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Oral Path > Salivary Gland Pathology > Flashcards

Salivary Gland Pathology Flashcards

1
Q 
Mixed Tumor (Pleomorphic adenoma)
Presentation
A
  • parotid > palate and lips
  • small, painless, slowly enlarging nodule
  • movable (except palatal tumor)
  • females 30-50 yo, children
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2
Q

Basal Cell Adenoma

Presentation

A
  • parotid (rare in oral cavity)
  • painless, slow-growing nodule
  • older males
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3
Q

Canalicular Adenoma

Presentation

A
  • 75% upper lip (and other minor salivary glands)
  • well-circumscribed, movable, slow-growing, painless nodule
  • older females
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4
Q

Central Mucoepidermoid Carcinoma

Presentation

A

jawbone (posterior mandible > maxilla)
all ages
females > males

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5
Q

Carcinoma Ex Mixed Tumor

Presentation

A
  • occurs in pre-existing mixed tumors with history of sudden enlargement
  • occurs in patients 10-15 years older than mixed tumor patients (30-50s)
  • pain and discomfort
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6
Q

Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum)

Presentation

A
  • parotid, 14% bilateral
  • males in 60s (10:1 male:female)
  • firm asymptomatic swelling
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7
Q

Oncocytoma (oxyphilic adenoma)

Presentation

A
  • parotid
  • oncocytic cystadenoma in buccal mucosa, upper lip (rare)
  • females in 70-80s
  • small, asymptomatic, encapsulated nodule
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8
Q

Mucoepidermoid Carcinoma

Presentation

A
  • parotid > palate, tongue, buccal mucosa, retromolar pad
  • low grade: posterior-lateral palate, slowly enlarging, painless lesions, not encapsulated, sometimes resembling mucocele in retromolar pad area
  • high grade: major glands (rare in mouth), rapidly growing, painful lesions, facial nerve paralysis, regional lymph node metastasis
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9
Q

Polymorphous Low Grade Adenocarcinoma

Presentation

A
  • minor glands: palate > upper lip, buccal mucosa
  • slow growing, rarely metastasizing, painless mass
  • females in 60s (6th-8th decade)
  • attracted to nerve
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10
Q

Adenoid Cystic Carcinoma (Cylindroma)

Presentation

A
  • minor and major glands including lacrimal gland, pharynx, larynx
  • palate, submandibular gland, tongue
  • middle aged (40-50s) and younger
  • local pain, facial nerve paralysis, fixation to deeper structures, local invasion
  • palatal tumor may be covered with normal-looking epithelium or be ulcerated
  • perineural invasion (pain and paresis)
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11
Q

Actinic Cell Carcinoma

Presentation

A
  • buccal mucosa and lips (otherwise rare in mouth)
  • young and Middle Ages (40-50s) but reported in older
  • females > males
  • bilateral parotid
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12
Q

Necrotizing Sialometaplasia

Presentation

A
  • benign inflammatory reaction
  • caused by local ischemia (sometimes by injection)
  • 2:1 male:female in 4th-5th decade
  • palate (75%) > buccal mucosa, lip
  • 2/3 bilateral palate
  • ulcerated, deep, well-circumscribed painless swelling
  • can mimic salivary gland malignancy
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13
Q

Mucocele

Presentation

A
  • Mucous extravasation type
  • Caused by trauma to duct (saliva seeps into extra cellular tissue, macrophages/lymphocytes/plasma cells create granulation tissue to wall off
  • lip or cheek biting
  • lower lip (very rare on upper lip) > buccal mucosa, FOM, (ventral tongue, soft palate)
  • light blue (superficial) to pink swelling that increases and decreases in size
  • 17% superficial 83% deep
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14
Q

Salivary Duct Cyst/Mucus Retention Cyst

Presentation

A
  • true development cyst of duct all origin
  • major and minor glands
  • unknown etiology
  • FOM, buccal mucosa, lips
  • similar clinical morphology as extravasation mucocele
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15
Q

Ranula (Frog’s Belly)

Presentation

A
  • unilateral or bilateral FOM
  • deep-seated normal color swelling
  • caused by localized dilatation of sublingual gland ducts with mucous pooling or severed salivary gland duct
  • ‘plunging ranula’ if penetrates mylohyoid
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16
Q 
Mixed Tumor (Pleomorphic adenoma)
Treatment and Prognosis
A

complete surgical removal with clean margins
-parotid: removal of involved lobe with preservation of facial nerve
-submandibular: removal of whole gland with tumor
-minor: removal with clean margins
-palate: excise in one piece with periosteum and overlying mucosa
tendency for recurrence (44% in parotid) if not treated thoroughly
5% risk of malignant transformation

17
Q 
Mixed Tumor (Pleomorphic adenoma)
Histopathology
A
  • well-demarced to encapsulated
  • cords, strands, and islands of cuboidal and spindle cells
  • stroma is loose and mucoid to dense
  • cartilage, bone, and keratin perals
18
Q

Basal Cell Adenoma

Histopathology

A
  • encapsulated
  • basaloid, uniform, monotonous cells in cords and duct-like structures
  • mitosis is rare
  • mistaken for adenoid cystic carcinoma
19
Q

Canalicular Adenoma

Histopathology

A
  • encapsulated
  • cords, duct-like structures of monotonous, cuboidal or low columnar basaloid cells
  • large cystic dilation of duct-like spaces
20
Q

Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum)

Histopathology

A
  • encapsulated

- papillary projections with double-layered lining of oncocytes and prominent lymphoid elements forming follicles

21
Q

Oncocytoma (oxyphilic adenoma)

Histopathology

A
  • encapsulated

- sheets of oncocytes filled with nonfunctional mitochondria

22
Q

Mucoepidermoid Carcinoma

Histopathology

A
  • invasion of surrounding tissue
  • low grade: mucous secreting cells and duct-like structures > epidermoid cells
  • high grade: epidermoid cells > mucous producing
23
Q

Polymorphous Low Grade Adenocarcinoma

Histopathology

A
  • cribiform, tubular, cystic
  • mitosis is rare
  • neural invasion is common
24
Q

Adenoid Cystic Carcinoma (Cylindroma)

Histopathology

A
  • Infiltrative growth pattern
  • small, dark, uniform cells in islands with typical cribiform, “Swiss cheese” pattern
  • perineural invasion
25
Q

Carcinoma Ex Mixed Tumor

Histopathology

A
  • foci of benign mixed tumor with high-grade ductal carcinoma changes
  • hyalinization, necrosis, sometimes calcification
26
Q

Acinic Cell Carcinoma

Histopathology

A
  • circumscribed or partially encapsulated
  • acinar cells at different stages of differentiation
  • stroma can be hyalinized with focal lymphocytic infiltrate
  • hemorrhage and hemosiderin pigment
27
Q

Necrotizing Sialometaplasia

Histopathology

A
  • ulceration
  • pseudoepitheliomatous hyperplasia
  • acinar necrosis with retention of lobular architecture
  • metaplastic changes in salivary gland ducts
28
Q

Mucocele

Histopathology

A

mucous retention or extravasation phenomenon
-cyst-like structure lined by fibrous or granulation tissue and filled with mucous and macrophages
mucous retention cyst
-cyst is a cavity lined by epithelium and filled with mucous

29
Q

Ranula (Frog’s Belly)

Histopathology

A
  • cystic cavity with lining epithelium and mucoid material

- sometimes can be like mucous extravasation mucocele

Oral Path (5 decks)

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