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Oral Pathology, Stephen > ch 11 Salivary Gland Pathology > Flashcards

ch 11 Salivary Gland Pathology Flashcards

(82 cards)

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1
Q

Parotid gives watery or thicker saliva

A

Watery (serrous)

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2
Q

Common lesion of the oral mucosa from rupture of salivary gland duct and spillage of mucin into surrounding soft tissue, lower lip 60%, can be fluctuant to firm

A

Mucocelle

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3
Q

Mucocele on the floor of the mouth that will appear bluish

A

Ranula

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4
Q

Epithelium-lined cavity that arises from salivary gland tissue that can be mistaken for ranula if in floor of mouth

A

Salivary duct cyst/mucous retention cyst

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5
Q

Treatment for mucocele, ranula, or salivary duct cyst

A

Surgical excision w/adjacent gland or marsupialization

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6
Q

A ranula can be on the midline, what other pathology can cross the midline

A

epidermoid cyst

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7
Q

This is a ranula that occurs when the spilled mucin dissects the mylohyoid

A

plunging ranula

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8
Q

How would a hemangioma look, feel different from a ranula

A

hemangioma more pebbly and irregular

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9
Q

Calcified structures that develop within the salivary ductal system, common in the submandibular gland because of its tortuous route and its more sebaceous excretions

A

Sialolithiasis

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10
Q

Common duct for Sialolithiasis

A

Wharton’s duct

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11
Q

inflammation of the salivary glands

A

Sialadenitis

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12
Q

What is reactive obstructive diseases

A

pain w/ salivation, obstructive means there’ s an obstruction, reactive means it’s not a neoplasm

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13
Q

What are non-infectious causes of Sialadenitis

A

Sjogrens syndrome, Sarcoidosis (granuloma disease), radiation therapy

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14
Q

Acute Sialadenitis character

A

Common in parotid w/ swelling and erythema

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15
Q

Chronic sialadenitis of submandibualr gland can lead to what persistent enlargement

A

Kuttner tumor

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16
Q

This form of sialadenitis occurs most commonly in teens and young adults

A

Subacute Necrotizing Sialadenitis

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17
Q

How differentiate sialadenitis from salivary gland tumore

A

Sialdenitis will have pain

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18
Q

Treatment of acute sialadenitis

A

Antibiotics and rehydration

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19
Q

rare inflammatory condition of minor glands causing lower lip swelling and subsequent eversion caused by hypertrophy and inflammation. Common in middle aged to older men

A

Cheilitis Glandularis

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20
Q

3 levels of Cheilitis Glandularis

A

Simple
Superficial Supurative (Baeltz’s Disease)
Deep supurative

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21
Q

Superficial supurative Cheilitis Glandularis and Deep Supurative Cheilitis Glandularis have what involvement and symptoms

A

Bacterial involvement w/ inflammation, swelling, suppuration, ulceration

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22
Q

Treatment for Cheilitis Glandularis

A

Vermillionectomy (lip shave)

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23
Q

Excess Salivation

A

Sialorrhea

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24
Q

Episodes of excess salivation for 2-5 min associated with prodrome of nausea and epigastric pain

A

Idiopathic Paroxysmal Sialorrhea

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25
Treatments for Sailorrhea
anticholinergics | Transdermal scopolamine Surgery if muscular involvement GERD meds if a factor
26
Subjective sensation of dry mouth
Xerostomia
27
First, Second, and Third leading cause of Xerostomia
Drugs
28
What’s the anti rule for xerostomia
if it’s an anti drug (e.g. antidepressant) it causes xerostomia
29
Treatments for Xerostomia
Biotene Prevident 5000 Pilocarpine 5 mg tabs
30
What infection is seen with Xerostomia
candidiasis | Cervical and root caries
31
This is a cause of Xerostomia that is normally a unilateral swelling of the parotid gland
Benign lymphoepithelial lesion
32
What is the characteristic histo associated with Benign Lymphepithelial Lesion
epimyoepithelial islands
33
Chronic, systemic autoimmune disease that principally involves the salivary and lacrimal glands resulting in xerostomia, xeropthalmia (dry eyes)
Sjogren Syndrome
34
What is dry eyes and dry mouth without another autoimmune disorder called
Sicca syndrome (primary Sjogren)
35
Xeropthalmia of Sjogren Syndrome called
eratoconjunctivitis sicca
36
Secondary Sjogren Syndrome means what
There’s another autoimmune component
37
What is the other autoimmune component commonly associated with Sjogren Syndrome
Rheumatoid Arthritis
38
Gender predilection of Sjogren Syndrome
Women (80-90%), middle aged
39
Symptoms associated with Sjogren syndrome or any xerostomia
``` red tender oral mucosa Angular cheilitis Candidiasis Cervical Decay Difficulty swallowing Altered taste Retrograde bacterial sialadenitis ```
40
Sialographic look or Sjogren syndrome
Fruit laden branchless tree
41
What is the tear test for Sjogren Syndrome
Schirmer test (<5mm tears for 5 min = Keratoconjuctivitis sicca)
42
noninflammatory disorder characterized by salivary gland enlargement, especially parotid, usually do to some underlying systemic problem
Sialadenosis/Sialosis
43
Systemic conditions associated with Sialadenosis
Diabetes melitis Malnutrition Alcoholism Bulimia
44
Locally destructive inflammatory condition of salivary glands caused by ischemia that leads to local infarction. The problem is it mimics a malignant process clinically and microscopically
Necrotizing Sialometaplasia
45
What is one way to differentiate Necrotizing Sialometaplasia from Oral Cancer
Cleaner borders around the lesion (cancer has ragged borders)
46
Where is Necrotizing Sialometaplasia commonly found
Palate salivary glands (squamous cell carcinoma rare on palate)
47
Treatment for Necrotizing Sialometaplasia
Biopsy and no treatment, will resolve in 5-6 weeks
48
Most common site for salivary gland tumors
Parotid gland
49
What is the most common parotid gland tumor
Pleomorphic Adenoma
50
What gland tumor has the highest rate of malignancy
Sublingual
51
Benign vs Malignant for Salivary Gland tumors
Parotid: 80% benign, 20% malignant Submand/palatal/Buccal: 50/50 Sublingual: 20% Benign, 80% malignant Upper lip glands: 80% benign, 20% malignant Lower lip glands: 20% benign, 80% malignant
52
Most common site for minor salivary gland tumors
palate
53
Common location for Pleomorphic adenoma
Superficial lobe parotid with swelling over ramus in front of ear
54
What is the exception about the Pleomorphic Adenoma
exception where tumor is immobile, but benign
55
What is the radiographic character of the Pleomorphic Adenoma
regular circumscribed border (malignant would have no clear border or moth eaten)
56
Treatment of Pleomorphic Adenoma
Surgical excision, 95% cure
57
Tumor that is exclusive to Parotid Gland
Warthin Tumor
58
Character of Warthin Tumor
Huge male predilection Does not occur in minor salivary glands Smokers at huge risk Parotid only
59
What is the histology associated with the Warthin Tumor
double row of oncocytes with adjacent lymphoid stroma
60
Where does the Warhtin tumor grow
Tail of parotid near angle of the mandible
61
Monomorphic adenoma found almost exclusively in the minor glands of the upper lip
Canalicular adenoma
62
Treatment for canalicular adenoma
Surgical excision
63
Difference between a Warthin tumor and an Oncocytoma (benign salivary gland tumor in 8th decade)
no lymphoid stroma around the double row of oncocytes
64
3 most common malignant salivary gland tumors
mucoepidermoid carcinoma Adenoid cystic carcinoma | Low Grade carcinoma
65
Most common malignant salivary gland neoplasm
mucoepidermoid carcinoma
66
Most common salivary gland tumor in childre
mucoepidermoid carcinoma
67
What gland is the Mucoepidermoid carcinoma common in
Parotid
68
Where is the second most common site for Mucoepirdermoid carcinoma
minor glands of palate
69
If there is a lesion, not tooth related, that is elevated on the palate, what is it until proven otherwise
salivary gland tumor
70
Histo of mucoepidermoid carcinoma
mucous producing cells and epidermoid cells
71
Mucoepidermoid carcinoma is the salivary gland tumor that most commonly
goes into bone
72
The higher the grade tumor of Mucoepidermoid carcinoma
the less prominent the cyst and the fewer mucous cells
73
Low grade mucoepidermoid carcinoma treatment
surgical resection with modest margin of surrounding normal tissue w/ good prognosis. Hige grade requires more resection and possible radiation with a more guarded prognosis.
74
Slow growing mass with pain early in the swelling common in minor salivary glands, meaning most common on palate
Adenoid Cystic Carcinoma
75
Most important clinical feature of Adenoid Cystic Carcinoma
Perineural invasion
76
What is the classic histology of Adenoid Cystic Carcinoma (Good exam question and picture)
Swiss cheese or cylinder look
77
Surgical consideration of Adenoid Cystic Carcinoma
relentless, hard to get rid of, doesn’t kill you quickly. Surgery w/ adjunct radiation
78
Where does Adenoid Cystic Carcinoma metastasize to
Lungs and bones
79
This is the third most common malignant salivary gland tumor and is exclusive to the minor salivary glands (which means itm most commonly occurs on the palate)
Polymorphous Low Grade Adenocarcinoma
80
2 malignant salivary gland tumors we should be able to identify histologically
Mucoepidermoid (mucous and epidermal cells) Adenoid Cystic Carcinoma (Swiss cheese look)
81
How is Polymorphous Low Grade Adenocarcinoma like Adenoid Cystic Carcinoma
both have perineural invasion, but polymorphous low grade adenocarcinoma perineural invasion does not affect prognosis
82
Treatment for Polymorphous Low-Grade Adenocarcinoma
Wide surgical resection with good prognosis

Oral Pathology, Stephen (13 decks)

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