SALIVARY GLANDS AND ASSOCIATED DUCTS

Question 1

refers to inflammation of the salivary glands. It may be acute or chronic and has a broad range of causes.

Answer 1

Sialadenitis

Question 2

Other conditions related to sialadenitis include:

Answer 2

Sjögren syndrome: chronic sialadenitis

Mikulicz syndrome: chronic sialadenitis

post-radiation: post-irradiative sialadenitis

iodine-131 administration

HIV-associated sialadenitis or immune reconstitution inflammatory syndrome (IRIS), often presenting with bilateral parotid swelling

Question 3

MOST commnly affected gland in sialadenitis

Answer 3

submandibular glands are the most commonly affected (approximately 85%)

Question 4

refers to the formation of calculi inside the ducts or parenchyma of salivary glands and most commonly occurs in the submandibular glands and their ducts.

Answer 4

Sialolithiasis

Question 5

Sialolithiasis is the most common disease of salivary glands, accounting for approximately 50% of all major salivary gland pathology.

Which gland is most commonly affected?

Answer 5

The submandibular salivary gland is most commonly affected (80-90% of cases) with almost all the remaining cases located in the parotid duct

Question 6

Contraindication to Sialography ?

Answer 6

active infection is suspected, sialography is contraindicated due to the risk of exacerbating the extent of infection

Question 7

? is the dilatation of the ducts within salivary glands. It is most commonly seen in the parotid gland and is associated with ascending infections and gland destruction.

Answer 7

Sialectasis (sialoangiectasis)

Question 8

Causes of Sialectasis

Answer 8

idiopathic
Sjogren syndrome
post-infectious
recurrent sialadenitis
salivary duct strictures
congenital (rare)

Question 9

most common salivary gland tumours.

Answer 9

pleomorphic adenomas.

Question 10

Most common location of pleomorphic adenoma?

Answer 10

Pleomorphic adenomas account for 70-80% of benign salivary gland tumours and are especially common in the parotid gland, comprising the majority of all parotid gland tumours Patients are typically middle-aged and the incidence is slightly higher in females than males (2:1). The oncogenic simian virus (SV40) may play a role in onset or progression and prior head and neck irradiation is a risk factor for the development of these tumours

They are less common in salivary glands other than the parotid but remain the most common benign tumour of each gland.

Pleomorphic adenomas are also commonly found in the lacrimal glands where they account for approximately 50% of lacrimal gland tumours

Question 11

Possible complications of pleomorphic adenoma?

Answer 11

There is a small risk of malignant transformation into a carcinoma ex-pleomorphic adenoma which is proportional to the time the lesion is in situ

Question 12

are benign, sharply demarcated salivary gland tumours, almost exclusively encountered in the parotid gland. They are of lymphoid origin and may be bilateral or multifocal in up to 20% of cases and are the most common neoplastic cause of multiple solid parotid masses.

Answer 12

Warthin tumours, also known as lymphomatous papillary cystadenomas

Question 13

2nd most common benign parotid gland tumour

what are the associations?

Answer 13

Warthin tumour (after pleomorphic adenoma) and represent up to 10% of all parotid tumours. They are the most common bilateral or multifocal benign parotid tumours. They typically occur in older age (6th decade) and are twice as common in men (2.2:1).

Associations
smoking

irradiation

Question 14

are cystic spaces (usually saliva containing) arising within a salivary gland

Answer 14

Sialoceles

Question 15

is a condition characterised by lymphatic infiltration of the salivary glands, especially the parotids. This condition of HIV patients can be part of the diffuse infiltrative lymphocytosis syndrome. The condition is one of the most important AIDS-associated oral lesions.

Answer 15

HIV-associated salivary gland disease

Question 16

is the second most common malignancy involving the minor salivary glands behind mucoepidermoid carcinoma and the second most common malignancy involving the parotid gland.

Answer 16

Adenoid cystic carcinoma

Question 17

MOST common malignancy involving the minor salivary glands?

Answer 17

mucoepidermoid carcinoma

Question 18

Adenoid cystic carcinomas are frequently associated with ?

Answer 18

perineural spread (via cranial nerve VII), which is well appreciated on MRI.

Question 19

The most common malignant salivary gland tumour of childhood?

seen throughout all adult age groups but are most common in middle age (35-65 years of age)

Answer 19

Mucoepidermoid carcinomas

most common malignant primary parotid gland tumour. A slight female predilection has been described, and radiation has been implicated as a risk factor

Question 20

Imaging features of Mucoepidermoid carcinomas

Answer 20

Low-grade tumours appear as well-circumscribed masses, usually with cystic components. The solid components enhance, and calcification is sometimes seen. They have appearances similar to pleomorphic adenomas.

Question 21

MOST common locations of Mucoepidermoid carcinomas

Answer 21

major salivary glands: ~50%

parotid gland: ~40%

submandibular gland: ~7%

sublingual gland: ~3%

minor salivary glands: ~50%

Question 22

rare malignant neoplasms that account for 1-3% of all salivary gland tumours.

location?

Answer 22

Acinic cell carcinomas

The majority arise in the parotid gland (81-98% 3) and they may be bilateral and multicentric