Salivary Gland Tumor Flashcards
What are the major salivary glands
Parotid
Submandibular
Sublingual
Largest salivary gland
Parotid
Main excretory duct of parotid
Stensen’s duct
Secretory duct of submandibular
Wharton’s duct
Produces the most saliva
Submandibular or submaxillary
Mainly secretes only pure serous
Parotid
Secretes both serous and mucous
Submandibular or submaxillary
Mixed but mucous is more than serous
Sublingual gland
Main duct of sublingual
Bartholin’s duct
Smaller ducts of sublingual gland that opens independently aong the sublingual fold
Duct of rivinus
Frequency and malignant % rate
parotid gland
Submandibular
Sublingual
Minoy salivary glands
65 25
10. 40
<1. 90
25. 25
Benign salivary gland tumors
Pleomorphic adenoma (mixed tumor)
Basal cell adenoma
Warthin’s tumor (papillary cystadenoma
Malignant salivary gland tumor
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma
Characterized by cytomorphological and architectural diversity with an adimxture of ductal and myoepithelial cells usually embedded in a chondromyxoid or fibrous stromal component
Pleomorphic adenoma
Clinical feature of pleomorphic adenoma
Adult, men = women
Asymptomatic submucosal mass
Palate > upper lip > buccal mucosa > other sites
Encapsulated; variable glandular patterns; epithelial and myoepithelial differentiation, no imtoses
Pleomorphic adenoma
Most common tumor of the major and minor salivary gland (50-70%)
Pleomorphic adenoma
% of occurence rate pleomorphic adenoma in the major salivary gland
85%
% of occurrence rate of pleomorphic adenoma in minor salivary glands
8-7%
Gross feature
Lobulated, enclosed within a connective tissue capsule
Minor glands = poorly defined, poor encapsulation
Pleomorphic adenoma
3 key histological features of pleomorphic adenoma
Ductal
Cellular part (myoepithelial cell)
Stroma
Major or minor plemorphic salivary gland
Filled with more cellular than ductal and stroma
Minor salivary gland
IHC profile for ductal component in pleomorphic adenoma
Cytokeratin 3,6,10,11,16
Keratin 7
Keratin 20 (-)
IHC profiling for the cellular component of pleomorphic adenoma
S-100, calponin, a-SMA, calponin
Essential diagnostic criteria for pleomorphic adenoma
Bilayered ducts, myoepithelial cells, chondromyxoid/fibrous stroma
No malignant cytomorphological features
Treatment and prognosis of pleomorphic adenoma
Complete surgical excision
Recurrences occur secondary to rupture and incomplete excision
Recurrence may induce malignant transformation (3%)
Benign salivary neoplasms of histologic uniformity
C
Basal cell adenoma
Composed of basaloid and luminal cells, often with basement membrane material pattern
What are its 4 patterns
Basal cell adenoma
Solid, tubular, cribriform, membranous
Solitary, painless mass, slow-growing and firm
35-80yo (60 mean age) < male
Basal cell adenoma