Salivary Glands Pathology (Non-Neoplastic)

Question 1

Stafne’s bone cavity (defect)

Answer 1

Developmental condition

- Traditionally thought to be developmental inclusion of submandibular salivary gland along lingual cortex of Md

Question 2

Symptoms and radiographic presentation of Stafne’s bone cavity

Answer 2

No signs or symptoms

Radiolucency, often corticated, below the inferior alveolar canal and roughly from angle to midbody

Question 3

Treatment of Stafne’s bone cavity

Answer 3

No treatment, recognition only

Not pathology!

Question 4

Mucocele

Answer 4

Traumatic severance of salivary duct resulting in mucus extravasation into connective tissue, not epithelial lined

• Not a cyst

Question 5

Location where mucoceles commonly occur

Answer 5

Lower lip
Lateral tongue
Ant. ventral tongue
Cheek

Question 6

What age group do mucoceles occur in

Answer 6

Kids and young adults

“the younger you are, more active you are, more chance for injury”

Question 7

Ranula

Answer 7

Mucoceles in floor of mouth

usually lateral to the midline

Question 8

Polunging (cervical) ranula

Answer 8

spilled mucin dissects through the mylohyoid muscle, producing swelling in neck. Can be potentially serious

Question 9

Salivary Duct Cyst

Answer 9

also known as mucus retention cyst

• True epithelial lined cyst from salivary duct
• Bluish (or normal color) soft fluctuant swelling

Question 10

Demographic pattern of Salivary Duct cyst

Answer 10

Mostly in adults

Occurs in major and minor glands, can be multiple

Question 11

Most common location of Salivary Duct Cyst

Answer 11

Parotid gland, **Palate (most common), FOM, Buccal mucosa, lips

Question 12

Sialolith, Sialolithiasis

Answer 12

(salivary stones)

• Calcifications in salivary duct
• *NOT due to hypercalcemia

Question 13

Where are Sialoliths most common

Answer 13

Most often in submandibular gland

Also in minor glands, upper lip, buccal mucosa

Question 14

Symptoms and radiographic features of Sialolith

Answer 14

Pain or swelling especially at meal time

Radiograph +-, sialography, ultrasound, CT

Question 15

TX of Sialolith

Answer 15

Gentle massage, increase fluid intake, moist heat, sialogogue, surgery

Question 16

Mumps

Answer 16

(Epidemic Parotitis)
Paramyxovirus infection primarily affect the salivary glands
- Also targets gonads. Esp. in boys it can produce sterility

Question 17

Anesthesia mumps

Answer 17

Self-limiting major gland swelling following general anesthesia

Question 18

Sialadenitis

Answer 18

Most bacterial infections due to staph or strep

Question 19

Symptoms or signs of Sialadenitis

Answer 19

Acute: Parotid, pain and swelling

Fever, often purulent exudate

Question 20

Kuttner tumor

Answer 20

Long standing chronic inflammation of submandibular gland producing significant swelling like a neoplasm.
- Sialadenitis

Question 21

Subacute necrotizing sialadenitis

Answer 21

Subset with rapid onset palatal swelling in teens or young adults, possibly viral

Question 22

Sialadenosis (Sialosis)

Answer 22

Non-inflammatory asymptomatic salivary gland enlargement

Question 23

Common locations of Sialadenosis

Answer 23

Mainly in parotid, hypertrophy of acini

Question 24

**Causes of Sialadenosis

Answer 24

• *Alcoholism
• Anorexia nervosa
• Bulimia

Question 25

Adenomatoid Hyperplasia of the Minor Salivary Glands

Answer 25

On hard or soft palate
Localized, sessile painless swelling
Pathogenesis unknown
NOT A NEOPLASM

Question 26

*Necrotizing Sialometaplasia

Answer 26

*Locally destructive inflammatory condition of the salivary glands due to *infarction from blockage of blood flow to gland

Question 27

Clinical characteristics of Necrotizing Sialometaplasia

Answer 27

Occurs frequently on palate, unilateral

- Mimic malignancy. Need biopsy to rule out.

Question 28

Cheilitis Glandularis

Answer 28

Swelling and eversion of the lower lip as a result of hypertrophy and inflammation of the minor salivary glands
- Ranges from slightly swollen to massive swelling, pain and suppuration

Question 29

Causes of Cheilitis Glandularis

Answer 29

Chronic sun damage

Retrograde infection

Question 30

Describe controversy of malignant potential and Cheilitis glandularis

Answer 30

Most likely not premalignant

Chronic sun damage predisposes to both conditions, one doesn’t cause the other

Question 31

Sialorrhea

Answer 31

Making too much saliva

Very rare

Question 32

Treatment of Sialorrhea

Answer 32

Anticholinergic medications

Surgery

Question 33

Lymphoepithelial Sialadenitis

Answer 33

Close association with Sjogren’s syndrome

- Non-neoplastic condition of salivary glands producing asymptomatic swelling

Question 34

Demographic pattern of Lymphoepithelial Sialadenitis

Answer 34

3:1 Female
4-7th decade
90% affect parotid, occasionally submandibular

Question 35

Sjogren’s syndrome

Answer 35

Autoimmune disease mainly affects salivary and lacrimal glands
- 80-90% female
- Results in xerostomia
Primary = no other autoimmune disease
Secondary = associated with other autoimmune diseases

Question 36

**Patients with Sjogren’s syndrome need to be monitored for what?

Answer 36

Increased risk for lymphoma (40x), marginal zone lymphoma (MALT lymphoma)

Question 37

Sarcoidosis

Answer 37

Multi-system granulomatous disorder of unknown cause

Question 38

Demographic patterns of Sarcoidosis

Answer 38

20-40 y/o
African American
White
Female

Question 39

Clinical signs of Sarcoidosis

Answer 39

Affects lungs, lymph nodes, skin, eyes and salivary glands

20% asymptomatic

Question 40

Heerfordt’s syndrome

Answer 40

Related to Sarcoidosis

• Parotid enlargement
• Anterior uveitis of the eye
• Facial paralysis
• Fever

Question 41

Frey Syndrome

Answer 41

Associated with Sarcoidosis

- Flusing, sweating, warmth in preauricular and temporal skin during chewing