SALIVARY GLAND PATHOLOGY

Question 1

SALIVARY GLANDS
 Major
(3)

Answer 1

 Parotid
 Submandibular
 Sublingual

Question 2

SALIVARY GLANDS
 Minor
(7)

Answer 2

 Palate
 Buccal mucosa
 Tongue
 Floor of mouth
 Labial mucosa
 Retromolar pad
 Oropharynyx

Question 3

DISTRIBUTION OF MINOR SALIVARY GLANDS
 Palate –%
 Tongue –%
 Lips –%
 Cheeks –%
 Retromolar –%

Answer 3

60
10
10
10
10

Question 4

Glands of Von Ebner

Answer 4

 Circumvalate papillae –
serous

Question 5

 Glands of Blandin and Nuhn

Answer 5

 Anterior ventral – mucous

Question 6

 Glands of Weber

Answer 6

 Posterior lateral border -
mucous

Question 7

GLANDS OF VON EBNER
(2)

Answer 7

 Circumvalate papillae
 Serous

Question 8

GLANDS OF WEBER
(2)

Answer 8

 Foliate papillae
 Mucous

Question 9

GLANDS OF BLANDIN AND NUNN
(2)

Answer 9

 Anterior ventral
 Mucous

Question 10

Mucin dissects through mylohyoid muscle, presenting as a

Answer 10

neck mass

Question 11

HISTOLOGY
(3)

Answer 11

Pseudoepitheliomatous hyperplasia
Sialometaplasia
Coagulative necrosis of the glands

Question 12

SJOGREN SYNDROME
(4)

Answer 12

Autoimmune disorder
Dry mouth and dry eyes
Primary vs. Secondary
Bilateral enlargement of parotid gland

Question 13

SJOGREN SYNDROME
Bilateral enlargement of parotid gland
(2)

Answer 13

 Benign lymphoepithelial lesion (BLEL)
 Mikulicz’s disease

Question 14

SJOGREN SYNDROME
Laboratory values
(4)

Answer 14

 Anti-SS-A
 Anti-SS-B
 RF
 ANA

Question 15

TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS
Parotid
 Benign
 Malignant

Answer 15

50%
50%

Question 16

TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS
Submandibular
 Benign
 Malignant

Answer 16

40%
60%

Question 17

TUMOR DISTRIBUTION:
MAJOR SALIVARY GLANDS
Sublingual
 Benign
 Malignant

Answer 17

20%
80%

Question 18

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
 Palate
 Benign
 Malignant

Answer 18

50%
50%

Question 19

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
 Buccal Mucosa
 Benign
 Malignant

Answer 19

50%
50%

Question 20

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Upper Labial Mucosa
 Benign
 Malignant

Answer 20

80%
20%

Question 21

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Lower Labial Mucosa
 Benign
 Malignant

Answer 21

15%
85%

Question 22

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Tongue
 Up to –% malignant

Answer 22

90

Question 23

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Floor of Mouth
 Up to –% malignant

Answer 23

90

Question 24

TUMOR DISTRIBUTION:
MINOR SALIVARY GLANDS
Retromolar pad
 Up to –% malignant

Answer 24

90

Question 25

Feature: Benign Growth rate Induration Symtomatology Ulceration

Answer 25

Slow growth Movable Asymptomatic Intact mucosa

Question 26

Feature: Malignant Growth rate Induration Symtomatology Ulceration

Answer 26

Rapid growth Fixed Symptomatic Ulcerated

Question 27

BENIGN SALIVARY GLAND TUMORS (5)

Answer 27

Benign Mixed Tumor (Pleomorphic Adenoma) Monomorphic Adenoma Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum) Oncocytoma Ductal Papillomas

Question 28

PLEOMORPHIC ADENOMA (3)

Answer 28

 Most common salivary gland neoplasm  Middle-aged females  Painless slowly growing mass

Question 29

PLEOMORPHIC ADENOMA HISTOLOGY (3)

Answer 29

Variable histology Mixture of ductal and myoepithelial elements Encapsulated

Question 30

MONOMORPHIC ADENOMA (3)

Answer 30

 Upper lip  Middle-aged females  Painless slowly growing mass

Question 31

MONOMORPHIC ADENOMA HISTOLOGY (5)

Answer 31

 Uniform pattern  Single layered cords of columnar or cuboidal epithelium  May demonstrate papillary projections  Loose connective tissue stroma, with prominent vascularity  Thin fibrous capsule

Question 32

PAPILLARY CYSTADENOMA LYMPHOMATOSUM (6)

Answer 32

2nd most common benign salivary gland neoplasm Parotid gland Bilateral Middle-aged males -Lower in blacks Smoking Painless slowly growing nodular mass

Question 33

PAPILLARY CYSTADENOMA LYMPHOMATOSUM HISTOLOGY (4)

Answer 33

 Oncocytic ductal epithelium  Uniform double rows  Lymphoid aggregate  Papillary cystic configuration

Question 34

ONCOCYTOMA (4)

Answer 34

Rare salivary gland neoplasm Large epithelial cells, oncocytes Females, 8th decade Parotid -`Painless slowly growing mass Multifocal

Question 35

ONCOCYTOMA HISTOLOGY (3)

Answer 35

 Large polyhedral cells abundant in granular eosinophilic cytoplasm - mitochondria  Limited stroma - Thin fibrovascular septa  Lymphoid infiltrate

Question 36

MALIGNANT SALIVARY GLAND TUMORS (6)

Answer 36

 Mucoepidermoid Carcinoma  Adenoid Cystic Carcinoma  Polymorphous Low-Grade Adenocarcinoma  Acinic Cell Carcinoma  Carcinoma ex-Mixed Tumor  Adenocarcinoma NOS

Question 37

MUCOEPIDERMOID CARCINOMA (3)

Answer 37

 Most common malignant salivary gland neoplasm  Middle-aged females  Clinically mistaken for a mucocele

Question 38

MUCOEPIDERMOID CARCINOMA HISTOLOGY (3)

Answer 38

 Mucous producing cells  Epidermoid (squamous) cells  May be cystic and / or solid

Question 39

ADENOID CYSTIC CARCINOMA (3)

Answer 39

 Best recognized salivary gland tumor  Middle-aged females  Slowly growing mass, painful

Question 40

ADENOID CYSTIC CARCINOMA HISTOLOGY (4)

Answer 40

Myoepithelial and ductal cells Perineural and perivascular invasion Cribiform pattern SWISS CHEESE

Question 41

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA (3)

Answer 41

 Common malignant MINOR salivary gland neoplasm  Middle-aged females  Favors palate

Question 42

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA HISTOLOGY (4)

Answer 42

 Deceptive uniform appearance  Different growth patterns  Perineural and perivascular invasion  Indian filing

Question 43

ACINIC CELL CARCINOMA (5)

Answer 43

Parotid Serous acinar differentiation Middle-aged females Slow-growing Low-grade malignancy

Question 44

ACINIC CELL CARCINOMA HISTOLOGY (4)

Answer 44

 Well circumscribed  May be infiltrative  Serous acinar cell  Abundant granular basophilic cytoplasm and a round, stained eccentric nucleus

Question 45

CARCINOMA EX-PLEOMORPHIC ADENOMA (4)

Answer 45

 Long standing pleomorphic adenoma  Older adults  Rapid growth  Pain and ulceration

Question 46

CARCINOMA EX-PLEOMORPHIC ADENOMA HISTOLOGY (2)

Answer 46

 Typical benign mixed tumor  Malignant degeneration - Cellular pleomorphism - Abnormal mitotic activity - Capsular invasion

Question 47

ADENOCARCINOMA NOS (2)

Answer 47

 Uncommon salivary gland neoplasm  Middle-aged females

Question 48

ADENOCARCINOMA NOS HISTOLOGY (1)

Answer 48

 Variable histology