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Pathology 2 > Salivary Gland Pathology > Flashcards

Salivary Gland Pathology Flashcards

1
Q
A
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2
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A
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3
Q

What are the major salivary glands?

A

 Parotid
 Submandibular
 Sublingual

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4
Q

Where are the minor salivary glands?

A

 Palate
 Buccal mucosa
 Tongue
 Floor of mouth
 Labial mucosa
 Retromolar pad
 Oropharynyx

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5
Q

The parotid gland is 100% __________ cells

A

serous acinar

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6
Q

The submandibular salivary gland is made of what cells?

A

serous acinar (mostly)
mucous acinar

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7
Q

The sublingual salivary gland is made of what cells?

A

mucous acinar (mostly)
serous acinar

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8
Q

What are the clear staining cells?
What are the purple granular cells?

A

Clear = mucous
purple granular = serous

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9
Q

What is the distribution of the minor salivary gland locations?

A

 Palate - 60%
 Tongue - 10%
 Lips - 10%
 Cheeks - 10%
 Retromolar - 10%

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10
Q

What are the minor salivary glands of the tongue?

A

Glands of Von Ebner
— Circumvalate papillae (serous)
Glands of Blandin and Nuhn
— Anterior ventral (mucous)
Glands of Weber
— Posterior lateral border (mucous)

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11
Q

What are the glands of von ebner?

A

Circumvalate papillae part of tongue – serous

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12
Q

What are the glands of blandin and nuhn?

A

Anterior ventral part of tongue – mucous

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13
Q

What are the gland of weber?

A

Posterior lateral border of tongue (foliate papillae) - mucous

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14
Q

What is a mucous extravasation reaction (mucocele)?

A

mucocele forms due to a disruption in the salivary system and the saliva does not go into the oral cavity

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15
Q

How can you tell a superficial mucocele from a different chronic condition of vesicles?

A
  • biopsy
  • no pain
  • goes away for a while
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16
Q

What is a mucocele associated with the sublingual gland?

A

ranula

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17
Q

Mucin dissects through mylohyoid muscle, presenting as a neck mass it is called a…

A

plunging ranula

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18
Q

What is a sialolith?

A

Salivary stone
- mucin gets trapped in the salivary duct and calcifies

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19
Q

Where do we typically see sialoliths in patients?

A

Wharton’s duct

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20
Q

What are patient’s symptoms for sialolith?

A
  • episodic swelling (especially around meal times)
  • pain
  • secondary infection
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21
Q

How can you see/visualize a sialolith in warton’s duct?

A

occlusal radiograph

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22
Q

What is necrotizing sialometaplasia?

A

reactive condition
- patient says “piece of roof of the mouth came out”
- areas of ulceration

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23
Q

What is the histology of necrotizing sialometaplasia?

A
  • Pseudoepitheliomatous hyperplasia (not cancer)
  • Sialometaplasia
  • Coagulative necrosis of the glands
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24
Q

What are the symptoms of sjogren syndrome?

A
  • Autoimmune disorder
  • Dry mouth and dry eyes
  • Primary vs. Secondary
  • Bilateral enlargement of parotid gland
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25
Q

If you biopsy the parotid gland of someone with sjogren what would the histology show?

A
  • Benign lymphoepithelial lesion (BLEL)
  • Mikulicz’s disease
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26
Q

What are the laboratory tests/values that are positive for sjogren syndrome?

A

 Anti-SS-A
 Anti-SS-B
 RF
 ANA

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27
Q

What is a different way to diagnose sjogrens syndrome besides parotid biopsy or labs?

A

lower lip biopsy
- look for lymphoid clusters

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28
Q

What is the percentage of benign/malignant tumors in parotid?

A

equally likely

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29
Q

What is the percentage of benign/malignant tumors in submandibular (don’t memorize %)?

A
  • Slightly more malignant
    benign - 40%
    malignant - 60%
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30
Q

What is the percentage of benign/malignant tumors in sublingual (don’t memorize %)?

A
  • way more likely to be malignant

benign - 20%
malignant - 80%

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31
Q

What is the percentage of benign/malignant tumors in palate salivary glands (don’t memorize %)?

A

equally likely

32
Q

What is the percentage of benign/malignant tumors in buccal mucosa salivary glands (don’t memorize %)?

A

equally likely

33
Q

What is the percentage of benign/malignant tumors in upper labial mucosa salivary glands (don’t memorize %)?

A

more likely to be benign

34
Q

What is the percentage of benign/malignant tumors in lower labial mucosa salivary glands (don’t memorize %)?

A

more likley to be malignant

35
Q

What is the percentage of benign/malignant tumors in tongue salivary glands (don’t memorize %)?

A

Up to 90% malignant

36
Q

What is the percentage of benign/malignant tumors in floor of mouth salivary glands (don’t memorize %)?

A

Up to 90% malignant

37
Q

What is the percentage of benign/malignant tumors in retromolar pad salivary glands (don’t memorize %)?

A

Up to 90% malignant

38
Q

What are the clinical features of benign salivary tumor?

A
  • slow growth
  • movable
  • asymptomatic
  • intact mucosa
39
Q

What are the clinical features of malignant salivary tumor?

A
  • rapid growth
  • fixed
  • symptomatic
  • ulcerated
40
Q

What is a pleomorphic adenoma?

A

benign mixed tumor
- painless slowly growing mass

41
Q

What is the most common salivary gland neoplasm?

A

pleomorphic adenoma

42
Q

What demographic is most affected by pleomorphic adenoma?

A

middle-aged females

43
Q

What does the histology of pleomorphic adenoma look like?

A

Variable histology
Mixture of ductal and myoepithelial elements
Encapsulated

44
Q

If a tumor is encapsulated what does that often suggest?

45
Q

What is a monomorphic adenoma?

A
  • painless slowly growing mass (upper lip)
46
Q

What demographic is most affected by monomorphic adenoma?

A

middle-aged females

47
Q

Where is a monomorphic adenoma commonly found?

48
Q

What does the histology of monomorphic adenoma?

A

 Uniform pattern
 Single layered cords of columnar or cuboidal epithelium
 May demonstrate papillary projections
 Loose connective tissue stroma, with prominent vascularity
 Thin fibrous capsule

49
Q

What does a histology slide of monomorphic adenoma look like?

A

No matter what type it is the slide all looks the same/uniform

50
Q

What is another name for papillary cystadenoma lymphomatosum?

A

Warthin’s tumor

51
Q

What is a papillary cystadenoma lymphomatosum (warthin’s tumor)?

A
  • painless slowly growing nodular mass
  • parotid gland (bilaterally)
52
Q

What is the 2nd most common bengin salivary gland neoplasm?

A

papillary cystadenoma lymphomatosum (warthin’s tumor)

53
Q

What demographic is papillary cystadenoma lymphomatosum (warthin’s tumor) usually seen?

A

Middle-aged males (lower in blacks)
- more common in smokers

54
Q

What does the histology of papillary cystadenoma lymphomatosum (warthin’s tumor) look like?

A
  • Oncocytic ductal epithelium
    — Uniform double rows
  • Lymphoid aggregate
  • Papillary cystic configuration
55
Q

What is the only salivary gland tumor that has smoking as an etiology?

A

papillary cystadenoma lymphomatosum (warthin’s tumor)

56
Q

What is an oncocytoma?

A
  • painless slowly growing mass (multifocal)
  • parotid
  • rare
57
Q

What demographic are oncocytomas usally found?

A

Females, 8th decade

58
Q

What does the histology of oncocytoma look like?

A
  • Large polyhedral cells abundant in granular eosinophilic cytoplasm
    —mitochondria
  • Limited stroma
    —Thin fibrovascular septa
  • Lymphoid infiltrate
59
Q

What are the malignant salivary gland tumors?

A

 Mucoepidermoid Carcinoma
 Adenoid Cystic Carcinoma
 Polymorphous Low-Grade Adenocarcinoma
 Acinic Cell Carcinoma
 Carcinoma ex-Mixed Tumor
 Adenocarcinoma NOS

60
Q

What is the most common malignant salivary land neoplasm?

A

mucoepidermoid carcinoma

61
Q

What demographic are mucoepidermoid carcinomas most often found?

A

middle-aged females

62
Q

What are mucoepidermoid carcinomas sometimes mistaken for?

63
Q

What is the histology of mucoepidermoid carcinoma?

A
  • Mucous producing cells
  • Epidermoid (squamous) cells
  • May be cystic and/or solid
64
Q

How can you tell the difference between high-grade mucoepidermoid carcinoma and squamous cell carcinoma?

A

presence of mucus cells in histology

65
Q

What is an adenoid cystic carcinoma?

A
  • Slowly growing mass, painful
  • best recognized salivary gland tumor
66
Q

What demographic are adenoid cystic carcinomas common in?

A

middle-aged females

67
Q

What is the histology of adenoid cystic carcinomas look like?

A

SWISS CHEESE
Myoepithelial and ductal cells
Perineural and perivascular invasion
Cribiform pattern

68
Q

What is polymorphous low-grade adenocarcinoma (PLGA)?

A
  • Common malignant MINOR salivary gland neoplasm
  • usually on palate
69
Q

What demographic are polymorphous low-grade adenocarcinomas common in?

A

middle-aged females

70
Q

What is the histology of polymorphous low-grade adenocarcinoma?

A

 Deceptive uniform appearance
 Different growth patterns
 Perineural and perivascular invasion
 Indian filing

71
Q

What is acinic cell carcinoma?

A
  • low-grade malignancy
  • serous acinar differentiation
  • parotid
  • slow growing
72
Q

What is the demographic for acinic cell carcinoma?

A

middle-aged females

73
Q

What is the histology of acinic cell carcinoma?

A

 Well circumscribed
 May be infiltrative
 Serous acinar cell
— Abundant granular basophilic cytoplasm and a round, stained eccentric nucleus

74
Q

What is a carcinoma ex-pleomorphic adenoma?

A
  • Long standing pleomorphic adenoma
  • pain and ulceration
  • rapid growth
  • older adults
75
Q

What is the histology of carcinoma ex-pleomorphic adenoma?

A

 Typical benign mixed tumor
 Malignant degeneration
— Cellular pleomorphism
— Abnormal mitotic activity
— Capsular invasion

76
Q

What is an adenocarcinoma NOS?

A
  • Uncommon salivary gland neoplasm
  • middle-aged females
  • variable histology

Pathology 2 (6 decks)

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