Oropharyngeal and Salivary Gland Disorders Flashcards Preview

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Flashcards in Oropharyngeal and Salivary Gland Disorders Deck (36)
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1
Q

how are cleft lip/ palate formed

A

failure of the maxillary and nasal/palatal bones to fuse

2
Q

when does the cleft lip form

A

weeks 4-6 in utero

3
Q

when does cleft palate form

A

weeks 6-12 in utero

4
Q

associations of cleft lip/ palate

A

Trisomy 13

Trisomy 18

smoking

EtOH

Phenytoin

Folate antagonists

hypervitaminosis A

5
Q

distinguish oral leukoplakia vs erythroplakia

which is more likely to become malignant transformation:

which cancer

A

leukoplakia: white plaque that cant be scraped off

erythroplakia: red velvety plaque (may be leveled or slightly depressed in the oral cavity that bleeds easily on contact

Erythroplakia is much more likely to become squamous cell carcinoma of the oral cavity

6
Q

intermediate variant of leukoplakia and erythroplakia

A

speckled leukoerythroplakia

7
Q

clinical and histological appearance of leukoplakia

A

clinical: relatively thin and smooth with well-demarcated borders

histology: severe dysplasia characterized by nuclear and cellular pleomorphism, numerous mitotic figures and loss of normal maturation

8
Q

clinical and histological appearance of erythroplakia

A

clinical: red velvety plaque

histology: severe dysplasia, carcinoma in situ, minimal invasion

9
Q

Name the molecular pathogenesis associated with squamous cell carcinoma of the oral cavity

A

inactivation/ mutation of p53 tumor suppressor genes

p63 and NOTCH1 are also associated

10
Q

associations of oral cavity squamous cell carcinoma

A

HPV-16

Tobacco

Alcohol

Actinic sunlight

11
Q

common sites of oral cavity squamous cell carcinoma

A

tonsils

base of tongue

pharynx

12
Q

microscopy of oral cavity squamous cell carcinoma

A

keratin pearls

numerous sets of islands of malignant keratinocytes invading the underlying connective tissue stoma and skeletal muscle

13
Q

how does squamous cell carcinoma of the oral cavity usually spread and where does it tend to metastasize

A

via lymphatics to the regional lymph node

usually spreads to lungs, liver and bones

14
Q

prognosis of oral squamous cell carcinoma

A

5 year survival rate for early stage ~80%.

late stage ~20 %

15
Q

another name for canker sore

A

aphthous ulcer

16
Q

what ar canker sores

A

common, recurrent painful, superficial mucosal ulcer

17
Q

associations of aphthous ulcers

A

stress

trauma

immunologic disorders

immune suppression

18
Q

What is a pleomorphic adenoma and where are they most commonly found

A

benign tumors of mixed ductal origin and myoepithelial cells

parotid>submandibular>minor salivary glands

19
Q

Pathogenesis of Pleomorphic adenoma

A

chromosomal rearrangements involving PLAG1 gene causes upregulated expression of genes that increase growth

20
Q

Most common benign salivary gland tumor

A

pleomorphic adenoma

21
Q

how do pleomorphic adenomas present

A

painless

slow-growing

mobile mass

parotid or submandibular

22
Q

Macro-morphology of pleomorphic adenoma

A

well rounded, well-demarcated mass with partially developed capsule

grey-white myxoid stroma with blue translucent areas of chondroid

23
Q

Micromorphology of pleomorphic adenoma

A

mixed cellular constitution with myoepithelial cells and chondroid tissue; typically dispersed within a mesenchyme-like background of loose myxoid tissue containing islands of cartilage and rarely foci of bone

cytokeratin

24
Q

another name for a Warthin tumor

A

papillary cystadenoma lymphomatosum

25
Q

where are Warthin tumors found

A

Parotid Gland only

26
Q

Describe a Warthin tumor

A

benign cystic tumor comprised of admixed epithelial and lymphoid tissue

fluid of cyst resembles motor oil

27
Q

clinical presentation of a warthin tumor

A

gradual, painless unilateral swelling of the parotid

28
Q

morphology of Warthin Tumor

A

Macro: pale grey surface punctuated by narrow cystic or cleft like spaces filled with mucinous/ serous secretions

Micro: double layer of neoplastic epithelial cells resting in a dense lymphoid stroma, sometimes bearing germinal centers

  • upper layer: palisading columnar cells with abundant finely granular eosinophilic cytoplasm*
  • lower layer: cuboidal and polygonal cells*
29
Q

what is a mucoepidermoid carcinoma

A

malignant tumor consisting of mucosal cells and squamous epithelium

Most common malignant salivary gland in children

30
Q

where are mucoepidermoid carcinomas usually found

A

minor salivary glands

31
Q

Morphology of mucoepidermoid carcinomas

A

capsule not really well defined

often infiltrative at the margins

pale grey-white transections containing mucin filled cysts

cords, sheets, or cystic configurations of squamous, mucous or intermediate cells

32
Q

Associated pathogenesis of mucoepidermoid carcinoma

A

t( 11q21 ; 19p13 )

creates a fusion gene of MECT1 and MAML2

33
Q

what is an adenoid cystic carcinoma

A

slow but infiltrative growth along nerve sheaths, with a cribriform tubular growth pattern

34
Q

where do most adenoid cystic carcinomas occur

and where do the metastasize

A

minor salivary glands (palatine)

invade perineural spaces

mets to: bone, brain, liver

35
Q

Morphology of adenoid cystic carcinoma

A

generally small, poorly encapsulated infiltrative, grey-pink lesions

small cells have dark compact nuclei and scant cytoplasm

spaces between tumor cells are often filled with hyaline material, thought to represent excess basement membrane

36
Q

what causes Sjogren Syndrome

A

autoinflammation of lacrimal and salivary glands

Presents as: xerostomia and xerophthalmia, occasionally raynaud phenomenon