Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

My BDS4 > Pathology of salivary gland tumours > Flashcards

Pathology of salivary gland tumours Flashcards

1
Q

How can salivary gland neoplasia present in major salivary glands? (3)

A
  • localised swelling = Asymmetry
  • Obstruction of the gland
  • Neurological change = especially from the facial nerve in parotid
    Pressure or infiltration of tumour along the nerve = paraesthesia and facial palsy etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the 3 characteristics of salivary gland tumours.

A
  • Painless
  • Slow growing
  • Well defined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 4 suggested causes of salivary gland tumours?

A

generally the aetiology is unclear

  • mobile phones? (not proven)
  • Radiation exposure
  • Viruses: EBV = increase in malignant salivary gland tumours
  • racial susceptibility ?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the general rule regarding salivary gland size and % malignancy?

A

The larger the gland the lower the incidence of malignancy/malignant tumours will be

parotid = 80% of tumour occur here and 15% are malignant

minor = 10% of tumours occur here and 45% are malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is malignancy of the salivary glands said to be complex?

A

malignancy can arise from a variety of different stem cell lines within the glands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are benign epithelial neoplasms also known as?

A

adenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are malignant epithelial neoplasms also known as?

A

adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where are salivary gland neoplasia present in minor/intraoral salivary glands commonly found? (2)

A

Most common area:
- Junction of hard/soft palate
- Upper lip/cheek

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is a fine needle aspirate technique useful for testing swellings?

what is the limitation of this test?

A

salivary gland tumours/other swellings directly under the skin

only provides a small amount of tissue, not enough for proper diagnosis/understanding of the pathology, however is enough to alert the surgeon if it’s benign or malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What technique for biopsy is useful for intraoral swellings?

A

incisional biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the name given to tumours which cannot be diagnosed?

A

Adenocarcinoma Not otherwise specified (NOS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the most common type of (salivary) gland tumour?

A

Pleomorphic Adenoma:
= 75% of all salivary tumours

Can be a benign tumour of any gland tissue (not just salivary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what salivary gland is most affected by a pleomorphic adenoma?

A

parotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe what can be found histologically/pathologically in a pleomorphic adenoma. (4)

A

Varied - “mixed tumour” = Name comes for the variety of tissue appearances within the tumour

Duct like structures surrounded by (purple mesh) myoepithelial cells

has a connective tissue Capsule = variable and incomplete in a lot of cases

myxomatous tissue - soft and jelly like tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why must patients be followed up for 5 years post removal of a pleomorphic adenoma? (3)

A

recurrence - multifocal = recurrence no. is more than the OG number
of tumours
commonly an Incomplete capsule = outgrowth of tumour growing into the surrounding tissues = high recurrence rate
- Recurrence esp higher in the minor salivary gland (as they have less complete capsules)

Myxomatous tissue:
- since its soft and jelly like its hard to remove and Any of this tissue left behind can give rise to another tumour

Progression to carcinoma (5%)
- The longer its present without removal = the higher the chances of it becoming malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do we treat pleomorphic adenomas?

A

wide local excision

17
Q

List the 3 distinctive factors in the pathology of a Warthins tumour.

A

– Completely encapsulated
– Recurrence is rare
– Malignant transformation rare

18
Q

Describe the histology of a warthins tumour. (4)

A

– Cystic spaces present

  • cystic spaced lined by 2x layers of pink epithelium and lymphoid tissue between

– Distinctive epithelium = oncocytic

– Can have germinal centres developing

19
Q

How do we manage a warthins tumour?

A

excision

20
Q

where is the highest proportion of salivary gland carcinomas found? (2)

A

in minor glands

sublingual gland

21
Q

what areas/epithelium can give rise to a pleomorphic adenoma within the salivary gland? (4)

A
  • Duct epithelium
  • Myoepithelial cells (similar features to muscle cells, lie around the ducts)
  • Myxoid areas (loose and gelatinous = hard to remove surgically)
  • “chondroid” areas (appear similar to cartilage tissue formation)
22
Q

what are the 2 main types of salivary gland carcinoma?

A
  1. Adenoid cystic carcinoma
  2. mucoepidermoid carcinoma
23
Q

how do Adenoid cystic carcinomas present? (3)

A
  • Slow growing
  • Painless
  • Nodule – then ulcerates and becomes painful as it progresses
24
Q

What are the patterns of histology which can be seen in the adenoid cystic carcinoma? (3)

A

cribriform (“swiss cheese” – holy cheese)

tubular
solid

25
Q

where can the adenoid cystic carcinoma spread to? (2)

how is it spread at a late stage?

A

local spread to nerves and bone

very infiltrative and grows by infiltration between the trabeculate of bones and along nerve fibres (perineural spread)

spreads late by metastasis via blood to lungs.

26
Q

What are the problems associated with the adenoid cystic carcinoma? (3)

A

Difficult to treat/completely eradicate = poor prognosis

Very infiltrative – grows by infiltration between the trabeculate of bones and along nerve fibres (perineural spread)

Recurrence common
- long term prognosis is poor

27
Q

What are the 2 cells types predominantly found in a mucoepidermoid carcinoma?

what does each form within the tumour?

A
  • Glandular part which forms mucous
  • Epidermoid/squamous cells – can form keratin within the tumour
28
Q

where can mucoepidermoid carcinomas also be found? (not in salivary glands)

A

Intraosseous occurrence (from within the jaw) bone occasionally

where is the source within the jaw bone?
- Lesions (usually cystic) can be lined with odontogenic epithelium
- Odontogenic epithelium is multipotential = can form mucous cells

29
Q

Describe the histology of a mucoepidermoid carcinoma.

A
  • Mucous secretion cells present – show up with a special alcian blue stain (Mucous can spill out into the tissues and appear blue)
  • Epidermoid cells
  • Cystic spaces
  • Necrotic areas
  • Bleeding
  • squamous epithelium
30
Q

list other carcinomas which can be found in salivary glands.

A
  • Acinic cell carcinoma
  • Rare
  • most found in the parotid
  • Slow growing and less aggressive
  • Histology varied, as is behaviour
  • Polymorphous adenocarcinoma (more common)
  • Occurs in Minor glands in palate
  • Clinically and pathologically looks like adenoid cystic carcinoma, Immunohistochemistry may be needed to differentiate the two
  • Better prognosis
  • Slower growing
  • Less metastasis
  • Locally infiltrative (nerves)
31
Q

where are most Acinic cell carcinomas found?

A

parotid

32
Q

where are Polymorphous adenocarcinomas found?

A

minor glands in the palate

33
Q

what tumour does the Polymorphous adenocarcinoma appear similar to clinically and pathologically?

how woudl we differentiate between the two?

A

adenoid cystic carcinoma,

Immunohistochemistry

My BDS4 (57 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions