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Oral Path 2 Finals > Salivary Gland Tumor > Flashcards

Salivary Gland Tumor Flashcards

1
Q

What are the major salivary glands

A

Parotid
Submandibular
Sublingual

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2
Q

Largest salivary gland

A

Parotid

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3
Q

Main excretory duct of parotid

A

Stensen’s duct

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4
Q

Secretory duct of submandibular

A

Wharton’s duct

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5
Q

Produces the most saliva

A

Submandibular or submaxillary

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6
Q

Mainly secretes only pure serous

A

Parotid

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7
Q

Secretes both serous and mucous

A

Submandibular or submaxillary

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8
Q

Mixed but mucous is more than serous

A

Sublingual gland

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9
Q

Main duct of sublingual

A

Bartholin’s duct

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10
Q

Smaller ducts of sublingual gland that opens independently aong the sublingual fold

A

Duct of rivinus

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11
Q

Frequency and malignant % rate

parotid gland
Submandibular
Sublingual
Minoy salivary glands

A

65 25
10. 40
<1. 90
25. 25

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12
Q

Benign salivary gland tumors

A

Pleomorphic adenoma (mixed tumor)
Basal cell adenoma
Warthin’s tumor (papillary cystadenoma

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13
Q

Malignant salivary gland tumor

A

Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma

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14
Q

Characterized by cytomorphological and architectural diversity with an adimxture of ductal and myoepithelial cells usually embedded in a chondromyxoid or fibrous stromal component

A

Pleomorphic adenoma

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15
Q

Clinical feature of pleomorphic adenoma

A

Adult, men = women

Asymptomatic submucosal mass

Palate > upper lip > buccal mucosa > other sites

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16
Q

Encapsulated; variable glandular patterns; epithelial and myoepithelial differentiation, no imtoses

A

Pleomorphic adenoma

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17
Q

Most common tumor of the major and minor salivary gland (50-70%)

A

Pleomorphic adenoma

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18
Q

% of occurence rate pleomorphic adenoma in the major salivary gland

A

85%

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19
Q

% of occurrence rate of pleomorphic adenoma in minor salivary glands

A

8-7%

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20
Q

Gross feature

Lobulated, enclosed within a connective tissue capsule

Minor glands = poorly defined, poor encapsulation

A

Pleomorphic adenoma

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21
Q

3 key histological features of pleomorphic adenoma

A

Ductal
Cellular part (myoepithelial cell)
Stroma

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22
Q

Major or minor plemorphic salivary gland

Filled with more cellular than ductal and stroma

A

Minor salivary gland

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23
Q

IHC profile for ductal component in pleomorphic adenoma

A

Cytokeratin 3,6,10,11,16
Keratin 7

Keratin 20 (-)

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24
Q

IHC profiling for the cellular component of pleomorphic adenoma

A

S-100, calponin, a-SMA, calponin

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25
Q

Essential diagnostic criteria for pleomorphic adenoma

A

Bilayered ducts, myoepithelial cells, chondromyxoid/fibrous stroma

No malignant cytomorphological features

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26
Q

Treatment and prognosis of pleomorphic adenoma

A

Complete surgical excision

Recurrences occur secondary to rupture and incomplete excision

Recurrence may induce malignant transformation (3%)

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27
Q

Benign salivary neoplasms of histologic uniformity

C

A

Basal cell adenoma

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28
Q

Composed of basaloid and luminal cells, often with basement membrane material pattern

What are its 4 patterns

A

Basal cell adenoma

Solid, tubular, cribriform, membranous

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29
Q

Solitary, painless mass, slow-growing and firm

35-80yo (60 mean age) < male

A

Basal cell adenoma

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30
Q

Location of basal cell adenoma if its a minor salivary gland in origin

31
Q

1-2% of all salivary gland adenoma, __% in parotid gland

32
Q

Feature:

Islands/sheets of isomorphic basaloid cells, show peripheral palisading cells at the periphery appearing cuboidal to low columnar

A

Solid type of basal cell adenoma

33
Q

Features:

Thin trabeculae and cords of epithelial cells separated by a delicately vascularized stroma

A

Trabecular form of basal cell adenoma

34
Q

Features:

Ductal structures with lining cells of cuboidal type surrounded by single or multiple layers of basaloid cells

A

Tubular type of basal cell adenoma

35
Q

Features:

Nodular variablt seized isands of tumor tissue urrounded by hyaline membrane, collagenous

A

Membranous type of basal cell adenoma

36
Q

A salivary tumor that is usually misdiagnosed with OKC and why?

A

Basal cell adenoma

Difference - OKC has stellate reticulum cells

37
Q

IHC profile of basal cell adenoma

A

Nuclear B-catenin, LEF-1

38
Q

Is nuclear B-catenin stain positive in pleomorphic adenoma?

39
Q

Essential diagnostic criteria for basal cell carcinoma

A

Basaloid appearance

Peripheral palisading

40
Q

Treatment and prognosis for basal cell adenoma

A

Excision, rarely occurs

Except for membranous type (recur 25%; malignant transformation)

41
Q

Benign salivary gland tumor composed of oncocytic epithelial cells lining ductial, papillary and cystic structures in a lymphoid stroma

A

Warthin’s tumor
(Papillary cystadenoma lymphomatosum)

42
Q

Entrapment of salivary gland elements in lymph nodes

<parotid, bilateral
<male (10:1)
62yo mean age

A

Warthin tumor

Papillary cystadenoma lymphomatosum

43
Q

Granular, eosinophilic cytoplasm due to numerous large mitochondria

44
Q

Gross feature:

Encapsulated, smooth to lobulated surface and a round outline

A

Warthin’s tumor

45
Q

Histologic features:

Columnar eosinophilic cells (oncocytes) bilaminar that overlie lymphoid tissue with germinal centers

A

Warthin’s tumor

(Papillary cystadenoma lymphomatosum)

46
Q

Bilaminar layer

A

Warthin’s tumor

47
Q

Essential diagnostic criteria for warthin’ tumor

A

Circumscribed mass with spaces lined with papillary bilayered oncocytic cells; lymphoid stroma

48
Q

Treatment and prognosis

Surgical excision
Recurrences due to incomplete removal
Malignant transformation is rare

A

Warthin’s tumor
(Papillary cystadenoma lymphomatosum)

49
Q

Characterized by mucous, intermediate and epidermoid (squamoid( tumor cells forming cystic and solid growth patterns, usually associated with MAML2 rearrangement

A

Mucoepidermoid carcinoma

50
Q

Most common malignancy of salivary gland

A

Mucoepidermoid carcinoma

51
Q

Most common salivary malignancy in children

A

Mucoepidermoid carcinoma

52
Q

60-90% occurs in the parotid gland

Often resembles extravasation or retention type mucocele

If occurs in the parotid land, facial nerve involvement

A

Mucoepidermoid carcnoma

53
Q

2 types of mucoepidermoid

And what type does it has more ducts and mucous cells

A

Low grade mucoepidermoid
High grade mucoepidermoid

Low grade =more ducts and mucous cells

54
Q

Low-grade lesions - excellent prognosis >95% five year survival

High-grade lesions - fair prognosis >40% five year survival

A

Mucoepidermoid carcinoma

55
Q

Mucous cells, intermediate cells, squamous cells

Cystic spaces and solid areas
PAS staining (+) mucinous areas

A

Histopathologic features of mucoepidermoid carcinoma

56
Q

IHC profile of mucoepidermoid carcinoma

A

P63, P40 (+)
S100, SOX10 (-)

57
Q

Diagnostic molecular pathology

A

MAML2 positive rearrangement

58
Q

Invasive carcinoma composed of eithelial and myoepithelial neoplastic cells arranged in tubular,cribriform and solid patterns associated with basophilic matrix and reducplicated basement membrane material, often associated with MYB, MYBL1 or NFIB rearrangement

A

Adenoid cystic carcinoma

59
Q

This lsalivary tumor exists mostly in minor salivary gland

It is a high grade salivary gland maligancy which spreads through perineural spaces

Local recurrence an metastasis; lung > nodes

5year survival rate 70%; 15-year survival 10%

A

Adenoid cystic carcinoma

60
Q

23% of al salivary gland carcinoma

A

Adenoid cystic carcinoma

61
Q

Adults; palatal mass/ulceration

Cribriform microscopic pattern

A

Adenoid cystic carcinoma

62
Q

Infiltrative, slow growing unilobular mass that is firm on palpation

Facial nerve paralysis

A

Adenoid cystic carcinoma

63
Q

Hallmark of adenoid cystic carcinoma

A

Perineural invasion

64
Q

IHC profile of adenoid cystic carcinoma

A

CK7 CD117 positive (ductal cells)

P63, p40, calponin, SMA (myoepithelial cells)

65
Q

Diagnostic molecular pathology of adenoid cystic carcinoma

A

MYB/MYBL1 rearrangement

66
Q

Prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome

A

Treatment/prognosis for adenoid cystic carcinoma

67
Q

Salivary gland carcinoma exhibiting serous acinar and lacking mucinous differentiation

Bilateral parotid 3%

90-95% parotid

A

Acinic cell carcinoma

68
Q

Second most common salivary gland malignancy in children

A

Acinic cell carcinoma

69
Q

Slow growing lesion

Pain

High grade tumors may be rapidly growing and fixed to adjacent structures that facial nerve paralysis

A

Acinic cell carcinoma

70
Q

Neoplastic cells are heterogeneous with the most comon cell type being the serous acinar cell

A

Acinic cell carcinoma

71
Q

Most common cell type of acinic cell carcinoma

A

Serous acinar cell

72
Q

Zymogen granules

A

Acinic cell carcinoma

73
Q

IHC profile of acinic cell carcinoma

A

SOX10 and DOG1(+)

P40/p63, S100 (-)

NR4A3 or NR4A2 (+)

74
Q

% of distant metastasis of acinic cell carcinoma and where

A

15% DM to LN (10%)

Oral Path 2 Finals (9 decks)

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