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Pathology II > Salivary Gland Pathology > Flashcards

Salivary Gland Pathology Flashcards

1
Q

Label the following structures of the salivary gland unit:

A

A- Stratified squamous epithelium
B- Extralobular duct
C- Striated duct
D- Intercalated duct
E- Acinar cells
F- Myoepithelial cells

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2
Q

Label the following structures of the salivary gland unit:

A

A- Acinus
B- Intercalated duct
C- Striated duct
D- Excretory duct

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3
Q

List the MAJOR salivary glands: (3)

A
  1. Parotid
  2. Submandibular
  3. Sublingual
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4
Q

List the locations of the MINOR salivary glands: (7)

A
  1. Palate
  2. Buccal mucosa
  3. Tongue
  4. Floor of mouth
  5. Labial mucosa
  6. Retromolar pad
  7. Oropharynx
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5
Q

What can be seen in the following histological slide?

A

Parotid gland

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6
Q

What can be seen in the following histological slide?

A

Parotid gland- pure serous

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7
Q

The parotid gland is a _____ gland

A

pure serous

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8
Q

What can be seen in the following histological slide? What are the dark staining purple areas?

A

Serous acini- zymogen granules

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9
Q

What can be seen in the following histological slide?

A

Submandibular gland

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10
Q

The submandibular gland is a _____ gland

A

seromucous

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11
Q

What can be seen in the following histological slide?

A

Sublingual gland

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12
Q

The sublingual gland is a _____ gland

A

mucoserous

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13
Q

What can be seen in the following histological slide?

A

sublingual gland

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14
Q

List the distribution of the following minor salivary glands:

a) Palate
b) Tongue
c) Lips
d) Cheeks
e) Retromolar

A

a) Palate: 60%
b) Tongue: 10%
c) Lips: 10%
d) Cheeks: 10%
e) Retromolar: 10%

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15
Q

Minors salivary glands of the tongue include: (3)

A
  1. Glands of Von Ebner
  2. Glands of Blandin & Nuhn
  3. Glands of Weber
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16
Q
  • Glands of Von Ebenr
  • Glands of Blandin & Nuhn
  • Glands of Weber

These are all:

A

Minor salivary glands of the tongue

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17
Q

List the location & type of minor salivary of the tongue:

Glands of Von Ebner

A

Location: circumvallate papillae
Type: Serous

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18
Q

List the location & type of minor salivary of the tongue:

Glands of Blandin & Nuhn

A

Location: Anterior ventral
Type: Mucous

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19
Q

List the location & type of minor salivary of the tongue:

Glands of Weber

A

Location: Posterior lateral border
Type: Mucous

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20
Q

What minor salivary gland is seen below?
Location?
Type?

A

Glands of Von Ebner
Circumvalate papillae
Serous

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21
Q

What minor salivary gland is seen below?
Location?
Type?

A

Glands of Weber
Foliate papillae
Mucous

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22
Q

What minor salivary gland is seen below?
Location?
Type?

A

Glands of Blandin & Nuhn
Anterior ventral
Mucous

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23
Q

A mucous extravasation reaction =

A

mucocele

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24
Q

Diagnose the following image:

A

mucocele

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25
Q

Diagnose the following image:

A

mucocele

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26
Q

The following histological and clinical images show:

A

mucous extravasation reaction (mucocele)

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27
Q

The following histological image shows:

A

mucocele

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28
Q

The following histological and clinical images show:

A

mucocele

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29
Q

Diagnose the following image:

A

mucocele

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30
Q

Diagnose the following image:

A

Ranula

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31
Q

When mucin dissects through mylohyoid muscle presenting as a neck mass:

A

Ranula

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32
Q

Diagnose the following image:

A

Ranula

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33
Q

What is represented by this schematic?

A

Sialolith

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34
Q

Diagnose the following image:

A

Sialolith

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35
Q

What structures are involved in a sialolith?

A

Submandibular gland (deep lobe) & Wharton’s duct

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36
Q

Diagnose the following images:

A

Sialolith

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37
Q

Diagnose the following radiographic image:

A

Sialolith

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38
Q

Diagnose the following image:

A

Sialolith

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39
Q

What can be seen in the following histological image?

A

Sialolith

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40
Q

Diagnose the following image:

A

Necrotizing sialometaplasia

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41
Q

Diagnose the following image:

A

Necrotizing sialometaplasia

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42
Q

Diagnose the following image:

A

Necrotizing sialometaplasia

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43
Q
  • autoimmune disorder
    -dry mouth & dry eyes
  • primary vs. secondary
  • bilateral enlargement of parotid gland
A

Sjogrens syndrome

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44
Q

What are some syndromes one may experience with Sjogrens syndrome:

A
  1. dry mouth & eyes
  2. B/L enlargement of parotid gland
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45
Q

What are some characteristic lab values of Sjogren syndrome?

A
  1. anti-SS-A
  2. anti-ss-B
  3. RF
  4. ANA
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46
Q

If a patient presents with benign lymphoepithelial lesion (BLEL) you may suspect:

A

Sjogrens syndrome

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47
Q

An autoimmune disease considered a form of Sjogrens syndrome in which the salivary and lacrimal glands become enlarged:

A

Mikulicz’s disease

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48
Q

-BLEL
-Mikulicz’s

These are both associated with:

A

Sjogren’s syndrome

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49
Q

Diagnose the following image:

A

Sjogren’s syndrome

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50
Q

Diagnose the following image:

A

Sjogren’s syndrome

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51
Q

The smalDiagnose the following images:

A

Sjögren’s syndrome

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52
Q

Describe the tumor distribution of the major salivary glands:

A) Parotid gland

B) Submandibular

C) Sublingual

A

A) Parotid gland
benign 50%
malignant 50%

B) Submandibular
benign 40%
malignant 60%

C) Sublingual
benign 20%
malignant 80%

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53
Q

Describe the tumor distribution of the minor salivary glands in the following areas:

A) Palate

B) Buccal mucosa

C) Upper labial mucosa

D) Lower labial mucosa

E) Tongue

F) Floor of mouth

G) Retromolar pad

A

A) Palate
b: 50%
m: 50%

B) Buccal mucosa
b: 50%
m: 50%

C) Upper labial mucosa
b: 80%
m: 20%

D) Lower labial mucosa
b: 15%
m: 85%

E) Tongue
- up to 90% malignant

F) Floor of mouth
- up to 90% malignant

G) Retromolar pad
- up to 90% malignant

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54
Q

Describe the following for a BENIGN salivary gland neoplasm:

growth rate:
induration:
symptomatology:
ulceration:

A

growth rate: SLOW GROWTH
induration: MOVABLE
symptomatology: ASYMPTOMATIC
ulceration: INTACT MUCOSA

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55
Q

Describe the following for a MALIGNANT salivary gland neoplasm:

growth rate:
induration:
symptomatology:
ulceration:

A

growth rate: RAPID GROWTH
induration: FIXED
symptomatology: SYMPTOMATIC
ulceration: ULCERATED

56
Q

Give some examples of benign salivary gland tumors: (5)

A
  1. benign mixed tumor (pleomorphic adenoma)
  2. monomorphic adenoma
  3. Warthin’s tumor (papillary cystadenoma lymphomatosum)
  4. oncocytoma
  5. ductal papillomas
57
Q

A papillary cystadenoma lymphomatosum may also be called:

A

Warthin’s tumor

58
Q

A benign mixed tumor of the salivary gland may also be called:

A

Pleomorphic adenoma

59
Q

Most common salivary gland neoplasm:

A

pleomorphic adenoma

60
Q

Pleomorphic adenomas are most common in:

A

middle-aged females

61
Q

Describe a pleomorphic adenoma:

A

painless, slow growing mass

62
Q

Diagnose the following image:

A

Pleomorphic adenoma

63
Q

Diagnose the following image:

A

Pleomorphic adenoma

64
Q

Diagnose the following image:

A

Pleomorphic adenoma

65
Q

Describe the histology of pleomorphic adenoma (3):

A
  1. variable histology
  2. mixture of ductal & myoepithelial elements
  3. encapsulated
66
Q
  • most common salivary gland neoplasm
  • middle-aged females
  • painless slow-growing mass
  • encapsulated
A

Pleomorphic adenoma

67
Q
  • upper lip
  • middle-aged females
  • painless slow-growing mass
  • thin fibrous capsule
  • uniform pattern
A

Monomorphic adenoma

68
Q

Diagnose the following image:

A

Monomorphic adenoma

69
Q

Describe the histology of a monomorphic adenoma: (5)

A
  1. uniform pattern
  2. single layered cords of columnar or cuboidal epithelium
  3. may demonstrate papillary projections
  4. loose connective tissue stroma, with prominent vascularity
  5. thin fibrous capsule
70
Q

The following histological characteristics describe:

  1. uniform pattern
  2. single layered cords of columnar or cuboidal epithelium
  3. may demonstrate papillary projections
  4. loose connective tissue stroma, with prominent vascularity
  5. thin fibrous capsule
A

monomorphic adenoma

71
Q

The following histological characteristics describe:

  1. variable histology
  2. mixture of ductal & myoepithelial elements
  3. encapsulated
A

pleomorphic adenoma

72
Q

Papillary cystadenoma lymphomatosum =

A

Warthin’s tumor

73
Q
  • 2nd most common benign salivary gland neoplasm
  • parotid gland
  • bilateral
  • middle-aged males (seen fewer in blacks)
  • smoking
  • painless slowly growing nodular mass
A

Papillary cystadenoma lymphomatosum (Warthin’s tumor)

74
Q

What is the second most common benign salivary gland neoplasm?

A

Papillary cystadenoma lymphomatosum (Warthin’s tumor)

75
Q

Where does a Papillary cystadenoma lymphomatosum (Warthin’s tumor) occur?

A

parotid gland (B/L)

76
Q

Papillary cystadenoma lymphomatosum (Warthin’s tumor) is most often seen in:

A

middle-aged males (fewer blacks)

77
Q

_____ is a risk factor for Papillary cystadenoma lymphomatosum (Warthin’s tumor)

78
Q

Describe Papillary cystadenoma lymphomatosum (Warthin’s tumor):

A

painless slow-growing nodular mass

79
Q

Diagnose this image:

A

Papillary cystadenoma lymphomatosum (Warthin’s tumor)

80
Q

Describe the histology of Papillary cystadenoma lymphomatosum (Warthin’s tumor): (3)

A
  1. oncocytic ductal epithelium (uniform double rows)
  2. lymphoid aggregate
  3. papillary cystic configuration
81
Q

The following histological characteristics describe:

  1. oncocytic ductal epithelium (uniform double rows)
  2. lymphoid aggregate
  3. papillary cystic configuration
A

Papillary cystadenoma lymphomatosum (Warthin’s tumor)

82
Q

What is seen in the following histological image?

A

Papillary cystadenoma lymphomatosum (Warthin’s tumor)

(KEY: DOUBLE ROWS)

83
Q

What is seen in the following histological image?

A

Papillary cystadenoma lymphomatosum (Warthin’s tumor)

(KEY: DOUBLE ROWS)

84
Q
  • rare salivary gland neoplasm
  • large epithelial cells, oncocytes
  • females, 8th decade
  • parotid gland
  • painless slow-growing mass
  • multifocal
A

Oncocytoma

85
Q

A rare salivary gland neoplasm that is multifocal and comprised of large epithelial cells:

A

oncocytoma

86
Q

Describe the cells found in an oncocytoma:

A

large epithelial cells (oncocytes)

87
Q

______ especially at age _____ are most at risk for oncocytomas

A

females; 80s

88
Q

Describe an oncocytoma:

A

painless, slow-growing multifocal mass

89
Q

Diagnose this image:

A

oncocytoma

90
Q

Describe the histology of an oncocytoma: (3)

A
  1. large polyhedral cells abundant in granular eosinophilic cytoplasm- mitochondria
  2. limited stroma- thin fibrovascular septa
  3. lymphoid infiltrate
91
Q
  1. large polyhedral cells abundant in granular eosinophilic cytoplasm- mitochondria
  2. limited stroma- thin fibrovascular septa
  3. lymphoid infiltrate

The following histological characteristics describes:

A

oncocytoma

92
Q

Describe the histology of necrotizing sialometaplasia: (3)

A
  1. pseudoepitheliomatous hyperplasia
  2. sialometaplasia
  3. coagulative necrosis of the glands
93
Q
  1. pseudoepitheliomatous hyperplasia
  2. sialometaplasia
  3. coagulative necrosis of the glands

The following histological characteristics describes:

A

Necrotizing sialometaplasia

94
Q

List some examples of MALIGNANT salivary gland tumors: (6)

A
  1. mucoepidermoid carcinoma
  2. adenoid cystic carcinoma
  3. polymorphous low-grade adenocarinoma
  4. acinic cell carcinoma
  5. carcinoma ex-mixed tumor
  6. adenocarcinoma NOS
95
Q
  • The most common malignant salivary gland neoplasm
  • Middle-aged females
  • clinically mistaken for a mucocele
A

Mucepidermoid carcinoma

96
Q

What is the most common malignant salivary gland neoplasm?

A

Mucoepidermoid carcinoma

97
Q

Mucoepidermoid carcinoma most commonly occurs in:

A

middle-aged females

98
Q

What is commonly misdiagnosed for a mucoepidermoid carcinoma?

99
Q

Diagnose the following image:

A

mucoepidermoid carcinoma

100
Q

Diagnose the following image:

A

mucoepidermoid carcinoma

101
Q

Diagnose the following image:

A

mucoepidermoid carcinoma

102
Q

Diagnose the following image:

A

mucoepidermoid carcinoma

103
Q

Describe the histological characteristics o a mucoepidermoid carcinoma: (3)

A
  1. mucous producing cells
  2. epidermoid (squamous) cells
  3. may be cystic and/or solid
104
Q

The following histological characteristics describe:

  1. mucous producing cells
  2. epidermoid (squamous) cells
  3. may be cystic and/or solid
A

mucoepidermoid carcinoma

105
Q
  • Best recognized salivary gland tumor
  • Middle-aged females
  • Slow-growing mass
  • Painful
A

Adenoid cystic carcinoma

106
Q

What is the “best recognized” salivary gland tumor?

A

Adenoid cystic carcinmoma

107
Q

Adenoid cystic carcinmoma is most commonly seen in:

A

middle-aged females

108
Q

Adenoid cystic carcinmoma can be described as ____ growing and ____

A

slow-growing; painful

109
Q

Diagnose the following image:

A

Adenoid cystic carcinoma

110
Q

Diagnose the following image:

A

Adenoid cystic carcinoma

111
Q

Diagnose the following image:

A

Adenoid cystic carcinoma

112
Q

Diagnose the following image:

A

Adenoid cystic carcinoma

113
Q

Diagnose the following image:

A

Adenoid cystic carcinoma

114
Q

Describe the histological characteristics of an Adenoid cystic carcinmoma: (4)

A
  1. myoepithelial & ductal cells
  2. perineural & perivascular invasion
  3. cribriform pattern
  4. SWISS CHEESE
115
Q

The following histological characteristics describe:

  1. myoepithelial & ductal cells
  2. perineural & perivascular invasion
  3. cribriform pattern
  4. SWISS CHEESE
A

Adenoid cystic carcinoma

116
Q

What pathology can be described as “Swiss cheese”

A

Adenoid cystic carcinoma

117
Q

The following histological image is characteristic of:

A

adenoid cystic carcinoma

(KEY: SWISS CHEESE)

118
Q

The following histological image is characteristic of:

A

adenoid cystic carcinoma

119
Q

PLGA:

A

Polymorphous Low-Grade Adenocarinoma

120
Q
  • common malignant MINOR salivary gland neoplasm
  • middle-aged females
  • favors palate
A

Polymorphous Low-Grade Adenocarinoma (PLGA)

121
Q

Diagnose the following image:

A

Polymorphous Low-Grade Adenocarinoma

122
Q

Diagnose the following image:

A

Polymorphous Low-Grade Adenocarinoma

123
Q

Describe the histology of Polymorphous Low-Grade Adenocarinoma: (4)

A
  1. deceptive uniform appearance
  2. different growth patterns
  3. perineural & perivascular invasion
  4. indian filing
124
Q

The following histological characteristics describe:

  1. deceptive uniform appearance
  2. different growth patterns
  3. perineural & perivascular invasion
  4. indian filing
A

Polymorphous Low-Grade Adenocarinoma

125
Q
  • parotid gland
  • serous acinar differentiation
  • middle-aged females
  • slow-growing
  • low-grade malignancy
A

Acinic cell carinoma

126
Q

Diagnose the following image:

A

acinic cell carcinoma

127
Q

Diagnose the following image:

A

acinic cell carcinoma

128
Q

Describe the histology of an acinic cell carcinoma: (3)

A
  1. well circumscribed
  2. may be infiltrative
  3. serous acinar cell (abundant granular basophilic cytoplasm and a round, stained eccentric nucleus)
129
Q

The following histological characteristics describe:

  1. well circumscribed
  2. may be infiltrative
  3. serous acinar cell (abundant granular basophilic cytoplasm and a round, stained eccentric nucleus)
A

acinic cell carcinoma

130
Q
  • Long-standing pleomorphic adenoma
  • older adults
  • rapid growth
  • pain & ulceration
A

Carcinoma ex-pleomorphic adenoma

131
Q

Diagnose the following image:

A

Carcinoma ex-pleomorphic adenoma

132
Q

Describe the histological characters of Carcinoma ex-pleomorphic adenoma: (5)

A
  1. typical benign mixed tumor
  2. malignant degeneration
  3. cellular pleomorphism
  4. abnormal mitotic activity
  5. capsular invasion
133
Q

The following histological characteristics describe:

  1. typical benign mixed tumor
  2. malignant degeneration
  3. cellular pleomorphism
  4. abnormal mitotic activity
  5. capsular invasion
A

Carcinoma ex-pleomorphic adenoma

134
Q
  • uncommon salivary gland neoplasm
  • middle-aged females
A

adenocarcinoma NOS

135
Q

Diagnose the following image:

A

adenocarcinoma NOS

136
Q

Describe the histology of adenocarcinoma NOS:

Pathology II (17 decks)

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