Salivary Glands

Question 1

Sialadenitis

Answer 1

Inflammation of salivary gland

Question 2

Most common type of inflammatory salivary gland lesion?

Answer 2

Mucoceles

Question 3

Most common type of viral sialadenitis?

Answer 3

Mumps

Question 4

Most common cause of nonspecific bacterial sialadenitis?

Answer 4

Sialolithiasis (condition of stone in salivary glands))

2nd bacterial infxn due to blocking stone

Question 5

Major characteristics for mumps infxn of salivary glands?

Answer 5

Bilateral inflamed parotid gland
Increased serum amylase (b/c of salivary gland or pancreatic involvement)
Complications: Orchitis (testicles), pancreatitis, aseptic meningitis

Question 6

What causes a mucocele?

Answer 6

Blockage or rupture of salivary gland duct and leakage of saliva into surrounding CT stroma

Question 7

Where and in whom are mucoceles seen?

Answer 7

Lower lip b/c of trauma; toddlers/young adults/geriatrics (b/c of falling down)

Question 8

What happens to mucoceles w/meals/

Answer 8

Changes size w/meals

Question 9

What to do w/mucoceles?

Answer 9

Must be excised along w/minor salivary gland to avoid recurrence

Question 10

What glands are usually involved w/sialolithiasis and what does it look like?

Answer 10

Submandibular glands (unilateral); painful enlargement + purulent ductal discharge

Question 11

What bacteria are usually involved w/sialolithiasis?

Answer 11

S. aureus and Strep. viridans

Question 12

What are predisposing factors (2) for sialolithiasis?

Answer 12

dehydration and decreased secretory fxn

Question 13

Sx of Sjoegren Syndrome (7)

Answer 13

dry eyes (keratoconjunctivitis sicca), dry mouth (xerostomia), parotid gland enlargement, dryness of nasal mucosa, epistaxis, recurrent bronchitis, pneumonitis

Question 14

Cause of Sjoegren Syndrome

Answer 14

Autoimmune –> destruction of lacrimal and salivary glands through type 4 hypersensitivity (lymphocyte-mediated damage w/fibrosis)

Question 15

Classic presentation of Sjoegren Syndrome

Answer 15

Recurrent dental carries in older woman (50-60)

“Can’t chew a cracker, dirt in my eye”

Question 16

Serology/Dx for Sjoegren Syndrome

Answer 16

ANAs in serology; lip biopsy to examine minor salivary glands

Question 17

Tumors of Salivary Glands (4)

Answer 17

Pleomorphic adenoma, warthin tumor (papillary cystadenoma lymphomatosum), mucoepidermoid carcinoma, and adenoid cystic carcinoma

Question 18

Which 2 salivary gland tumors are benign?

Answer 18

Pleomorphic adenoma and warthin tumor

Question 19

Which 2 salivary gland tumors are malignant?

Answer 19

mucoepidermoid carcinoma and adenoid cystic carcinoma

Question 20

Most common tumor of salivary gland?

Answer 20

Pleomorphic adenoma

Question 21

What is pleomorphic adenoma composed of?

Answer 21

Stromal (e.g. cartilage) and epithelial origin (e.g. glands)

Question 22

Presentation of pleomorphic adenoma?

Answer 22

Mobile (b/c has not invaded tissue), painless (b/c has not invaded CN7), circumscribed (distinct from surrounding tissue) mass at angle of jaw

Question 23

Signs that pleomorphic adenoma has transformed into carcinoma?

Answer 23

Signs of facial nerve damage b/c CN7 runs thru parotid gland

Question 24

Risk factor for pleomorphic adenoma?

Answer 24

Radiation

Question 25

Major characteristics for Warthin tumor (6) ?

Answer 25

Germinal centers (lymph node like stroma)
Lots of lymphocytes
Parotid gland
M>F
50-70
Smokers

Question 26

Most common malignant tumor of salivary gland?

Answer 26

Mucoepidermoid carcinoma

Question 27

Mucoepidermoid carcinoma are composed of?

Answer 27

Mucinous and squamous cells

Question 28

Where do mucoepidermoid carcinoma arise?

Answer 28

Parotid gland (so commonly involve CN7)

Question 29

Major characteristics for Adenoid Cystic Carcinoma? (4)

Answer 29

Minor salivary glands (but worse if found in major)
Slow growing
Recurrent
Cribiform patterns