SALIVARY GLAND PATHOLOGY Flashcards
SALIVARY GLANDS
Major
(3)
Parotid
Submandibular
Sublingual
SALIVARY GLANDS
Minor
(7)
Palate
Buccal mucosa
Tongue
Floor of mouth
Labial mucosa
Retromolar pad
Oropharynyx
DISTRIBUTION OF MINOR SALIVARY GLANDS
Palate –%
Tongue –%
Lips –%
Cheeks –%
Retromolar –%
60
10
10
10
10
Glands of Von Ebner
Circumvalate papillae –
serous
Glands of Blandin and Nuhn
Anterior ventral – mucous
Glands of Weber
Posterior lateral border -
mucous
GLANDS OF VON EBNER
(2)
Circumvalate papillae
Serous
GLANDS OF WEBER
(2)
Foliate papillae
Mucous
GLANDS OF BLANDIN AND NUNN
(2)
Anterior ventral
Mucous
Mucin dissects through mylohyoid muscle, presenting as a
neck mass
HISTOLOGY
(3)
Pseudoepitheliomatous hyperplasia
Sialometaplasia
Coagulative necrosis of the glands
SJOGREN SYNDROME
(4)
Autoimmune disorder
Dry mouth and dry eyes
Primary vs. Secondary
Bilateral enlargement of parotid gland
SJOGREN SYNDROME
Bilateral enlargement of parotid gland
(2)
Benign lymphoepithelial lesion (BLEL)
Mikulicz’s disease
SJOGREN SYNDROME
Laboratory values
(4)
Anti-SS-A
Anti-SS-B
RF
ANA
TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS
Parotid
Benign
Malignant
50%
50%
TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS
Submandibular
Benign
Malignant
40%
60%
TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS
Sublingual
Benign
Malignant
20%
80%
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Palate
Benign
Malignant
50%
50%
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Buccal Mucosa
Benign
Malignant
50%
50%
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Upper Labial Mucosa
Benign
Malignant
80%
20%
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Lower Labial Mucosa
Benign
Malignant
15%
85%
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Tongue
Up to –% malignant
90
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Floor of Mouth
Up to –% malignant
90
TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Retromolar pad
Up to –% malignant
90
Feature: Benign
Growth rate
Induration
Symtomatology
Ulceration
Slow growth
Movable
Asymptomatic
Intact mucosa
Feature: Malignant
Growth rate
Induration
Symtomatology
Ulceration
Rapid growth
Fixed
Symptomatic
Ulcerated
BENIGN SALIVARY GLAND
TUMORS
(5)
Benign Mixed Tumor (Pleomorphic Adenoma)
Monomorphic Adenoma
Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum)
Oncocytoma
Ductal Papillomas
PLEOMORPHIC ADENOMA
(3)
Most common salivary gland neoplasm
Middle-aged females
Painless slowly growing mass
PLEOMORPHIC ADENOMA
HISTOLOGY
(3)
Variable histology
Mixture of ductal and
myoepithelial elements
Encapsulated
MONOMORPHIC ADENOMA
(3)
Upper lip
Middle-aged females
Painless slowly growing mass
MONOMORPHIC ADENOMA
HISTOLOGY
(5)
Uniform pattern
Single layered cords of columnar or cuboidal epithelium
May demonstrate papillary projections
Loose connective tissue stroma, with prominent vascularity
Thin fibrous capsule
PAPILLARY CYSTADENOMA
LYMPHOMATOSUM
(6)
2nd most common benign salivary gland
neoplasm
Parotid gland
Bilateral
Middle-aged males
-Lower in blacks
Smoking
Painless slowly growing nodular mass
PAPILLARY CYSTADENOMA
LYMPHOMATOSUM
HISTOLOGY
(4)
Oncocytic ductal epithelium
Uniform double rows
Lymphoid aggregate
Papillary cystic configuration
ONCOCYTOMA
(4)
Rare salivary gland neoplasm
Large epithelial cells, oncocytes
Females, 8th decade
Parotid
-`Painless slowly growing mass Multifocal
ONCOCYTOMA
HISTOLOGY
(3)
Large polyhedral cells abundant in granular
eosinophilic cytoplasm
- mitochondria
Limited stroma
- Thin fibrovascular septa
Lymphoid infiltrate
MALIGNANT SALIVARY GLAND
TUMORS
(6)
Mucoepidermoid Carcinoma
Adenoid Cystic Carcinoma
Polymorphous Low-Grade Adenocarcinoma
Acinic Cell Carcinoma
Carcinoma ex-Mixed Tumor
Adenocarcinoma NOS
MUCOEPIDERMOID CARCINOMA
(3)
Most common malignant salivary gland
neoplasm
Middle-aged females
Clinically mistaken for a mucocele
MUCOEPIDERMOID CARCINOMA
HISTOLOGY
(3)
Mucous producing cells
Epidermoid (squamous) cells
May be cystic and / or solid
ADENOID CYSTIC CARCINOMA
(3)
Best recognized salivary gland tumor
Middle-aged females
Slowly growing mass, painful
ADENOID CYSTIC CARCINOMA
HISTOLOGY
(4)
Myoepithelial and ductal cells
Perineural and perivascular invasion
Cribiform pattern
SWISS CHEESE
POLYMORPHOUS LOW-GRADE
ADENOCARCINOMA
(3)
Common malignant MINOR salivary gland
neoplasm
Middle-aged females
Favors palate
POLYMORPHOUS LOW-GRADE
ADENOCARCINOMA
HISTOLOGY
(4)
Deceptive uniform appearance
Different growth patterns
Perineural and perivascular invasion
Indian filing
ACINIC CELL CARCINOMA
(5)
Parotid
Serous acinar differentiation
Middle-aged females
Slow-growing
Low-grade malignancy
ACINIC CELL CARCINOMA
HISTOLOGY
(4)
Well circumscribed
May be infiltrative
Serous acinar cell
Abundant granular basophilic cytoplasm and a
round, stained eccentric nucleus
CARCINOMA EX-PLEOMORPHIC
ADENOMA
(4)
Long standing pleomorphic adenoma
Older adults
Rapid growth
Pain and ulceration
CARCINOMA EX-PLEOMORPHIC
ADENOMA
HISTOLOGY
(2)
Typical benign mixed tumor
Malignant degeneration
- Cellular pleomorphism
- Abnormal mitotic activity
- Capsular invasion
ADENOCARCINOMA NOS
(2)
Uncommon salivary gland neoplasm
Middle-aged females
ADENOCARCINOMA NOS
HISTOLOGY
(1)
Variable histology