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bds4 > Salivary glands tumours/ Salivary gland swelling and enlargement > Flashcards

Salivary glands tumours/ Salivary gland swelling and enlargement Flashcards

1
Q

Why might a salivary gland encounter change is size (4)?

A
  • Secretion retention
  • Chronic sialadentitis
  • Gland hyperplasia
  • Salivary neoplasma
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2
Q

How would you describe a salivary gland neoplasm? (3)

A
  • Painless
  • Slow growing
  • Well defined
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3
Q

What nerve can be affected in a neoplasm in the parotid gland?

A

Facial nerve

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4
Q

List the distribution of tumours in the salivary gland

A
  • Parotid - 80% - 15% malignant
  • Submandibular - 10% - 30% malignant
  • Minor - 10% - 45% malignant
  • Sublingual - 0.5% - 80% malignant
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5
Q

Two examples of epithelial salivary neoplasms?

A

Adenoma - 11 types
Adenocarcinoma - 20 types

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6
Q

Two examples of non epithelial salivary neoplasms?

A

Lymphoma
Sarcoma

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7
Q

3 clinical featured of major gland neoplasm?

A

Asymmetry
Obstruction
Pain and facial palsy in late stages

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8
Q

What feature is considered a malignancy in minor salivary glands?

A

Ulceration

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9
Q

Where do minor salivary gland tumours usually appear?

A
  • Junction of hard and soft palate
  • Upper lip and cheek
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10
Q

What are 3 diagnosis techniques for salivary gland tumours?

A
  • Ultrasound guided fine needle aspiration
  • Core biopsy
  • Incisional biopsy
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11
Q

3 problems in diagnosing salivary gland tumours?

A
  • Variation within tumour due to complex pathology
  • Common featured between different types
  • Not all tumours fit the classification
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12
Q

Most common site of pleomorphic adenoma?

A

Parotid gland

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13
Q

What type of tumour is pleomorphic adenoma?

A

Mixed tumour

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14
Q

3 histological features of pleomorphic adenoma?

A

Duct epithelium
Myoepithelial cells
Myxoid and chondroid areas
Variable capsule

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15
Q

What % for pleomorphic adenoma progress to cancer?

A

5%

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16
Q

What problem might be associated with pleomorphic adenoma other than malignancy?

A

Recurrence

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17
Q

What is the most common gland to be affected by warthin’s tumour (15%)?

A

Parotid

18
Q

3 histological sites of adenolymphoma?

A

Cystic spaces
Distinctive pink epithelium
lymphoid tissue

19
Q

How does adenoid cystic carcinoma (5%) spread?

A

through nerves and bones

20
Q

Why is adenoid cystic carcinoma difficult to treat?

A

Due its high rate of recurrence

21
Q

Where do adenoid cystic carcinoma metastasise to in late stages ?

A

to the lungs by blood

22
Q

What are the 3 patterns of adenoid cystic carcinoma?

A
  • Cribriform
  • Tubular
  • Solid
23
Q

Which glands do adenoid cystic carcinoma mostly affect?

A

Minor glands

24
Q

What is the 2 types of mucoepidermoid carcinoma (3-5%) when it comes to grading?

A

Cystic and solid

25
Q

How does mucoepidermoid carcinoma spread?

A

Lymphatic

26
Q

2 cell types found histologically in mucoepidermoid carcinoma?

A

Squamous and glandular

27
Q

By order list salivary gland tumours from the commonest to the rarest?

A
  1. Pleomorphic adenoma (75%)
  2. Salivary gland carcinoma and warthins tumour(15%)
  3. Adenoid cystic carcinoma (5%)
  4. Mucoepidermoid carcinoma (3-5%)
  5. acinic cell carcinoma
28
Q

Two viruses that cause changes in salivary gland size?

A

paramyxovirus (mumps)
HIV

29
Q

Two reasons why there is secretion retention in a salivary gland?

A
  • Mucocele
  • Duct obstruction
30
Q

Two conditions that cause salivary gland hyperplasia?

A
  • Sialosis
  • Sjogren’s syndrome
31
Q

Which vaccine prevents mumps?

A

MMR

32
Q

Give 4 symptoms of mumps infection?

A
  • xerostomia
  • headache
  • loss of appetite
  • Fatigue and pyrexia
33
Q

How does paramyxovirus spread?

A

Droplet

34
Q

What is a mucocele?

A

A recurrent swelling due to secretion retention in the duct of a salivary gland

35
Q

What the most common sites of a mucocele?

A
  • Junction of the hard and soft palate
  • Lower lip
36
Q

What is a subacute obstruction of the salivary gland?

A

Swelling associated with meals due to obstruction of salivary gland ducts most common in the submandibular gland due to sialoliths or duct damage due to chronic infection

37
Q

How is subacute obstruction different between parotid and submandibular?

A
  • Duct blockage in submandibular
  • Duct stricture in parotid
38
Q

What investigations would you carry out if suspected a sailolith?

A
  • Radiography - lower true occlusal , OPT
  • Sialography
  • isotope scan if gland function uncertain
  • Ultrasound
39
Q

How to manage subacute obstruction?

A
  • Surgical sialolith removal
  • Sialography for no stone cases
  • If fixed swelling remove gland
40
Q

What is sialosis?

A

Inflammation of salivary gland leading to enlargement

41
Q

What 4 factors may contribute to sialolis?

A
  • alcohol
  • Cirrhosis
  • Diabetes
  • Drugs
42
Q

4 investigations you would carry out for Sialosis?

A
  • Blood tests - general ones , bilirubin
  • Autoantibody screening (ANA, anti-ro and anti-la)
  • MRI of major salivary glands

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