Non-Neoplastic Salivary Gland Disease

Question 1

Which glands are major salivary glands?

Answer 1

Parotid
Submandibular
Sublingual

Question 2

What glads are minor salivary glands?

Answer 2

Throughout the mouth e.g on palate and lips

Question 3

Where is partoid gland and what type of saliva?

Answer 3

Preauricular

Serous secretions

Question 4

How much saliva does parotid contribute?

Answer 4

20-40%

Question 5

What type of saliva does submandibular gland produce?

Answer 5

Mixed - mucous and serous

Question 6

How much saliva does submandibular gland contribute?

Answer 6

60-70%

Question 7

Where is sublingual gland and what type of saliva?

Answer 7

Located floor of mouth

Mucous secretion

Question 8

Which major salivary gland is biggest?

Answer 8

Parotid

Question 9

What saliva do minor salivary glands produce?

Answer 9

Mucus

Question 10

Exception of mucus producing minor salivary gland?

Answer 10

Serous gland of von ebner - posterior-lateral of tongue

Question 11

What are 3 types of non-neoplastic lesions?

Answer 11

Developmental
Inflammatory
Obstructive/ trauma

Question 12

Example of developmental non-neoplastic lesion?

Answer 12

Stafne bone cavity

Question 13

What is stafne bone cavity

Answer 13

Heterotropic salivary tissue - push into mandible = indentation

Question 14

How does starfne bone cavity present?

Answer 14

Unilocular, corticated well defined radiolucency at angle of mandible
Always under ID canal

Question 15

Example inflammatory non-neoplastic disease?

Answer 15

Sialodenitis - can be chronic or acute

Question 16

Example of acute sialodenoitis

Answer 16

Bacterial

Viral

Question 17

Examples chronic sialodenitis?

Answer 17

Bacterial
Post-irradiation
Sjogrens

Question 18

Example of bacterial sialodenitis?

Answer 18

Acute parotitis

Question 19

What is acute parotitis?

Answer 19

Ascending infection - travel from mouth into parotid duct then gland
Causes actue swelling and pain
Pus exudes from duct

Question 20

What cause acute parotitis?

Answer 20

Oral bacteria e.g staph aurus

Question 21

How does recurrent parotitis vary in children and adults?

Answer 21

Adults - recurrent to dry mouth

Children - recurrent from childhood

Question 22

How does recurrent parotitis present in adults?

Answer 22

40-60 yrs 
F>M
Unilateral 
Secondary xerostomia : sjogrens, drug-induced, radiattion damage 
Ascending infection

Question 23

How does recurrent parotits present in children?

Answer 23

up to 15yrs
M = F
Bilateral
No obvious cause/ predisposing factors
Suddent onset 
Weeks duration w/ periods of quiescence 
Not suppurative

Question 24

How does reccurent parotitis in children present sialogram?

Answer 24

Snow storm appearnace

Punctate sialectasis - gradular destruction acinar elements = reduced flow

Question 25

What see in histology of recurrent parotitis?

Answer 25

Non-specific Dilation of epithelial lines salivary ducts w/ prominent fibrosis around duct (replace salivary tissue) Acini and duct damaged Blue dots = lymphocytes

Question 26

Most common type of viral sialodenitis?

Answer 26

Mumps

Question 27

What causes mumps?

Answer 27

Mumps virus = paramyxovirus

Question 28

How does mumps presnet clinically?

Answer 28

Acute bilateral parotid swelling Pain, fever and malaise Can spread to other glands/organs

Question 29

How long does mumps last?

Answer 29

Self limiting 10-14 days | Incubation period 2-3 wweeks

Question 30

Complications of mumops?

Answer 30

Orchitis Meningitis Oophoritis Pancreitis

Question 31

What is chronic sialodenitis usually secondary to?

Answer 31

Duct obstruction - often due calculi

Question 32

When does radiation sialodentitis occur?

Answer 32

Doses over 20Gy High risk above 30Gy Severe damage 50Gy

Question 33

What types of acini are most sensitive to radiation?

Answer 33

Serous

Question 34

What does radiation sialodenitis cause?

Answer 34

Inflammation and fibrosis of glands = loss of function

Question 35

What is salivary calculi?

Answer 35

Accumulation of calcium and phosphate salts which deposit in salivary duct/ gland

Question 36

Where is most common gland for salivary calculi?

Answer 36

Submandibular gland

Question 37

Why is most common gland for calculi submandibular gland?

Answer 37

Only major gland pushing saliva up against gravity - ascending duct Duct - bend (mylohyoid) can cause obstruction

Question 38

How does salivary calculus present on radiograph?

Answer 38

Opaque

Question 39

What does obstruction of calculi cause?

Answer 39

Obstruction --> saliva retnetion --> inflammation --> fibrosis --> loss of function --> further swelling and fibrosis

Question 40

What see histology of salivary calculi?

Answer 40

Fibrosis and inflammation Destruction of architecture Loss acini

Question 41

Examples of non-neoplastic disease caused by obstruction/ trauma?

Answer 41

Salivary calculi Mucous cysts Necrotising sialometaplasia

Question 42

Types of mucoceles?

Answer 42

Mucous retention | Mucous extravasation

Question 43

Where is most common site of mucocele?

Answer 43

Lower tip - most common site for trauma

Question 44

How do mucoceles present?

Answer 44

Usually in children | Painless swellings - rupture and recur

Question 45

What is most common mucoele?

Answer 45

Mucous extravasation

Question 46

What is mucous extravasation cyst?

Answer 46

Caused by ruptured duct - mucous spills into adjacent connective tissue

Question 47

Histology of mucous extravasation cyst?

Answer 47

Lining of fibrous and granulation tissue Lumen of cyst filled w/ mucous Macrophage filled with mucous No epithelial lining

Question 48

Where is most common to see mucous retention cyst?

Answer 48

Floor of mouth/ buccal mucosa | Often older age groups

Question 49

What cause mucous retention cyst?

Answer 49

Blocked duct - collection mucous | No ruptured duct

Question 50

What see histology mucous retention cyst?

Answer 50

Blocked duct - duct dilation Lumen filled with mucous Lined w/ ductal epithelium Cyst wall - fibrous tissue w/ glands

Question 51

What is a ranula?

Answer 51

Mucocele in the floor of the mouth - arise from sublingual gland

Question 52

How does necrotising sialometaplasia present?

Answer 52

Indurated, ulcerated swelling, often on palate - often mistaken for malignancy

Question 53

What is necrotising sialometaplasia?

Answer 53

Benign inflammatory disease

Question 54

What histology of necrotising sialometaplasia?

Answer 54

Squamous metaplasia of salivary ducts - islands of epithelium deep connective tissue Necrosis of acini