Salivary Glands Pathology (Non-Neoplastic) Flashcards
Stafne’s bone cavity (defect)
Developmental condition
- Traditionally thought to be developmental inclusion of submandibular salivary gland along lingual cortex of Md
Symptoms and radiographic presentation of Stafne’s bone cavity
No signs or symptoms
Radiolucency, often corticated, below the inferior alveolar canal and roughly from angle to midbody
Treatment of Stafne’s bone cavity
No treatment, recognition only
Not pathology!
Mucocele
Traumatic severance of salivary duct resulting in mucus extravasation into connective tissue, not epithelial lined
- Not a cyst
Location where mucoceles commonly occur
Lower lip
Lateral tongue
Ant. ventral tongue
Cheek
What age group do mucoceles occur in
Kids and young adults
“the younger you are, more active you are, more chance for injury”
Ranula
Mucoceles in floor of mouth
usually lateral to the midline
Polunging (cervical) ranula
spilled mucin dissects through the mylohyoid muscle, producing swelling in neck. Can be potentially serious
Salivary Duct Cyst
also known as mucus retention cyst
- True epithelial lined cyst from salivary duct
- Bluish (or normal color) soft fluctuant swelling
Demographic pattern of Salivary Duct cyst
Mostly in adults
Occurs in major and minor glands, can be multiple
Most common location of Salivary Duct Cyst
Parotid gland, **Palate (most common), FOM, Buccal mucosa, lips
Sialolith, Sialolithiasis
(salivary stones)
- Calcifications in salivary duct
- *NOT due to hypercalcemia
Where are Sialoliths most common
Most often in submandibular gland
Also in minor glands, upper lip, buccal mucosa
Symptoms and radiographic features of Sialolith
Pain or swelling especially at meal time
Radiograph +-, sialography, ultrasound, CT
TX of Sialolith
Gentle massage, increase fluid intake, moist heat, sialogogue, surgery
Mumps
(Epidemic Parotitis)
Paramyxovirus infection primarily affect the salivary glands
- Also targets gonads. Esp. in boys it can produce sterility
Anesthesia mumps
Self-limiting major gland swelling following general anesthesia
Sialadenitis
Most bacterial infections due to staph or strep
Symptoms or signs of Sialadenitis
Acute: Parotid, pain and swelling
Fever, often purulent exudate
Kuttner tumor
Long standing chronic inflammation of submandibular gland producing significant swelling like a neoplasm.
- Sialadenitis
Subacute necrotizing sialadenitis
Subset with rapid onset palatal swelling in teens or young adults, possibly viral
Sialadenosis (Sialosis)
Non-inflammatory asymptomatic salivary gland enlargement
Common locations of Sialadenosis
Mainly in parotid, hypertrophy of acini
**Causes of Sialadenosis
- *Alcoholism
- Anorexia nervosa
- Bulimia
Adenomatoid Hyperplasia of the Minor Salivary Glands
On hard or soft palate
Localized, sessile painless swelling
Pathogenesis unknown
NOT A NEOPLASM
*Necrotizing Sialometaplasia
*Locally destructive inflammatory condition of the salivary glands due to *infarction from blockage of blood flow to gland
Clinical characteristics of Necrotizing Sialometaplasia
Occurs frequently on palate, unilateral
- Mimic malignancy. Need biopsy to rule out.
Cheilitis Glandularis
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
Causes of Cheilitis Glandularis
Chronic sun damage
Retrograde infection
Describe controversy of malignant potential and Cheilitis glandularis
Most likely not premalignant
Chronic sun damage predisposes to both conditions, one doesn’t cause the other
Sialorrhea
Making too much saliva
Very rare
Treatment of Sialorrhea
Anticholinergic medications
Surgery
Lymphoepithelial Sialadenitis
Close association with Sjogren’s syndrome
- Non-neoplastic condition of salivary glands producing asymptomatic swelling
Demographic pattern of Lymphoepithelial Sialadenitis
3:1 Female
4-7th decade
90% affect parotid, occasionally submandibular
Sjogren’s syndrome
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
**Patients with Sjogren’s syndrome need to be monitored for what?
Increased risk for lymphoma (40x), marginal zone lymphoma (MALT lymphoma)
Sarcoidosis
Multi-system granulomatous disorder of unknown cause
Demographic patterns of Sarcoidosis
20-40 y/o
African American
White
Female
Clinical signs of Sarcoidosis
Affects lungs, lymph nodes, skin, eyes and salivary glands
20% asymptomatic
Heerfordt’s syndrome
Related to Sarcoidosis
- Parotid enlargement
- Anterior uveitis of the eye
- Facial paralysis
- Fever
Frey Syndrome
Associated with Sarcoidosis
- Flusing, sweating, warmth in preauricular and temporal skin during chewing
