention cyst?

Answer 11

Mucin/ mucuous

Question 12

What see histology mucous retnetion cyst?

Answer 12

Enlargemnt of duct due to blockage

Question 13

What is chronic sialadenitis?

Answer 13

Chronic inflammation of gland

Question 14

What see histologically in chronic sialadenitis?

Answer 14

Destruction normal architecture
Destruction acini
Fibrosis
Chronic inflammatory cells

Question 15

What would be differentials of longstanding swelling on the palate?

Answer 15

Salivary gland tumour - benign/ malignant can’t tell clinically

Question 16

Examples of benign and malignant salivary gland tumours?

Answer 16

Benign: pleomorphic adenona
Malignant: adenocystic carcinoma

Question 17

What see benign salivary gland tumour?

Answer 17

Well defined and capsulated tumour

No evidence invasion/ malignancy

Question 18

Histology seen pleomorphic adenoma?

Answer 18

Variable

Duct like structures - lined by epithelium

Question 19

Management pleomorphic adenoma?

Answer 19

Conservative excision - remove tumour and capusle

Question 20

What features of salivary gland swelling would raise cocnern?

Answer 20

Rapid growth
Pain
Ill-defined borders

Question 21

What see on histology of salivary gland tumour suggest malignant?

Answer 21

Infiltrative and invasive lesion
Tumour islands
Peri-neural invasion

Question 22

What see histology adeno-cystic carcnoma?

Answer 22

Swiss cheese pattern

Question 23

Management adeno-cystic carcinoma?

Answer 23

Remove w/ clear margins - likely resection +- neck dissection +- radio/chemo