Salivary Pathology Flashcards
Major salivary glands
Parotid glands, submandibular glands, sublingual gland
Minor salivary glands
- Palate (between midline and palatal gingiva)
- Lining mucosa (cheeks, vestibules, FOM, lips)
- Tongue (ventral & lateral surfaces)
The _____ nerve loops under the _____ duct.
lingual, submandibular
Gland with mostly serous acini
Parotid gland
Gland with mixed acini
Submandibular
Gland with purely mucous acini
Sublingual
_____ cells surround salivary acini and ducts
Myoepithelial
Non-infectious sialadenitis can be caused by
- Post-irradiation
- Immune mediated
- Sarcoidosis
Infectious sialadenitis can be
- Bacterial (acute, chronic, TB, Actinomycosis)
- Viral (mumps, cytomegalic inclusion disease, HIV)
Sialadenitis generally presents as
pain and swelling
Typically a retrograde infection, leading to progressive swelling of the gland 1-2 weeks + malaise, anorexia, dehydration +/- obstruction, fever & purulent exudate of stenson’s duct + pain exacerbated by eating or drinking
Acute bacterial parotitis
Predisposing factors of acute bacterial parotitis
Mouth dryness and/or dehydration, obstructed duct, poor oral hygiene, elderly pts
Acute bacterial parotitis appears microscopically as
sheets of neutrophils
Viral parotitis (Mumps) is a highly contagious viral disease caused by a member of
Paramyxovirus
Mumps is transmitted by
- direct contact, droplet spread
- Virus enter through nose/mouth and replicates in URT and LNs. Spreads to salivary glands and gonads, pancreas, meninges
Clinical symptoms of Mumps
Fever, malaise, headache/myalgia, painful swelling of parotids, submandibular, sublingual glands (pancreas, choroid plexus for the brain, ovaries, and testes in some cases)
Mumps breakouts occur in people living in
close quarters
Complications of Mumps
Deafness, pancreatitis, meningitis, inflammation of the testis and ovaries.
Children are vaccinated against mumps at what age with what vaccine?
1 y/o, MMR
Testing for Mumps
Clinical presentation, labs for Mumps specific IgM, IgG, or viral culture from parotid swab
Non-infectious sialadenitis includes
Immune-mediated sialadenitis (Sjogren syndrome), Sarcoidosis, Post-irradiation
Chronic swelling of the Parotid glands accompanied by dry mouth and eyes. More frequently accompanied by other autoimmune disease (RA, SLE)
Immune mediated sialadenitis (Sjogren syndrome)
Chronic non-tender swelling of the parotid and may be other salivary glands
Sarcoidosis
Severe dryness of mouth + mucositis + candidal infection
Post-irradiation
Mucoepidermoid carcinoma, adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, carcinoma ex pleomorphic adenoma all ex of
Malignant salivary gland tumors
Pleomorphic adenoma (Benign mixed tumor), Warthin’s tumor, monomorphic adenoma, Canalicular adenoma are ex of
Benign salivary gland tumors
Most (65%) of salivary gland tumors are found in the
Parotid gland
Accessory gland tumors are mostly found in the
palate
anatomic distribution of salivary gland tumors
1) Parotid (65%)
2) Accessory (25%)
3) Submandibular (10%)
4) Sublingual (<1%)
T or F: Salivary gland tumors are mostly Benign.
True (60%)
Most common salivary gland tumor is
Pleomorphic adenoma
Parotid gland is ____ benign
2/3
Submandibular is ____ benign
1/2
T or F: Sublingual gland tumors are mostly malignant.
T
Palate tumors are ____ benign
1/2
Upper lip tumors are mostly
benign
Lower lip tumors are mostly
malignant
Retromolar area tumors are mostly
malignant
Clinical cystic presentation could be
mucocele, ranula, cystic tumors
Ulcer clinical presentation could be
Necrotizing sialometaplasia, neoplasms
Mucoceles are mostly found on
the lower lip (80%)
Mucoceles are most common in what decades
1st-3rd
Mucoceles are caused by
trauma, laceration of salivary excretory salivary duct, mucin spillage into tissue.
Mucoceles exclusively affect ______ glands
minor
Clinical presentation of mucoceles
Dome-shaped, translucent/bluish nodule, fluctuant, often increasing and decreasing in size
Less common that conventional mucocele, appear as small blisters, often burst/heal and recur
superficial mucocele
Mucocele of ventral surface of tongue
Cyst of Blandin Nuhn
Mucocele tx
surgical excision of swelling and damaged salivary glands.
Location of mucous pooling in ranula is dicated by
mylohyoid clinical presentation
Ranula tx:
excision of mass and associated sublingual gland
Mucocele in FOM
Ranula
A true cyst of salivary duct origin
Salivary duct cyst (mucous cyst, mucous retention cyst)
Most common sites of Salivary duct cyst
Palate, FOM