Salivary Gland Pathology

Question 1

Common lesion resulting from damage of the salivary duct, with extravasation (spillage) of mucin into the surrounding tissue, frequently due to local trauma

Answer 1

Mucocele (Mucus Extravasation Phenomenon)

Question 2

Most on the LOWER LIP of children or young adults, fluctuant, dome shaped swelling with a translucent blue color, may wax and wane

Answer 2

Mucocele

Question 3

variant of mucocele secondary to superficial location of the mucin, palate, retromolar pad, posterior buccal mucosa

Answer 3

superficial mucocele

Question 4

variant of mucocele occuring in the floor of the mouth, usually from the sublingual gland, although some arise from the submandibular duct

Answer 4

ranula

Question 5

translucent blue or normal colored, fluctuant swelling in the floor of the mouth, may cause elevation of the tongue

Answer 5

ranula

Question 6

Variant of ranula- mucin penetrating the mylohyoid muscle, showing submandibular swelling or swelling of the neck

Answer 6

plugging ranula

Question 7

epithelial-lined cavity filled with mucin, most probably arise secondary to ductal obstruction, which increases intraluminal pressure, probably represent ductal ectasia (dilation) rather than a true cyst

Answer 7

salivary duct cyst (mucus retention cyst; mucus duct cyst)

Question 8

typically adults; major (parotid) or minor glands (floor of mouth, buccal mucosa, lips; fluctuant asymptomatic swelling

Answer 8

salivary duct cyst

Question 9

cystic space lined by cuboidal or columnar epithelium; may acquire papillary infoldings

Answer 9

salivary duct cyst

Question 10

salivary duct calcifications of unknown etiology; arise secondary to deposition of calcium salts around a nidus of debris; unrelated to calcium-phosphorus metabolism

Answer 10

sialolithiasis

Question 11

usually within the submandibular duct; episodic pain and/or swelling; may have palpable mass; minor gland involvement will often be asymptomatic; radiographic appearance- opaque mass

Answer 11

sialolithiasis

Question 12

concentric laminations around an amorphous central nidus; inflammation of duct and adjacent glands; may see squamous, oncocytic, or mucous cell metaplasia

Answer 12

sialolithiasis

Question 13

inflammation of salivary glands; infectious (viral, bacterial) or noninfectious (sjogren, sarcoidosis, radiation) etiology, “surgical mumps”- post abdominal surgery

Answer 13

sialadenitis

Question 14

_ _ sialadenitis- typically involves the parotid, swollen, painful gland, purulent discharge

Answer 14

acute bacterial

Question 15

_ sialadenitis- usually secondary to recurrent or persistent ductal obstruction (sialolith), episodic pain and swelling, usually at mealtime, submandibular involvement may include persistent enlargement (Kuttner tumor)

Answer 15

chronic

Question 16

excessive salivation; associated with local irritation (dentures), medications, heavy metal poisoning, GI reflux disease; may also be seen in patients with poor neuromuscular control

Answer 16

sialorrhea

Question 17

drooling, choking; may cause irritation or open sores of the surrounding skin

Answer 17

sialorrhea

Question 18

subjective sensation of dry mouth; secondary to a number of systemic conditions; aging, smoking, or medications and treatments

Answer 18

xerostomia

Question 19

systemic diseases associated w/ xerostomia

Answer 19

sjogren, diabetes, sarcoidosis, HIV

Question 20

The following medications are associated with _: antihistamines (diphenhydramine), decongestants (pseudoephedrine), antidepressants (amitriptyline), antipsychotics, antihypertensives, anticholinergics (atropine, scopolamine)

Answer 20

xerostomia

Question 21

F>M, elderly; thick, foamy saliva; dry mucosa, with atrophy and fissuring; increased incidence of candidiasis infection

Answer 21

xerostomia

Question 22

_-related caries: caries of the root surface or cervical area secondary to lack of salivary protection

Answer 22

xerostomia

Question 23

intense lymphocytic infiltration of the salivary glands; most are associated with Sjogren

Answer 23

Benign lymphoepithelial lesion

Question 24

benign lymphoepithelial lesion by itself

Answer 24

Mikulicz’s disease

Question 25

benign lymphoepithelial lesion in combination with another disease such as sjogren's syndrome

Answer 25

Mikulicz's syndrome

Question 26

typically bilateral; F>M, average age 50; usually an asymptomatic, diffuse swelling of the parotid gland; epimyoepithelial islands

Answer 26

benign lymphoepithelial lesion

Question 27

surgical removal of the involved gland; good prognosis, although an increased risk of developing lymphoma; MALT lymphoma

Answer 27

benign lymphoepithelial lesion

Question 28

autoimmune disorder affecting the salivary and lacrimal glands

Answer 28

sjogren syndrome

Question 29

_ sjogren syndrome- sjogren along

Answer 29

primary

Question 30

_ sjogren syndrome- sjogren along with another autoimmune disorder (SLE, rheumatoid arthritis)

Answer 30

secondary

Question 31

unknown etiology, although an association with certain histocompatibility antigens (HLA-DRw52, HLA-B8, HLA-DR3) has been found

Answer 31

Sjogren

Question 32

F>>M, Sicca syndrome

Answer 32

sjogren

Question 33

xerostomia and xeropthalmia

Answer 33

sicca syndrome

Question 34

sialographic appearance- "Fruit-laden, branchless tree"

Answer 34

Sjogren

Question 35

Anti-SS-A (anti-Ro), Anti-SS-B (anti-La)

Answer 35

Sjogren

Question 36

Major glands show benign lymphoepithelial lesion; labial salivary gland biopsy shows focal aggregates or lymphocytes

Answer 36

Sjogren

Question 37

40-fold increase in development of lymphoma (non-Hodgkin's B-cell)

Answer 37

Sjogren

Question 38

Noninflammatory salivary gland enlargement, usually associated with an underlying systemic disorder; conditions associated include diabetes, alcoholism, anorexia nervosa, bulimia, malnutrition; these conditions result in dysregulation of the autonomic innervation of the salivary acini

Answer 38

sialodenosis

Question 39

typically bilateral involvement of the parotid glands; slowly progressing painless or painful swelling of the involved gland

Answer 39

sialadenosis

Question 40

may see a decrease in salivation; sialographic presentation- Leafless tree

Answer 40

sialadenosis

Question 41

Prominent zymogen granules

Answer 41

sialadenosis

Question 42

_ associated with alcoholism or diabetes may show atrophy and fatty infiltrate

Answer 42

sialadenosis

Question 43

localized swelling (hyperplasia) of minor salivary glands; unknown pathogenesis; significance lies in the resemblance to neoplasia

Answer 43

adenomatoid hyperplasia

Question 44

soft or firm swelling of the soft or hard palate; 4th-6th decade; asymptomatic

Answer 44

adenomatoid hyperplasia

Question 45

Hyperplastic aggregates of normal salivary gland tissue

Answer 45

adenomatoid hyperplasia

Question 46

Locally destructive inflammatory process of unknown etiology; possibly due to local ischemia; may be associated with previous surgery, adjacent tumors, dental infections, trauma

Answer 46

necrotizing sialometaplasia

Question 47

M>F, average age 46, most involve the palatal salivary glands; Unilateral>bilateral

Answer 47

necrotizing sialometaplasia

Question 48

initial painful swelling; 2-3 weeks, necrotic tissue sloughs, leaving a crater-like ulcer; may resemble a malignant process

Answer 48

necrotizing sialometaplasia

Question 49

Squamous metaplasia of the salivary ducts (often misdiagnosed); pseudoepitheliomatous hyperplasia of the overlying epithelium; process may mimic malignancy

Answer 49

necrotizing sialometaplasia

Question 50

Resolves within 5-6 weeks

Answer 50

necrotizing sialometaplasia

Question 51

Most salivary gland tumors (up to 2/3) involve the _ gland

Answer 51

parotid

Question 52

Most salivary gland tumors (up to 3/4) are benign or malignant?

Answer 52

benign

Question 53

_ gland- 8-11% of tumors, with up to 45% malignant

Answer 53

submandibular

Question 54

_ gland- rare site for tumors but most (up to 90%) are malignant

Answer 54

sublingual

Question 55

Second most common site for tumors is the _ _ glands, with almost 50% malignant

Answer 55

minor salivary

Question 56

the most common of all salivary gland tumors; tumor arises from a mixture of ductal epithelium and myoepithelial elements; the term pleomorphic refers to the variety of patterns that may be seen

Answer 56

pleomorphic adenoma (benign mixed tumor)

Question 57

F>M, mostly in young adults; slowly growing, rubbery firm mass; parotid tumors usually located within the superficial lobe; palate is the most common site for minor salivary tumors, followed by upper lip

Answer 57

pleomorphic adenoma

Question 58

myoepithelial component and stroma is highly variable; tumors may be composed almost entirely of myoepithelial cells

Answer 58

pleomorphic adenoma

Question 59

as many as _% of pleomorphic adenomas may undergo malignant transformation (carcinoma ex pleomorphic adenoma)

Answer 59

5%

Question 60

second most common benign tumor of the parotid; uncertain pathogenesis; strongly associated with history of smoking

Answer 60

Warthin's tumor (papillary cystadenoma lymphomatosum)

Question 61

M>F, older adults, slow growing mass (firm or fluctuant) involving the tail of the parotid; 5-14% bilateral

Answer 61

warthin's tumor

Question 62

cystic spaces surrounded by a double row of oncocytes; prominent lymphoid stroma

Answer 62

warthin's

Question 63

original terminology for benign salivary tumors of one cell type; archaic term

Answer 63

monomorphic adenoma

Question 64

tumor of minor salivary glands, primarily those of the upper lip; older adults; F>M; slow growing, firm to fluctuant mass

Answer 64

canalicular adenoma

Question 65

often encapsulated; columnar or cuboidal cells arranged in cords or parallel rows

Answer 65

canalicular adenoma

Question 66

common malignant salivary tumor of mucous and squamous differentiation; highly variable biologic bahavior

Answer 66

mucoepidermoid carcinoma

Question 67

the most common malignant salivary gland tumor (children as well); F>M; parotid and minor glands of the palate most common sites

Answer 67

mucoepidermoid carcinoma

Question 68

typically an asymptomatic swelling; intraosseous tumors sometimes occur; mixture of mucous and squamous cells in variable ratios

Answer 68

mucoepidermoid carcinoma

Question 69

central tumor, possibly arising from entrapped ectopic salivary gland tissue or odontogenic epithelium; the most common intraosseous salivary gland tumor; histologically identical to soft tissue tumor

Answer 69

intraosseous (central) mucoepidermoid carcinoma

Question 70

F>M, middle-aged adults; mandible>maxilla; swelling, pain, paresthesia; unilocular or multilocular radiolucency

Answer 70

intraosseous mucoepidermoid carcinoma

Question 71

salivary gland malignancy of serous acinar differentiation; typically considered a low-grade malignancy

Answer 71

acinic cell adenocarcinoma

Question 72

F>M, average age 45; most commonly involves the parotid gland or minor glands of the buccal mucosa; typically asymptomatic

Answer 72

acinic cell adenocarcinoma

Question 73

malignant counterpart to pleomorphic adenoma

Answer 73

malignant mixed tumor

Question 74

pleomorphic adenoma that undergoes malignant transformation; F>M, older adults; most involve the major glands, primarily the parotid; present for years with recent increase in size and/or symptoms

Answer 74

carcinoma ex pleomorphic adenoma

Question 75

rare tumor, featuring malignant epithelial and stromal components

Answer 75

carcinosarcoma

Question 76

histologically benign pleomorphic adenoma that has metastasized to distant location

Answer 76

metastasizing mixed tumor

Question 77

tumor showing residual benign tumor and areas featuring malignant characteristics of the epithelial component

Answer 77

carcinoma ex PA

Question 78

carcinomatous and sarcomatous areas

Answer 78

carcinosarcoma

Question 79

common and well recognized salivary gland malignancy; relentless tumor requiring long-term follow-up; F>M, middle aged adults; majority involve the minor salivary glands of the palate; typically painful

Answer 79

adenoid cystic carcinoma

Question 80

may cause ulceration of the overlying mucosa; may erode adjacent bone

Answer 80

adenoid cystic carcinoma

Question 81

recently recognized tumor (1983); currently seen as one of the more common salivary gland tumors

Answer 81

Polymorphous low-grade adenocarcinom

Question 82

F>M, older adults; most involve the minor salivary glands of the palate; usually painless mass of long duration

Answer 82

polymorphous low-grade adenocarcinoma

Question 83

deceptively uniform cells with round or ovoid nuclei and abundant cytoplasm; "Indian filling"

Answer 83

polymorphous low-grade adenocarcinoma