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Oral Path > Salivary Glands > Flashcards

Salivary Glands Flashcards

1
Q

Developmental

A

congenital
parents may or may not be affected
symmetric features, bilateral

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2
Q

Neoplastic

A

malignant vs benign

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3
Q

reactive

A

inflammatory, infectious, traumatic, autoimmune

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4
Q

Developmental diagnostic seive

A

salivary gland aplasia

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5
Q

traumatic diagnostic seive

A

mucocele, necrotizing sialometaplasia

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6
Q

inflammatory or infective diagnostic seive

A

sialoliths, sialadenitis, cheilitis, galndularis

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7
Q

autoimmune/systemic diagnostic seive

A

sjögren’s syndrome, SLE

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8
Q

neoplastic diagnostic seive

A

ploemoprhic adenoma, mucoepidermoid carcinoma

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9
Q

drug induced diagnostic seive

A

xerostomia, sialadenosis

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10
Q

idiopathic diagnostic seive

A

xerostomia

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11
Q

diagnostic work up

A

history
examination
investigations

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12
Q

sialolithiasis/mucous plug

A

calcified structures, pain, swelling
salivary duct
calcium deposition around a nidus
wharton’s duct common

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13
Q

sialolithiasis/mucous plug management

A

cannulation
endoscopic removal
surgical excision

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14
Q

sialadenitis

A

acute or chronic
infectious (staph a.)
non infectious (sjögren’s syndrome, sarcoidosis, allergies)
swelling, erythema, pus, pain

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15
Q

sialadenitis histopathology

A

acute=accumulation of neutrophils in ducal system and acini
chronic=scattered or patchy infiltration of salivary parenchyma by lymphocytes and plasma cells
atrophy of acini and duct all dilation is common

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16
Q

sialadenitis management

A

acute=antibiotics, rehydration, abscess drainage

chronic=cannulation, antibiotics

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17
Q

mucocele

A

rupture of a salivary gland duct and spillage of mucin into the surrounding tissues
result of local trauma

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18
Q

mucocele histopathology

A

granulation tissue response

numerous foamy histiocytes

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19
Q

mucocele treatment

A

surgical excision
remove feeding minor salivary glands
risk of recurrence

20
Q

ranula

A

mucocele on the floor of mouth

21
Q

ranula management

A

marsupialization

surgical excision

22
Q

necrotizing sialometaplasis

A

uncommon, locally destructive inflammatory condition
result of ischemia of salivary tissue
mimics a malignant process

23
Q

necrotizing sialometaplasis predisposing factors

A 
traumatic injuries
dental injections
ill-fitting dentures
upper respiratory infections
adjacent tumors
previous surgery
24
Q

necrotizing sialometaplasis clinical features

A

developers in the palatal salivary glands (75% on posterior palate)
hard palate affect more often than the soft
appears initially as a non ulcerated swelling, associate with pain or paresthesia
2-3 weeks, tissue slough out, leaving crater like ulcer

25
Q

necrotizing sialometaplasis histopathology

A

acinar necrosis followed by associated squamous metaplasia of salivary ducts

26
Q

necrotizing sialometaplasis treatment

A

biopsy
if diagnosed no specific treatment is indicated or necessary
lesion resolves on own in about 5-6 weeks

27
Q

salivary gland tumors

A

epithelial neoplasms (unilateral swelling of parotid)
9/10 tumors affect parotid, are benign, are PSAs
next common is carcinoma

28
Q

salivary gland tumors types

A

benign (pleomorphic adenoma, warthin’s tumor)

malignant (mucoepidermoid carcinoma, adenoid cystic carcinoma)

29
Q

pleomorphic adenoma

A

most common neoplasm
slow growing, lobulated, rubbery swelling, bluish appearance
benign but recurs if excision in inadequate
poorly encapsulated, intimate relationship with facial nerve (difficult to completely excises)

30
Q

pleomorphic adenoma histopathology

A 
originate from ductal epithelium
reminiscent of connective tissue
mixed tumor (myxoid or cartilage tissue)
thin fibrous capsule
mixture of glandular epithelium and myoepithelial cells
31
Q

pleomorphic adenoma management

A

malignant degeneration resulting in carcinoma
malignant change is uncommon
surgery

32
Q

warthin’s tumor

A

papillary cyst adenoma lympomatosum
parotid
found in smokers, autoimmune disease or exposed to radiation
benign

33
Q

warthin’s tumor clinical features

A

painless nodular mass on parotid gland
firm or fluctuant
near angle of mand.

34
Q

warthin’s tumor management

A

surgical removal

rare recurrence

35
Q

monomorphic adenoma

A

benign encapsulated
females, upper lip and buccal mucosa
epithelial cells

36
Q

mucoepidermoid carcinoma

A

parotid gland
a symptomatic swelling
facial nerve palsy
minor glands are clinically mistaken for a mucocele

37
Q

mucoepidermoid carcinoma histopathology

A

mucus-producing cells and squamous cells

38
Q

mucoepidermoid carcinoma management

A

early stage parotid treated by subtotal parotidectomy
advanced total removals of parotid
radical neck dissection
postoperative radiation

39
Q

mucoepidermoid carcinoma prognosis

A

low-grade tumors have good prognosis

high-grade tumors is guarded (survival rate of 30-54%)

40
Q

adenoid cystic carcinoma

A

minor salivary glands (palate)

41
Q

adenoid cystic carcinoma histopathology

A

myoepithelial cells and ductal cells
cribriform, tubular, and solid
perineural invasion

42
Q

adenoid cystic carcinoma management

A

local recurrence, distant metastasis

surgical excision and adjunct radiation therapy

43
Q

adenoid cystic carcinoma prognosis

A

survival rate decreases over time, due to prone recurrence and metastasis

44
Q

polymorphous low-grade adenocarcinoma

A

lobular
palate, lip, buccal mucosa
painless swelling, may ulcerated and bleed
variety of growth patterns within the same lesion
local excision

45
Q

acinic cell adenocarcinoma

A 
rare
unilateral
asymptomatic enlarging mass
grayish, solid, cystic (honeycomb)
surgical excision, possible post surgical radiation tx
46
Q

xerostomia

A

oral dryness, salivary hypofunction
concurrent findings=burning mouth syndrome, candidiasis, rampant caries, perio
management with pilocarpine, cevimeline

47
Q

sjögren’s syndrome

A

dry eyes and dry mouth
patients older than 40, female more common
over counter eye drops and sipping water
pilocarpine or cevimeline

Oral Path (8 decks)

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