Pathology of Salivary Gland Tumours Flashcards
What can cause an increase in gland size
Secretion retention (mucocele, duct obstruction)
Chronic sialadenitis
Gland hyperplasia
Salivary neoplasms
What can cause neoplasia (changes in size) in glands
Salivary tumours
-usually painless slow growing and well defined
What is the epidemiology of salivary gland tumours
uncommon, most in adults
10 per 100,000 of general population
3% of head and neck neoplasms
75% benign
What gland is more common to get tumours
parotid
Why is the pathology of salivary gland tumours complex
Arrise from stem cells
What are clinical features of a salivary gland tomour
Major gland
-Lump
-Asymmetry
-Obstruction
-Late signs are pain and facial palsey
How do you diagnose a salivary gland tumour
Ultrasound guided fine needle aspirate
Core biopsy
incisional biopsy
What are the problems in tumour diagnosis
Lots of different tumour types
Variation within a tumour because tissues originate from different stem cell lines so pathology may be complex
There are common features between types
Not all tumours fit the classification
Immunohistochemistry may be needed to differentiate many of these tumours
What is the most common salivary tumour and what is it like
Pleomorphic adenoma, 75% of all salivary tumours
Most commonly parotid
Slow growth
Has a varied histology
-Duct epithelium
-Myoepithelial cells
-Myxoid and “chondroid” areas
The capsule is variable
What is the treatment and problems of pleomorphic edenoma
Tx- wide local excision
Problems-Recurrence and a 5% progression to carcinoma
What is a warthins tumour, what else is it called and what is it like
Adenolymphoma
15% of tumours
Most parotid
Occasiobally bilateral
Histology
-Cystic
-Distinctive epithelium (Oncocytic,pink)
-lymphoid tissue
Treated by excision
What is the incidence of salivary gland carcinomas
15% of salivary tumours
<1% of all malignancys
What is Adenoid cystic carcinoma
Carcinoma that is 5% more likely in minor glands
Has varried patterns
-cribriform
-tubular
-solid
Difficult to treat
Has a local spread to nerves and bone
Late spread to lungs by blood
What is a Adenoid cystic carcinoma
Carcinoma with a histology of 2 cell types
-Squamous (epidermoid)
-Glandular (mucous)
Name 4 salivary carcinomas
Adenoid cystic carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma
Polymorphous adenocarcinoma
