Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS4 Tutorials > Salivary Gland Pathology > Flashcards

Salivary Gland Pathology Flashcards

1
Q

What is a mucocele?

A

Mucous extravasation cyst or phenomenon
- Consists of cavity, wall, lining
- Mucocele is lined with macrophages instead of epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does a mucocele present?

A

Fluid filled

Erythematous periphery with translucent/blue centre

Burst and comes back in same place

Lower lip

Younger patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What questions should we ask patients about any lump?

A
  • How long has it been there?
  • Has it changed in size?
  • Pain?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do blisters in pemphigoid/gus differ from mucocele?

A

Blisters tend to occur in different places
 Recurs but not in exact same place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a ranula and its features?

A

Like a mucocele in floor of the mouth which is larger
- Very translucent
- Resembles belly of frog
- Plunging ranula- can affect swallowing and breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How may a ranula be treated?

A

Marsupialisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes mucoceles?

A

Trauma to duct of salivary gland resulting in severance and leaking and collects in connective tissue (bite, fight, bike accident)
-> Location of saliva is abnormal- body forms wall of granulation tissue around it to contain it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a mucocele treated?

A
  • Surgical removal of gland and injured duct
  • May heal itself
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a mucous retention cyst?

A

As a result of dilation of ducts of glands, saliva collects within

** Something expanding may be putting pressure on duct causing this collection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the clinical features of a mucous retention cyst?

A

 Upper lip usually
 Older people
 Has epithelial lining
 Can occur within maxillary sinus (may be discovered incidentally on CBCT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the histopathological features of a mucocele?

A
  • Cavity- filled with saliva, may have some neutrophils
  • Wall- granulation tissue
  • Lining- made of macrophages (foam cells)
  • On outer surface- epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the histological features of granulation tissue? (first stage in healing process)

A
  • Macrophages- remove debris, phagocytosis of necrotic tissue or pathogens, they will try to engulf saliva as well (become big and pale- collections of foam cells)
  • Plasma cells
  • BVs- many capillaries
  • Lymphocytes
  • Fibroblasts- form collagen (appears pink/brown)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens to granulation tissue over time?

A

Becomes more fibrous and less cellular
-> BVs also reduce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What else can cause macrophages to become foam cells?

A

If they engulf lipid, mucous/mucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where doe sialoliths tend to block minor salivary glands?

A

Buccal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is submandibular gland most likely to get blocked?

A
  • Duct is long and goes in upward direction
  • Produces mixed secretion (can thicken if dehydrated or due to medication)
  • The duct is also curved- promotes stagnation of saliva
17
Q

What type of sialoliths can occur?

A

Mucous plug- not seen on plain radiographs

Calcified- seen on plain radiographs (lower occlusal used)

-> both may be palpable

18
Q

How are sialoliths treated?

A
  • Surgery to remove stone (and perhaps part of the gland)
  • Retrieval of stone
19
Q

What are the histopathological features of sialoliths?

A
  • Dilated duct
  • Calcification
  • Lining of duct- becomes stratified squamous epithelium with thin layer of keratin on surface (changes from columnar), due to trauma and friction from jagged edges of sialolith (metaplasia)
  • Inflammatory cells within gland- saliva being secreted collects and is moved very slowly within gland causing chronic sialadenitis
  • Dark acini- serous
  • Pale acini- mucous
20
Q

What is the likely cause of a slow growing lump present in palate with pink appearance with presence of red capillaries and rubbery texture?

A

 Pleomorphic adenoma- commonest type of salivary gland tumour (can occur anywhere- lip, tongue, lacrimal glands, mucosa but classically seen in palate)

21
Q

What are the layers to consider when evaluating swelling in the palate?

A

Epithelium (if it looks uniform it is unlikely to be coming from here)

Lamina propria connective tissue (BVs, fibrous tissue, minor salivary glands, nerves)

Bone

Consider if it is close to teeth- abscess (check if TTP, radiograph, sensibility test, fluctuant texture)

22
Q

What is meant by pleomorphic in terms of cancer?

A

cells change in size, shape and appearance

23
Q

What is meant by pleomorphic in terms of adenoma?

A

variety of tissue appearances (no 2 are the same under microscope)

24
Q

How is a Pleomorphic Adenoma treated?

A

Excisional biopsy
 If larger- may be an incisional biopsy (then removed)

25
Q

What are the histopathological features of Pleomorphic Adenomas?

A

Myopepithelial cells in sheets or duct shapes- source

Fibrous tissue- dense/hyalinised
-> lack of nuclei and fibrous cells

Myxomatous tissue- soft and jelly like
-> difficult to remove surgically

Fat tissue

Appears appearing like bone and cartilage

Incomplete capsule- tumour can grow through gaps

26
Q

What is the main complication for pleomorphic adenoma?

A

If it remains for long periods of time- it can undergo malignant transfer (5%)
 Carcinoma ex-pleomorphic adenoma

27
Q

How long is the follow up after a PA removal?

A

5 year follow up for Pleomorphic Adenoma
 Recurrence is more likely in tumours that arise from minor glands

28
Q

What is the most common salivary gland site for Pleomorphic Adenoma?

A

Parotid

29
Q

What are the tissue layers to consider when we see swelling in the face?

A
  • Skin (epidermis)
  • Epithelium
  • Dermis (fibrous connective tissue)- muscle, nerve endings, blood vessels, fibroblasts, collagen, lymphatics, sweat glands, hair, sebaceous glands, nails in some regions
  • Bone (osteoma)
  • Muscle (myoma)
  • Fat (lipoma)
30
Q

What is the likely cause of an asymptomatic slo growing swelling below the ear which has been present for many years?

A

Warthin’s tumour

31
Q

What is another swelling covered in normal skin that can be seen in head and neck?

A

Epidermal cyst (sebaceous cysts are also possible)
- Usually on scalp or back of neck

32
Q

What are the clinical features of Warthin’s tumour?

A
  • Slow growing
  • Occurs exclusively within parotid gland
  • Associated with smoking
  • Can be bilateral
  • Can be multifocal- more than one tumour within one gland (entirely separate)
33
Q

How does warthin’s tumour originate?

A

Originates from entrapment of lymphoid tissue within salivary gland tissue (or VV) during foetal development

34
Q

How does Warthin’s tumour appear histologically?

A
  • Round
  • Well defined fibrous capsule (all contained within this)
  • Dark staining- lymphoid tissue (contains germinal centres- formation of lymphocytes occurs here)
  • Pink cells- lining of cystic spaces (contains protein)
  • Columnar epithelium
  • Plaque cells replace salivary gland acini in major glandular tissue around warthins tumour (dry mouth)
  • Congestion and inflammation within the gland can occur around tumour (pressure leading to stagnation of saliva resulting in sialadenitis)
35
Q

How is Warthin’s tumour treated?

A

Surgical removal- easy due to capsule
-> Malignant potential and recurrence is very rare

36
Q

What are the histological features of Adenoid Cystic Carcinoma?

A
  • Made up of small cuboidal cells with dark nuclei (cells are not pleomorphic- they are regular in shape and size)
  • May have tubular, sheet, Swiss cheese appearance (cribriform)
  • Spaces in cribriform regions- not cysts but contain ground substance of connective tissue within them (good prognostic indicator)
  • Perineural invasion is common- malignant cells grow along the myelin sheath (whirlpool appearance), can be multiple instances of this within one malignant lesion
37
Q

How do carcinomas usually metastasise?

A

LN then blood

38
Q

How does adenoid cystic carcinoma spread?

A

Goes straight to blood then other areas of body, commonly the lungs
-> Metastases to LN comes as third stage

BDS4 Tutorials (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions