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PATH II > salivary glands > Flashcards

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
Q
A

ranula

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26
Q

plunging ranula

A

occurs if ranula goes beneath the mylohyoid: mucin dissects thru the mm
will present as a neck mass

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27
Q

sialolith

A

salivary stone
trapped saliva will calcify and obstruct the duct

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28
Q

common location sialoliths and why

A

whartons duct due to the many turns

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29
Q

indications of sialoliths

A

swelling near glands around meal time
may be painful due to infection

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30
Q

sialoliths with palpation

A

hard

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31
Q

sialoliths at stensons duct may present with?

A

pus

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32
Q

what can we use to locate sialoliths

A

occ radiogrpahs

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33
Q

tx of sialoliths

A

excision

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34
Q

histo app of sialoliths

A

calcifed tissue

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35
Q

necrotizing sialometaplasia

A

unknown cause, reactive condition
can present with swelling and ulceration that can be bilateral or unilateral

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36
Q
A

necrotizing sialometaplasia

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37
Q

necrotizing sialometaplasia histology

A

RESEMBLES CANCER
Pseudoepitheliomatous hyperplasia: resembles cancers
Sialometaplasia of glandualr tissue to squamous cells
Coagulative necrosis of the glands= loss of architecture

38
Q

SJOGREN SYNDROME
 dx?
Dry?
Primary vs. Secondary?
Bilateral enlargement of? also called?

A

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
Q

lab values of SS

A

 Anti-SS-A: specific
 Anti-SS-B: specific
 RF: non specific
 ANA: non specific

40
Q

what biopsy can be done with SS?

A

lip biopsy of the minor glands

41
Q

what to look for with SS histo?

A

lymphocyte aggregates

42
Q
A

SS, lymphocyte aggreagte

43
Q

%benign/malignant

TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS

A
44
Q

%benign/malignant

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
palate, buccal, upper lip, lower lip, tongue, floor, retromolar pad

A
45
Q

benign vs malignant

clinical presentation of salivary neoplasms
growth rate?
induration?
symptoms?
ulceration?

A
46
Q

BENIGN SALIVARY GLAND
TUMORS

A

Benign Mixed Tumor (Pleomorphic Adenoma)

Monomorphic Adenoma

Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum)

Oncocytoma

Ductal Papillomas

47
Q

Most common salivary gland neoplasm?

A

pleomorphic adenoma

48
Q

PLEOMORPHIC ADENOMA
 commonality?
 demo?
 presentation

A

 Most common salivary gland neoplasm
 Middle-aged females
 Painless slowly growing mass

49
Q

pleomorphic adenoma histology

A

Variable histology
Mixture of ductal and myoepithelial elements
Encapsulated
often cartilage like app

50
Q
A

pleomorphic adenoma

51
Q

monomorphic adenoma
location? demo? presentation?

A

 Upper lip
 Middle-aged females
 Painless slowly growing mass

52
Q

histology of a monomorphic adenoma
 pattern?
 cords of?
 May demonstrate?
 stroma? vascularity?
 capsule?

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

53
Q

PAPILLARY CYSTADENOMA
LYMPHOMATOSUM/ WHARTINS TUMOR
common? which gland? uni or bilat? demo? race? associated with? presentation?

A

 2nd most common benign salivary gland neoplasm
Parotid gland
Bilateral
Middle-aged males
 Lower in blacks
Smoking
Painless slowly growing nodular mass

54
Q

epithelium? what cells aggregate? configuration?

PAPILLARY CYSTADENOMA
LYMPHOMATOSUM/ WHARTINS TUMOR histology

A

 Oncocytic (granulaur cyto due to accumulation of altered mito) ductal epithelium- Uniform double rows
 Lymphoid aggregate
 Papillary cystic configuration

55
Q

ONCOCYTOMA
common?
 cells?
 demo?
 gland?
 presentation

A

ONCOCYTOMA
Rare salivary gland neoplasm
Large epithelial cells, oncocytes
Females, 8th decade
Parotid
Painless slowly growing mass that is Multifocal

56
Q

cells? stroma? infiltrate?

oncocytoma histology

A

 Large polyhedral cells abundant in granular eosinophilic cytoplasm due to mitochondria
 Limited stroma- Thin fibrovascular septa
 Lymphoid infiltrate

57
Q

MALIGNANT SALIVARY GLAND
TUMORS

A

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

58
Q

MUCOEPIDERMOID CARCINOMA
 commonality?
 demo?
 Clinically mistaken for?

A

 Most common malignant salivary gland neoplasm
 Middle-aged females
 Clinically mistaken for a mucocele

59
Q

cells present? can present in what forms?

MUCOEPIDERMOID CARCINOMA histology

A

 Mucous producing cells
 Epidermoid (squamous) cells
 May be cystic and / or solid

60
Q

HIGH-GRADE
MUCOEPIDERMOID
CARCINOMA can be similar in app to? how to distinguish?

A

similar to SCCa in appearence, use mucicarmine stain

61
Q

recognized? demo? presentation?

ADENOID CYSTIC CARCINOMA

A

 Best recognized salivary gland tumor
 Middle-aged females
 Slowly growing mass, painful, can be ulcerative

62
Q

cells? invasion where? pattern?

ADENOID CYSTIC CARCINOMA histology

A

Myoepithelial and ductal cells
Perineural and perivascular invasion= poor prognosis
Cribiform pattern/ SWISS CHEESE

63
Q

commonality? where? demo?

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA
(PLGA)

A

 Common malignant MINOR salivary gland neoplasm
 Middle-aged females
 Favors palate

64
Q

deceptive? growth? invasion? distinct cell pattern?

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA
(PLGA)
histology

A

 Deceptive uniform appearance
 Different growth patterns
 Perineural and perivascular invasion but better prognosis than adenoid cystic carcinoma
 Indian filing

65
Q

gland? what is affected? demo? growth? grade?

acinic cell carcinoma

A

Parotid mainly
Serous acinar differentiation
Middle-aged females
Slow-growing= Low-grade malignancy

66
Q

circumscribed? infiltration? cell app (cyto/nuc)?

acinic cell carcinoma histology

A

 Well circumscribed
 May be infiltrative
 Serous acinar cell: Abundant granular basophilic cytoplasm and a round, stained eccentric (non-central) nucleus

67
Q

demo? growth? s/s?

CARCINOMA EX-PLEOMORPHIC ADENOMA

A

 Long standing pleomorphic adenoma that undergoes malignant transformation
 Older adults
 Rapid growth
 Pain and ulceration

68
Q

CARCINOMA EX-PLEOMORPHIC ADENOMA HISTOLOGY

A

 Typical benign mixed tumor that undergoes Malignant degeneration:
1. Cellular pleomorphism
1. Abnormal mitotic activity
1. Capsular invasion

69
Q

commonality? demo?

ADENOCARCINOMA NOS

A

 Uncommon salivary gland neoplasm
 Middle-aged females

70
Q

ADENOCARCINOMA NOS histo

A

variable, cannot be specified

71
Q

what neoplasm has a swiss cheese histo?

A

adenoid cystic carcinoma

72
Q

 Most common salivary gland neoplasm
 Middle-aged females
 Painless slowly growing mass

A

PLEOMORPHIC ADENOMA
 commonality?
 demo?
 presentation

73
Q

Variable histology
Mixture of ductal and myoepithelial elements
Encapsulated
often cartilage like app

A

pleomorphic adenoma histology

74
Q

 Upper lip
 Middle-aged females
 Painless slowly growing mass

A

monomorphic adenoma
location? demo? presentation?

75
Q

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

A

histology of a monomorphic adenoma
 pattern?
 cords of?
 May demonstrate?
 stroma? vascularity?
 capsule?

76
Q

 2nd most common benign salivary gland neoplasm
Parotid gland
Bilateral
Middle-aged males
 Lower in blacks
Smoking
Painless slowly growing nodular mass

A

PAPILLARY CYSTADENOMA
LYMPHOMATOSUM/ WHARTINS TUMOR
common? which gland? uni or bilat? demo? race? associated with? presentation?

77
Q

 Oncocytic (granulaur cyto due to accumulation of altered mito) ductal epithelium- Uniform double rows
 Lymphoid aggregate
 Papillary cystic configuration

A

epithelium? what cells aggregate? configuration?

PAPILLARY CYSTADENOMA
LYMPHOMATOSUM/ WHARTINS TUMOR histology

78
Q

Rare salivary gland neoplasm
Large epithelial cells, oncocytes
Females, 8th decade
Parotid
Painless slowly growing mass that is Multifocal

A

ONCOCYTOMA
common?
 cells?
 demo?
 gland?
 presentation

79
Q

 Large polyhedral cells abundant in granular eosinophilic cytoplasm due to mitochondria
 Limited stroma- Thin fibrovascular septa
 Lymphoid infiltrate

A

cells? stroma? infiltrate?

oncocytoma histology

80
Q

 Most common malignant salivary gland neoplasm
 Middle-aged females
 Clinically mistaken for a mucocele

A

MUCOEPIDERMOID CARCINOMA
 commonality?
 demo?
 Clinically mistaken for?

81
Q

 Mucous producing cells
 Epidermoid (squamous) cells
 May be cystic and / or solid

A

cells present? can present in what forms?

MUCOEPIDERMOID CARCINOMA histology

82
Q

similar to SCCa in appearence, use mucicarmine stain

A

HIGH-GRADE
MUCOEPIDERMOID
CARCINOMA can be similar in app to? how to distinguish?

83
Q

 Best recognized salivary gland tumor
 Middle-aged females
 Slowly growing mass, painful, can be ulcerative

A

recognized? demo? presentation?

ADENOID CYSTIC CARCINOMA

84
Q

Myoepithelial and ductal cells
Perineural and perivascular invasion= poor prognosis
Cribiform pattern/ SWISS CHEESE

A

cells? invasion where? pattern?

ADENOID CYSTIC CARCINOMA histology

85
Q

 Common malignant MINOR salivary gland neoplasm
 Middle-aged females
 Favors palate

A

commonality? where? demo?

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA
(PLGA)

86
Q

 Deceptive uniform appearance
 Different growth patterns
 Perineural and perivascular invasion but better prognosis than adenoid cystic carcinoma
 Indian filing

A

deceptive? growth? invasion? distinct cell pattern?

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA
(PLGA)
histology

87
Q

Parotid mainly
Serous acinar differentiation
Middle-aged females
Slow-growing= Low-grade malignancy

A

gland? what is affected? demo? growth? grade?

acinic cell carcinoma

88
Q

 Well circumscribed
 May be infiltrative
 Serous acinar cell: Abundant granular basophilic cytoplasm and a round, stained eccentric (non-central) nucleus

A

circumscribed? infiltration? cell app (cyto/nuc)?

acinic cell carcinoma histology

89
Q

 Long standing pleomorphic adenoma that undergoes malignant transformation
 Older adults
 Rapid growth
 Pain and ulceration

A

demo? growth? s/s?

CARCINOMA EX-PLEOMORPHIC ADENOMA

90
Q

 Typical benign mixed tumor that undergoes Malignant degeneration:
1. Cellular pleomorphism
1. Abnormal mitotic activity
1. Capsular invasion

A

CARCINOMA EX-PLEOMORPHIC ADENOMA HISTOLOGY

91
Q

 Uncommon salivary gland neoplasm
 Middle-aged females

A

commonality? demo?

ADENOCARCINOMA NOS

92
Q

variable, cannot be specified

A

ADENOCARCINOMA NOS histo

PATH II (25 decks)

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