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salivary glands Flashcards

1
Q

salivary gland structure

A
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2
Q

segements of salivary ducy

A

intercalated, striated, excretory (in order)

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3
Q

major salivary glands

A

parotid
subman
subling

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4
Q

locations of minor glands

A

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

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5
Q

parotid H/E app?

A

purely serous acini= eosinophilic

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6
Q

which gland

A

parotid

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7
Q

what granules are present in serous acini

A

zymogen

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8
Q

acini of subman

A

mixed gland, mainly serous

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9
Q

what stain can we use to deomstrate mucus acini

A

mucicarmine

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10
Q

which gland

A

subman

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11
Q

acini of sublingual gland

A

mucoserous, mainly mucus

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12
Q

which gland

A

sublingual

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13
Q

DISTRIBUTION OF MINOR SALIVARY GLANDS

A

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

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14
Q

what is happening

A

salivation of minor glands

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15
Q

minor glands of the tongue

A

 Glands of Von Ebner

 Glands of Blandin and Nuhn

 Glands of Weber

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16
Q

 Glands of Von Ebner

A

 Circumvalate papillae –
serous

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17
Q

 Glands of Blandin and Nuhn

A

 Anterior ventral – mucous

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18
Q

 Glands of Weber

A

 Posterior lateral border at foliate papilla -
mucous

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19
Q

MUCOUS EXTRAVASATION REACTION OF SALIVARY GLANDS

A

due to disruption of the duct system (often from trauma), leads to a mucocele

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20
Q

app of mucocele

A

swelling, sometimes bluish

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21
Q

mucus extravasation rxn histo (mucocele)

A

would see enlarged ducts with granulation tissue surrounding mucus with inflammatory cells in it

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22
Q

what is this

A

mucocele

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23
Q

mucocele of the palate

A

often superfifical and pop, often multiple present
would need a biopsy to confirm

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24
Q

Ranula

A

mucocele of the subman gland

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25
ranula
26
plunging ranula
occurs if ranula goes beneath the mylohyoid: mucin dissects thru the mm will present as a neck mass
27
sialolith
salivary stone trapped saliva will calcify and obstruct the duct
28
common location sialoliths and why
whartons duct due to the many turns
29
indications of sialoliths
swelling near glands around meal time may be painful due to infection
30
sialoliths with palpation
hard
31
sialoliths at stensons duct may present with?
pus
32
what can we use to locate sialoliths
occ radiogrpahs
33
tx of sialoliths
excision
34
histo app of sialoliths
calcifed tissue
35
necrotizing sialometaplasia
unknown cause, reactive condition can present with swelling and ulceration that can be bilateral or unilateral
36
necrotizing sialometaplasia
37
necrotizing sialometaplasia histology
RESEMBLES CANCER Pseudoepitheliomatous hyperplasia: resembles cancers Sialometaplasia of glandualr tissue to squamous cells Coagulative necrosis of the glands= loss of architecture
38
SJOGREN SYNDROME  dx? Dry? Primary vs. Secondary? Bilateral enlargement of? also called?
Autoimmune disorder Dry mouth and dry eyes Primary vs. Secondary due to other AI condition Bilateral enlargement of parotid gland= Benign lymphoepithelial lesion (BLEL) or Mikulicz’s disease
39
lab values of SS
 Anti-SS-A: specific  Anti-SS-B: specific  RF: non specific  ANA: non specific
40
what biopsy can be done with SS?
lip biopsy of the minor glands
41
what to look for with SS histo?
lymphocyte aggregates
42
SS, lymphocyte aggreagte
43
# %benign/malignant TUMOR DISTRIBUTION: MAJOR SALIVARY GLANDS
44
# %benign/malignant TUMOR DISTRIBUTION: MINOR SALIVARY GLANDS palate, buccal, upper lip, lower lip, tongue, floor, retromolar pad
45
# benign vs malignant clinical presentation of salivary neoplasms growth rate? induration? symptoms? ulceration?
46
BENIGN SALIVARY GLAND TUMORS
Benign Mixed Tumor (Pleomorphic Adenoma) Monomorphic Adenoma Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum) Oncocytoma Ductal Papillomas
47
Most common salivary gland neoplasm?
pleomorphic adenoma
48
PLEOMORPHIC ADENOMA  commonality?  demo?  presentation
 Most common salivary gland neoplasm  Middle-aged females  Painless slowly growing mass
49
pleomorphic adenoma histology
Variable histology Mixture of ductal and myoepithelial elements Encapsulated often cartilage like app
50
pleomorphic adenoma
51
monomorphic adenoma location? demo? presentation?
 Upper lip  Middle-aged females  Painless slowly growing mass
52
histology of a monomorphic adenoma  pattern?  cords of?  May demonstrate?  stroma? vascularity?  capsule?
 Uniform pattern  Single layered cords of columnar or cuboidal epithelium  May demonstrate papillary projections  Loose connective tissue stroma, with prominent vascularity  Thin fibrous capsule
53
PAPILLARY CYSTADENOMA LYMPHOMATOSUM/ WHARTINS TUMOR common? which gland? uni or bilat? demo? race? associated with? presentation?
 2nd most common benign salivary gland neoplasm Parotid gland Bilateral Middle-aged males  Lower in blacks Smoking Painless slowly growing nodular mass
54
# epithelium? what cells aggregate? configuration? PAPILLARY CYSTADENOMA LYMPHOMATOSUM/ WHARTINS TUMOR histology
 Oncocytic (granulaur cyto due to accumulation of altered mito) ductal epithelium- Uniform double rows  Lymphoid aggregate  Papillary cystic configuration
55
ONCOCYTOMA common?  cells?  demo?  gland?  presentation
ONCOCYTOMA Rare salivary gland neoplasm Large epithelial cells, oncocytes Females, 8th decade Parotid Painless slowly growing mass that is Multifocal
56
# cells? stroma? infiltrate? oncocytoma histology
 Large polyhedral cells abundant in granular eosinophilic cytoplasm due to mitochondria  Limited stroma- Thin fibrovascular septa  Lymphoid infiltrate
57
MALIGNANT SALIVARY GLAND TUMORS
 Mucoepidermoid Carcinoma  Adenoid Cystic Carcinoma  Polymorphous Low-Grade Adenocarcinoma  Acinic Cell Carcinoma  Carcinoma ex-Mixed Tumor  Adenocarcinoma NOS
58
MUCOEPIDERMOID CARCINOMA  commonality?  demo?  Clinically mistaken for?
 Most common malignant salivary gland neoplasm  Middle-aged females  Clinically mistaken for a mucocele
59
# cells present? can present in what forms? MUCOEPIDERMOID CARCINOMA histology
 Mucous producing cells  Epidermoid (squamous) cells  May be cystic and / or solid
60
HIGH-GRADE MUCOEPIDERMOID CARCINOMA can be similar in app to? how to distinguish?
similar to SCCa in appearence, use mucicarmine stain
61
# recognized? demo? presentation? ADENOID CYSTIC CARCINOMA
 Best recognized salivary gland tumor  Middle-aged females  Slowly growing mass, painful, can be ulcerative
62
# cells? invasion where? pattern? ADENOID CYSTIC CARCINOMA histology
Myoepithelial and ductal cells Perineural and perivascular invasion= poor prognosis Cribiform pattern/ SWISS CHEESE
63
# commonality? where? demo? POLYMORPHOUS LOW-GRADE ADENOCARCINOMA (PLGA)
 Common malignant MINOR salivary gland neoplasm  Middle-aged females  Favors palate
64
# deceptive? growth? invasion? distinct cell pattern? POLYMORPHOUS LOW-GRADE ADENOCARCINOMA (PLGA) histology
 Deceptive uniform appearance  Different growth patterns  Perineural and perivascular invasion but better prognosis than adenoid cystic carcinoma  Indian filing
65
# gland? what is affected? demo? growth? grade? acinic cell carcinoma
Parotid mainly Serous acinar differentiation Middle-aged females Slow-growing= Low-grade malignancy
66
# circumscribed? infiltration? cell app (cyto/nuc)? acinic cell carcinoma histology
 Well circumscribed  May be infiltrative  Serous acinar cell: Abundant granular basophilic cytoplasm and a round, stained eccentric (non-central) nucleus
67
# demo? growth? s/s? CARCINOMA EX-PLEOMORPHIC ADENOMA
 Long standing pleomorphic adenoma that undergoes malignant transformation  Older adults  Rapid growth  Pain and ulceration
68
CARCINOMA EX-PLEOMORPHIC ADENOMA HISTOLOGY
 Typical benign mixed tumor that undergoes Malignant degeneration: 1. Cellular pleomorphism 1. Abnormal mitotic activity 1. Capsular invasion
69
# commonality? demo? ADENOCARCINOMA NOS
 Uncommon salivary gland neoplasm  Middle-aged females
70
ADENOCARCINOMA NOS histo
variable, cannot be specified
71
what neoplasm has a swiss cheese histo?
adenoid cystic carcinoma
72
 Most common salivary gland neoplasm  Middle-aged females  Painless slowly growing mass
PLEOMORPHIC ADENOMA  commonality?  demo?  presentation
73
Variable histology Mixture of ductal and myoepithelial elements Encapsulated often cartilage like app
pleomorphic adenoma histology
74
 Upper lip  Middle-aged females  Painless slowly growing mass
monomorphic adenoma location? demo? presentation?
75
 Uniform pattern  Single layered cords of columnar or cuboidal epithelium  May demonstrate papillary projections  Loose connective tissue stroma, with prominent vascularity  Thin fibrous capsule
histology of a monomorphic adenoma  pattern?  cords of?  May demonstrate?  stroma? vascularity?  capsule?
76
 2nd most common benign salivary gland neoplasm Parotid gland Bilateral Middle-aged males  Lower in blacks Smoking Painless slowly growing nodular mass
PAPILLARY CYSTADENOMA LYMPHOMATOSUM/ WHARTINS TUMOR common? which gland? uni or bilat? demo? race? associated with? presentation?
77
 Oncocytic (granulaur cyto due to accumulation of altered mito) ductal epithelium- Uniform double rows  Lymphoid aggregate  Papillary cystic configuration
# epithelium? what cells aggregate? configuration? PAPILLARY CYSTADENOMA LYMPHOMATOSUM/ WHARTINS TUMOR histology
78
Rare salivary gland neoplasm Large epithelial cells, oncocytes Females, 8th decade Parotid Painless slowly growing mass that is Multifocal
ONCOCYTOMA common?  cells?  demo?  gland?  presentation
79
 Large polyhedral cells abundant in granular eosinophilic cytoplasm due to mitochondria  Limited stroma- Thin fibrovascular septa  Lymphoid infiltrate
# cells? stroma? infiltrate? oncocytoma histology
80
 Most common malignant salivary gland neoplasm  Middle-aged females  Clinically mistaken for a mucocele
MUCOEPIDERMOID CARCINOMA  commonality?  demo?  Clinically mistaken for?
81
 Mucous producing cells  Epidermoid (squamous) cells  May be cystic and / or solid
# cells present? can present in what forms? MUCOEPIDERMOID CARCINOMA histology
82
similar to SCCa in appearence, use mucicarmine stain
HIGH-GRADE MUCOEPIDERMOID CARCINOMA can be similar in app to? how to distinguish?
83
 Best recognized salivary gland tumor  Middle-aged females  Slowly growing mass, painful, can be ulcerative
# recognized? demo? presentation? ADENOID CYSTIC CARCINOMA
84
Myoepithelial and ductal cells Perineural and perivascular invasion= poor prognosis Cribiform pattern/ SWISS CHEESE
# cells? invasion where? pattern? ADENOID CYSTIC CARCINOMA histology
85
 Common malignant MINOR salivary gland neoplasm  Middle-aged females  Favors palate
# commonality? where? demo? POLYMORPHOUS LOW-GRADE ADENOCARCINOMA (PLGA)
86
 Deceptive uniform appearance  Different growth patterns  Perineural and perivascular invasion but better prognosis than adenoid cystic carcinoma  Indian filing
# deceptive? growth? invasion? distinct cell pattern? POLYMORPHOUS LOW-GRADE ADENOCARCINOMA (PLGA) histology
87
Parotid mainly Serous acinar differentiation Middle-aged females Slow-growing= Low-grade malignancy
# gland? what is affected? demo? growth? grade? acinic cell carcinoma
88
 Well circumscribed  May be infiltrative  Serous acinar cell: Abundant granular basophilic cytoplasm and a round, stained eccentric (non-central) nucleus
# circumscribed? infiltration? cell app (cyto/nuc)? acinic cell carcinoma histology
89
 Long standing pleomorphic adenoma that undergoes malignant transformation  Older adults  Rapid growth  Pain and ulceration
# demo? growth? s/s? CARCINOMA EX-PLEOMORPHIC ADENOMA
90
 Typical benign mixed tumor that undergoes Malignant degeneration: 1. Cellular pleomorphism 1. Abnormal mitotic activity 1. Capsular invasion
CARCINOMA EX-PLEOMORPHIC ADENOMA HISTOLOGY
91
 Uncommon salivary gland neoplasm  Middle-aged females
# commonality? demo? ADENOCARCINOMA NOS
92
variable, cannot be specified
ADENOCARCINOMA NOS histo

PATH II (32 decks)

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