Salivary Gland Neoplasm

Question 1

Give examples of benign salivary gland neoplasm?

Answer 1

Pleomorphic adenoma
Warthin tumour
Basal cell adenoma

Question 2

Give examples of malignant neoplasm?

Answer 2

Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Polymorphous adenocarcinoma
Acini cell carcinoma

Question 3

How to classify salivary gland tumours?

Answer 3

Epithelial or non-epithelial

Question 4

Examples of epithelial salivary gland tumours?

Answer 4

Adenoms

Carcinomas

Question 5

Where do adenomas develop?

Answer 5

In glands which secrete fluid

Question 6

Are adenoma benign or malignant?

Answer 6

Benign

Question 7

Where do carcinomas develop?

Answer 7

In tissue that line the inner or outer surfaces of the body

Question 8

Where is most common site for salivary gland tumour?

Answer 8

70% parotid
Then submandibular
1% sublingual

Question 9

Most common type salivary gland tumour?

Answer 9

70% pleomorphic adenoma

Question 10

How often do get minor salivary gland tumour? What is issue?

Answer 10

20% in minor glands

50% are malignant

Question 11

Where do salivary gland tumours most often present?

Answer 11

Palate

Question 12

% of benign tumour in major glands?

Answer 12

80%

Question 13

Example of benign epithelial neoplasm?

Answer 13

Adenoma

Question 14

Example of adenoma?

Answer 14

Plemorphic adenoma
Warthins tumour
Basal cell adenoma

Question 15

Give basic info about pelomorphic adenoma?

Answer 15

Most common salivary gland tumour
Often found parotid - next common site is palate
Benign

Question 16

Common age ground for pelomorphic adenoma?

Answer 16

30-60 years

Question 17

Histology of pleomorphic adenoma?

Answer 17

Mixed pattern- islands and strands of epithelial cells
Ductal structures
Can have myxoid, mucoid or chondroid stroma
Encapsulated
Lobular pattern

Question 18

Where are warthin tumour found?

Answer 18

ALWAYS in parotid

Question 19

What gender is warthin tumour more common?

Answer 19

Male 60:40

Question 20

What see histology of war thins tumour?

Answer 20

Irregular cysts
Line onocytic duct epithelium
Stroma comprised of lymphoid tissue

Question 21

How are adenoma names?

Answer 21

According to pattern

Question 22

What is most common malignant salivary tumour?

Answer 22

Mucoepidermoid carcinoma

Question 23

Most common site mucoepidermoid carcinoma?

Answer 23

Parotid

Question 24

How many much-epidermoid carcinoma metastasise?

Answer 24

10-15%

Question 25

Histology of mucoepidermoid carcinoma?

Answer 25

Mixture of mucous and epidermoid cells Lesions usually multi cystic High grade lesion may be solid w/ few mucous cells

Question 26

What is second most common malignant tumour?

Answer 26

Adenoid cystic carcinoma

Question 27

Most common site for ACC?

Answer 27

Parotid

Question 28

Issue with adenoid cystic carcinoma?

Answer 28

75% pt die within 20 years - highly malignant | Metastasis via blood stream and nerve invasion

Question 29

Histology adenoid cystic carcinoma?

Answer 29

Infiltrative tumour - no capsule | Characteristic multi cystic/ cribriform pattern 'Swiss cheese'

Question 30

What salivary gland tumour has Swiss cheese appearance?

Answer 30

Adenoid cystic carcinoma

Question 31

What salivary gland tumour is only found intra-oral?

Answer 31

Polymorphous adenocarcinoma

Question 32

Histology of polymorphous adenocarcinoma?

Answer 32

Variable histological pattern - lobules, ductal structure, cribriform areas Perineural invasion Infiltrative growth

Question 33

What is polymorphous adenocarcinoma often misdiagnosed as?

Answer 33

Pelomorphic adenoma | Adenoid cystic carcinoma

Question 34

What is recurrence rate of acini cell carcinoma?

Answer 34

30%

Question 35

Histological appearance acini cell carcinoma?

Answer 35

Variable; solid, microcytic, papillary cystic, follicular | Lympoid tissue and germinal centre common

Question 36

What is risk of pleomorphic adenoma becoming malignant?

Answer 36

10% become malignant

Question 37

What clinical sign would make think pelomorphic adenoma has become malignant?

Answer 37

When have hx of slow growing lesion which has recently increased in size

Question 38

Name for malignant pleomorphic adenoma?

Answer 38

Carcinoma ex plemoprhic adenoma

Question 39

Histology if plemorphic adenoma is carcinoma?

Answer 39

Typical plemorphic adenoma pattern | Area cytological atypia

Question 40

Example of tumour like lesions?

Answer 40

Onocytosis Necrotising sialometaplasia Salivary gland cyst Chronic sialodenitis

Question 41

What is sjogrens syndrome?

Answer 41

Autoimmune disorder characterised by lymphocytes mediated destruction of exocrine gland

Question 42

What is seen in primary SS?

Answer 42

Dry eyes and mouth

Question 43

What is seen secondary SS?

Answer 43

Dry eye +/or mouth and connective tissue disease

Question 44

Who often presents w/ SS?

Answer 44

90% females | Middle age

Question 45

Symptoms SS?

Answer 45

Dry mouth - dry mucosa, lobulated tonuge Infection - candidosis Caries Dry eyes

Question 46

Pathology of SS?

Answer 46

Lymphocytic infiltrate in salivary gland Minor glands: focal sialodenitis Major: lymphoepithelial lesions

Question 47

Histology SS?

Answer 47

Gland replaced by lymphocytes Acini disappear Duct proliferate = epithelial islands - infiltrated by lymphocytes

Question 48

What can SS lesions progress to?

Answer 48

Lymphoma