Pathology of salivary gland

Question 1

The inflammation of the salivary glands is known as what?

Answer 1

Sialadenitis

Question 2

Salivary gland stones

Answer 2

Sialolithiasis

Question 3

The infection (Acute bacterial parotitis) if the formation of what?

Answer 3

Calcus formaion in the submandibular gland.

Question 4

The acute bacterial parotitis affect which age group

Answer 4

Young to middle-aged adults

Question 5

Main symptoms of acute bacterial parotitis

Answer 5

Pain and swelling beneath the jaw

Question 6

what worsen the symptoms of acute bacterial parotitis

Answer 6

Symptoms appear, or worsen, before and during eating

Question 7

what is sialolithiasis?

Answer 7

Salivary duct obstruction by stones (Usually idiopathic)

Question 8

What are causes of sialadenitis?

Answer 8

o Trauma: usually manifests as a mucocele (fluctuant bluish swelling) resulting from either blockage or rupture of a salivary gland duct with mucus extravasation
o Viral infections: especially mumps
o Bacterial infections: non-specific bacterial sialadenitis is usually caused by infection with S.aureus and Streptococcus viridans following sialolithiasis
o Autoimmune disease

Question 9

One word

The autoimmune disorder characterised by destruction of lacrimal and salivary glanss resulting in inability to produce tears and saliva, commonly seen in females.

Answer 9

Sjogren syndrome

Question 10

The primary diseases of sjogren syndrome is called what?

Answer 10

SICCA Syndrome

Question 11

explain how the sjogren syndrome occurs

Answer 11

Its occurs secondary to other autoimmune disorders e.g rheumatoid arthritis

Question 12

Presence of which antibodies is asscociated with sjogren syndrome

Answer 12

Presence of anti-ribonucleoprotein antibodies like SS-A (Ro) and SS-B (La)

Question 13

Presence or SS-A (Ro) is associated with?

Answer 13

Early disease onset, longer disease duration and extra glandular manifestations, e.g. cutaneous vasculitis and nephritis

Question 14

Clinical features of sjogren sydrome

Answer 14

Clinical features
Dry mouth (xerostomia)
Dry eyes (keratoconjunctivitis sicca), due to lymphocytic infiltration and destruction of the lacrimal gland..
Patients with Sjogren syndrome have an increased risk of developing lymphoid malignancies.

Question 15

Where do neaoplasm of salivary glands arises?

Answer 15

65-80% of all salivary gland neoplasms arise in parotid, 10% in submandibular gland and rest in the minor salivary glands

Question 16

Which tumours of are benign and maligannt in salivary glands

Answer 16

Majority of parotid tumours are benign, while higher proportions of submandibular and minor salivary gland tumours are malignant

Question 17

Most common form of benign salivary gland tumpurs are?

Answer 17

Pleomorphic adenoma and warthin tumpur

Question 18

Most common malignant tumours of salivary galns are?

Answer 18

Mucoepidermoid carcinoma

Question 19

what is pleomorphic adenoma (Mixed tumours)?

Answer 19

Most common salivary gland neoplasm (Parotid gland»submandibular»Minor salivary glands)

Question 20

Tje pleomorphic adenoma consists of what?

Answer 20

Consists of a mixture of ductal (epithelilal) and myoepithelial cells within a chondromyxoid or fibrous (mesenchymal) stroma, associated with PLAG1 or HMGA2 alterations

Question 21

what are clinical features of pleomorphic adenoma?

Answer 21

Usually presents as painless slow-growing mobile discrete mass

Question 22

Does the pleomorphic adenoma recur?

Answer 22

May recur, low rate of malignant tranformation (increases with age of lesion)

Question 23

Explain the gross appearance of pleomorphic adenoma?

Answer 23

Circumscribed lobulated mass with tan, white, translucent or gelatinous cut surface

Question 24

Name the tumour that consists of oncocytic epithelial cells lining ductal, papillary and cystic structures associated witha lymphoid rich stroma

Answer 24

Warthin tumour

Question 25

Explain the clinical features of warthin tumour?

Answer 25

40-60yo M>F, particulary in smokers.

Question 26

is warthin tumour recur?

Answer 26

Rarely recurs unless incompletetly excised

Question 27

Gross appearance of warthin tumour

Answer 27

usually unifocal but can be multifocal/bilateral. well circumscibed round to oval mass with pale gray surface and cystic/cleft-like spaces +/- papillary projections filled with mucinous secretions

Question 28

The microscopic appearance of the warthin tumour looking at the example

Answer 28

Papillary cystadenoma lymphomatosum, microscopic Papillary fronds project into cystic to cleftlike spaces filled with pale pink mucinous to serous secretions. The papillary fronds are covered by a double layer of pink (oncocytic) cuboidal to columnar epithelium

Question 29

The most common primary malignant tumpur of salivary glans (mostly in parotid glands)

Answer 29

Mucoepidermoid carcinoma

Question 30

The mucoepidermoid carcinoma consists of what?

Answer 30

Consists of mucous, intermediate and epidermoid (squamous) epithelium cells forming solid and cystic areas.

Question 31

The mucepidermoid carcinoma is assocted with what?

Answer 31

MAML2 gene rearrangement

Question 32

List the clinical fearures of mucoepidermoid carcinoma

Answer 32

Wide age range include children

Question 33

The prognosis of mucoepidermoid carcinoma

Answer 33

depends on hostologic grade

Question 34

The gross appearance of mucoepidermoid carcinoma

Answer 34

Pale gray-white firm to soft solid tumours +/- cystic areas, may appear circumscribed or infilrative

Question 35

Where does Adenoid cystic carcinoma occur?

Answer 35

Approximately half occur in the minor salivary glands, can also occur in sites outside of the salivary glands e.g, nose, upper airways, lung, breast

Question 36

The adenoid cystic carcinoma consits of what?

Answer 36

Consists of basaloid cells forming tubular, solid or cribriform growth patterns with basophilic or hyaline matrix/basement membrane material

Question 37

The adenoid cystic carcunoms is associated with what?

Answer 37

Associated with MYB, MYBL1 or NFIB reaarangement

Question 38

What are clinical features of adenoid cystic carcinoma

Answer 38

Usually older patients. Tends to be slow-growing but can have rapid course in the presence of high grade transformation. Frequent perineurial invasion

Question 39

The gross appearance od adenoid cystic carcinoma

Answer 39

Poorly circumscribed tan-gray/whte firm solid mass