Salivary/Pancreatic pathology - Collins Flashcards
List 8 autoimmune/infectious salivary gland diseases.
Mumps Cytomegaloviral Sialadenitis Bacterial Sialadenitis Sarcoidosis Sjögren’s Syndrome Salivary Lymphoepithelial Lesion Xerostomia or dry mouth Halitosis
Name 3 benign neoplasms of the salivary gland.
Mixed Tumor (pleomorphic adenoma)
Monomorphic Adenomas
Ductal papilloma
This benign tumor is composed of cartilage and epithelial tissue, arises in the parotid, and is a mobile, painless, circumscribed mass at the angle of the jaw. Small potential for malignant conversion after decades.
Pleomorphic adenoma
Benign cystic tumor with lymphocytes and germinal centers. 2nd most common tumor of the salivary gland. generally arises in the parotid. Sometimes bilateral (10%)
Warthin’s tumor.
**Both lymphoid and oncocytic components must be present to diagnose warthing (from slides)
Warthins Has Abundant Lymphoid and Epithelial components = WHALE
This tumor commonly arises in the salivary glands of the upper lip. It is primarily epithelial in nature, and presents bilaterally 12% of the time. It has rare malignant potential.
Monomorphic adenoma
Types: Basal Cell Adenoma Canicular Adenoma Myoepithelioma Adenoma Clear Cell Adenoma Membranous Adenoma Glycogen-Rich Adenoma
This type of monomorphic adenoma is distinguished histologically from pleomorphic adenomas by the absence of stroma and the presence of a uniform epithelial pattern.
“uniform basaloid epithelial cells with a monomorphous pattern”
Basal cell adenoma
Name some features of a salivary gland tumor that suggest malignancy.
Induration (hardness) Fixed to Overlying Skin or mucosa Ulceration of skin or mucosa Rapid Growth; Growth Spurt Short Duration Pain, often severe Facial N. Palsy
What is the most common malignant tumor of the salivary gland?
What are two important characteristics of this tumor?
Mucoepidermoid carcinoma.
MECs contain two major elements: mucin-producing cells and epithelial cells (Epidermoid and Mucinous components).
What is the second most common malignant tumor of the salivary gland?
What are some notable features?
Adenoid cystic carcinoma.
Adenoid cystic carcinoma with Swiss cheese pattern.
ACC is the most common malignant tumor found in the submandibular, sublingual, and minor salivary glands.
What are 6 endocrine pancreatic cancers?
1) Gastrinoma (Zollinger-Ellison Syndrome)
2) Glucagonoma
3) Insulinoma
4) Nonfunctional islet cell tumors (NICT)
5) Somatostatinoma
6) VIP-Releasing Tumor
What are 6 exocrine pancreatic cancers?
1) Acinar Cell Carcinoma – Rare, leads to overproduction of lipase
2) Adenocarcinoma – 90% of all pancreatic cancer starts in duct
3) Adenosquamous carcinoma - forms glands that flatten as it grows
4) Intraductal Papillary-Mucinous Neoplasm – fingerlike projections into the duct, prelude to malignancy
5) Mucinous Cystadenocarcinoma – rare malignant spongy cystic tumor
6) Pancreatoblastoma – Rare, occurs in kids
This malignancy may present as episodic hypoglycemia with mental status changes that are relieved by administration of glucose. Diagnosed by low serum glucose, elevated insulin, and elevated C-peptide.
This is the most common pancreatic neuroendocrine tumor.
Insulinoma.
This malignancy presents as treatment-resistant peptic ulcers which may extend into the jejunum.
Gastrinoma (Zollinger - Ellison syndrome)
This malignancy presents as achlorhydria and cholelithiasis with steatorrhea. Can occur anywhere in the duodenum or pancreas.
What explains the achlorhydria?
The steatorrhea?
Stomatostatinomas.
High levels of somatostatin prevent gastrin secretion which leads to achlorhydria.
Steatorrhea is due to inhibition of CCK.
This malignancy presents with watery diarrhea, hypokalemia, and achlorhydria.
VIPomas secrete excessive vasoactive intestinal peptide.
