Pathology Of Salivary Glands

Question 1

Congenetal (salicary glands)

Answer 1

Heterotopia

Question 2

Heterotopia

Answer 2

Salivary gland tissue present in areas it’s not supposed to be)

Intranodal or extranodal (mandible, ear, tonsil, pituitary, thyroid)

Question 3

Acquired (salivary glands)

Answer 3

Sialadenosis
Obstructive disorders
Inflammatory Disorders

Question 4

Sialadenosis

Answer 4

Bilateral, painless enlargement of salivary glands

Question 5

Causes of Sialadenosis

Answer 5

▪ Nutritional (Alcoholism, Cirrhosis, Kwashiorkor and Pellagra
▪ Endocrine (Diabetes, Thyroid disease, Gonadal dysfunction)
▪ Neurochemical (Vegetative state, Lead, Mercury, Iodine, Thiouracil)

Question 6

Obstructive disorders

Answer 6

1-mucocele
2-ranula
3-sialolithiasis

Question 7

Mucocele

Answer 7

Cyst filled with mucus and lined by granulation tissue

Question 8

Mucocele usually in

Answer 8

Small glands in lower lip

Question 9

Mucocele characterstics

Answer 9

Small
Bluish
Transparent
Rupture and reform

Question 10

Mucocele microscpy

Answer 10

Granulation tissue surrounding extravasated mucus

Question 11

Ranula

Answer 11

Type of mucocele in the floor of the mouth

blue dome shaped swelling in the floor of mouth (FOM)

Question 12

Rabula in ——— mucocele

Answer 12

Larger

Question 13

Conse of ranula

Answer 13

Elevate tongue

Question 14

Ranula ( distinguish it from a midline dermoid cyst)

Answer 14

Located lateral to the midline

Question 15

Sialolithiasis

Answer 15

Stones in the salivary glands that result in a mechanical obstruction of the salivary duct

Question 16

Sialolithiasis is a major cause of

Answer 16

unilateral diffuse parotid or submandibular gland swelling

Question 17

most common site of sialolithiasis

Answer 17

submandibular gland

Question 18

Sialolithiasis Usually post-inflammatory (due to

Answer 18

increased viscosity of the secretions)

Question 19

Sialolithiasis on x-ray

Answer 19

Radiopaque

Question 20

Sialolithiasis

Answer 20

swelling, pain at meal time (Due to increased salivation when eating

Question 21

Sialolithiasis cause

Answer 21

correlation with smoking and gout

Question 22

Predisposing factors to salivary gland infection:

Answer 22

▪ Duct obstruction by stones (sialolithiasis)
▪ impacted food debris
▪ edema consequent to injury
▪ Dehydration and decreased secretory function (predispose to bacterial invasion)
▪ Extremes of age
▪ Poor oral hygiene

Question 23

Acute Sialadenitis:

Most causaitve agent

Answer 23

mostly bacterial (e.g. s. aureus)

ascending infection from the mouth

Question 24

Acute Sialadenitis often affects

Answer 24

Major glands

More common in parotid

Question 25

Why Acute Sialadenitis is more common in oatitid

Answer 25

because they’re serous (Mucoid saliva contains elements that protect against bacterial infection)

Question 26

Acute Sialadenitis: | Gross

Answer 26

gland is red and tender, pus coming out of the duct

Question 27

Chronic Sialadenitis: | Causes

Answer 27

MTB/ recurrent sialadenitis

Question 28

recurrent sialadenitis → patients who have:

Answer 28

1. duct obstruction 2. hyposecretion of saliva (xerostomia) 3. ascending infection:

Question 29

Chronic Sialadenitis: | Microscopy

Answer 29

prominent inflammatory cell infiltrates, increased replacement of parenchyma with adipose cells, periductal fibrosis and ductal dilation

Question 30

Viral sialadenitis: | Causes

Answer 30

EBV, CMV, Mumps (paramyxovirus)

Question 31

Mumps

Answer 31

Upper respiratory infection (droplet) —> incubation period (2-3 wks) —> viremia (during which patient presents with fever) —> localize in certain tissues (salivary glands, testes, CNS)

Question 32

Mumps gross

Answer 32

uni/bilateral painful swelling of parotid gland

Question 33

Mumps microsco

Answer 33

interstitial lymphoplasmacytic infiltrate

Question 34

Mumps rare complicatins

Answer 34

orchitis, menigoencephalitis, pancreatitis, arthritis, May be serious in adults –> sterility & deafness

Question 35

Lst common immunilogic disorder associated with salivary | gland dissase

Answer 35

Sjogren’s syndrome:

Question 36

Sjogren’s syndrome:

Answer 36

``` autoimmune disorder characterized by keratoconjunctivitis sicca (dry eyes) and xerostomia (dry mouth) ```

Question 37

Primary Sjogren’s syndrome:

Answer 37

without other connective tissue disease (but frequently associated with involvement of other organs, including the thyroid, lung and kidney)

Question 38

Secondary Sjogren’s syndrome:

Answer 38

associated with other connective tissue disorders (SLE, rheumatoid arthritis, scleroderma, polymyositis)

Question 39

Sjogren’s syndrome | Pathogenesis

Answer 39

lymphocyte-mediated destruction of the exocrine glands → dry eyes and dry mouth

Question 40

Sjogren’s syndrome: 90% cases in ? Average age of onset?

Answer 40

women 50 yrs

Question 41

Sjogren’s syndrome may progress to

Answer 41

B cell lymphoma

Question 42

Mikulicz syndrome:

Answer 42

combination of salivary and lacrimal gland inflammatory enlargement (usually painless) and xerostomia

Question 43

Mikulicz syndrome | Causes

Answer 43

sarcoidosis, leukemia, lymphoma, and idiopathic lymphoepithelial hyperplasia

Question 44

Xerostomia

Answer 44

dry mouth - from decrease production of saliva

Question 45

Xerostomia increased incidence with increased

Answer 45

age

Question 46

Xerostomia | Causes

Answer 46

``` autoimmune disorders (Sjögren syndrome), radiation therapy, side effect of medications ```

Question 47

Xerostomia gross

Answer 47

Oral cavity shows dry mucosa and/or atrophy of tongue papillae with fissuring and ulcerations

Question 48

Xerostomia Complications

Answer 48

increased dental caries and candidiasis, as well as difficulty in swallowing and speaking

Question 49

Salivary gland tumors: - Uncommon, usually in ——— predominance - Mostly (75%) in——- gland

Answer 49

adults, slight female parotid

Question 50

Proportion of malignant and benign varies with the gland of origin:

Answer 50

Parotid: Most common site but tumors here are mostly benign Submandibular and sublingual: Less common sites but higher percentage of malignancy

Question 51

Pleomorphic adenomas originate from

Answer 51

Intercalated duct cells and | Myoepithelial cells

Question 52

Oncocytic tumors originate from

Answer 52

Striated duct cells

Question 53

Acinous cell tumors originate from

Answer 53

Acinad cells

Question 54

Mucoepidermoid tumors and SCC develop in the

Answer 54

Excretory duct