Oral Pathology Salivary Gland Pathology Flashcards

Terms Definitions
A bluish, dome-shaped swelling if superficial or of normal color if deep in the tissues and is typically covered by an intact epithelium is?
Mucocele
Where are Mucoceles most common?
The lower lip (approx. 81 %), floor of the mouth, ventral tongue and buccal mucosa
What typically causes Mucocele?
Traumatic severance of the salivary gland excretory duct.
What treatment is used for a Mucocele?
Surgical excision, if needed, is the treatment of choice. Removal of the adjacent minor salivary gland helps prevent recurrence.
A Mucocele that occurs on the floor of the mouth is termed?
Ranula
“Plunging” or cervical ranulas dissect through what muscle to produce swelling in the neck?
Mylohyoid
What is the cause of a ranula?
Usually severance of the sublingual gland duct although severance of the submandibular duct may be the cause. Blockage of the duct with a salivary gland stone (sialolith) may produce a ranula which is a true mucous cyst.
How would you distinguish a ranula from a midline dermoid cyst?
Unilateral, lateral location.
A solitary, asymptomatic, mobile, non-tender swelling covered by an intact epithelium usually the same color as the surrounding tissue is?
Salivary duct cyst
Where are Salivary duct cysts more common?
The palate, cheek, floor of the mouth, they may occur in the major glands with the parotid being the most common major gland site.
What is the cause of Salivary duct cysts?
Blockage of the salivary gland excretory duct by a sialolith.
A patient presenting with episodic pain and swelling particularly around mealtime most likely has?
Salivary gland stone
Salivary gland stones occur most often where?
The submandibular gland ducts but they may also occur in the minor glands particularly of the upper lip and buccal mucosa.
An Inflammation of the salivary glands is termed?
Sialadenitis
The most common viral infection is?
Mumps
Most bacterial infections arise as a result of?
Ductal obstruction or decreased salivary flow
Acute bacterial sialadenitis is most common where?
In the parotid
Overlying skin that is erythematous and a patient with low-grade fever, trismus and purulent discharge probably has what?
Acute Sialadenitis (in the parotid)
Would periodic swelling and pain be acute or chronic sialadenitis?
Chronic
A lesion usually involving the minor glands of the hard or soft palate is?
Subacute necrotizing sialadenitis.
The difference B/T subacute necrotizing sialadenitis and necrotizing sialometaplasia is?
It appears as a painful nodule, which does not ulcerate or slough like necrotizing sialometaplasia.
The most common cause of acute bacterial sialadenitis is?
Staphylococcus aureus
An uncommon inflammatory condition characteristically affecting the minor glands of the lower lip producing swelling and eversion, with duct openings that are dilated and inflamed and digital pressure often producing a mucopurulent secretion is?
Cheilitis Glandularis
The treatment of choice for persistent cases of Chelititis Glandularis is?
vermilionectomy (lip shave).
T/F cases of Chelitis Glandularis have been associated with Squamos cell Carcinoma?
True (18%-35%)
An Overproduction of saliva is termed?
Sialorrhea (can produce drooling and choking).
Aphthous ulcers and ill-fitting dentures along with rabies, heavy metal poisoning, gastroesophageal reflux disease and certain drugs such as lithium and cholinergic agonists as well as neurologic disorders such as cerebral palsy can all be causes of what?
Minor sialorrhea
Sialorrhea treatment includes?
Anticholinergic medications, surgical correction and speech therapy have all been used in appropriate situations.
Social embarrassment, soiling of clothes and bed linens can be significant problems associated with?
Sialorrhea
A patiet with foamy or thick and “ropey” saliva and the dorsal tongue is fissured with atrophy of the filiform papilla probably has?
Xerostomia
T/F The incidence of oral candidiasis, dental decay, particularly cervical and root caries increases with xerostomia?
True
Salivary gland aplasia, aging, smoking, mouth breathing, local radiation therapy, Sjögren syndrome, HIV infection and some medications can all be causes of?
Xerostomia
This presents as bilateral salivary gland swelling and is often a component of Sjogrens Syndrome?
Benign Lymphoepithelial Lesion
What gland is most often affected in benign lymphoepithelial lesion?
Parotid gland
Clinical presentation of painless swelling of the lacrimal and salivary glands due to a lesion histologically diagnosed as benign lymphoepithelial lesion is?
Mikulicz disease
Clinical presentation of lacrimal and salivary glands swelling secondary to other disease entities such as TB, sarcoid and lymphoma is?
Mikulicz Syndrome
In general what is the prognosis of a Benign Lyphoepithelial lesion?
Good, however you have an increased risk of lymphoma
A chronic, systemic autoimmune disorder that principally involves the salivary and lacrimal glands is?
Sjogren Syndrome
The principal oral symptom of Sjogren Syndrome is?
Xerostomia
What form of Sjogren Syndrome will a patient present with dry eyes and mouth plus another associated autoimmune disease such as rheumatoid arthritis, SLE, scleroderma?
Secondary (Primary will not present with another autoimmune disease)
A non-inflammatory disorder characterized by salivary gland enlargement, most common of the parotid is?
A non-inflammatory disorder characterized by salivary gland enlargement, most common of the parotid is?
Sialography demonstrates what type of pattern?
Leafless tree
What condition is frequently associated with an underlying systemic problem such as diabetes, general malnutrition, alcoholism and bulimia?
Sialadenosis (It is thought that these conditions cause a dysregulation of the autonomic innervation of the salivary acini producing the enlargement.)
An uncommon lesion characterized by localized swelling that mimics a neoplasm commonly affecting the minor salivary glands is?
Adenomatoid Hyperplasia (of the Minor Salivary Glands)
An uncommon, locally destructive inflammatory condition of salivary glands commonly affecting palatal salivary glands which sloughs leaving a crater-like ulcer after 2-3 weeks is?
Necrotizing Sialometaplasia
Why would a biopsy be necessary in Necrotizing Sialometaplasia?
To rule out Malignancy
Assuming that no malignancy is found what are the treatment steps in Necrotizing Sialometaplasia?
Nothing, the lesion should resolve by itself in 5-6 weeks
The gland that is most common to have a tumor is?
Parotid
A tumor found in which gland is almost always (90%) malignant?
Sublingual glands
The most common salivary neoplasm is?
Pleomorphic Adenoma (Benign Mixed Tumor)
Pleomorphic adenomas are derived from a mixture of _________ and _______ elements giving it remarkable diversity in microscopic appearance?
Ductal and myoepithelial
The most common location for a pleomorphic Adenoma intraorally is?
Palate, followed by the upper lip and buccal mucosa
An 85 year old woman has a slow-growing firm, painless swelling in a major salivary gland. What is most likely?
Oncocytoma
A metaplastic transformation of ductal and acinar cells to oncocytes found primarily in the parotid gland of older adults is?
Oncocytosis (not to be confused with oncocytoma)
The most common site of a Canalicular Adenoma is?
The upper lip (75%) then buccal mucosa (this pathology affects the minor salivary glands exclusively)
A benign salivary gland tumor with tumor cells that have a basaloid appearance is?
Basal Cell Adenoma
An exophytic papillary growth which occurs more commonly on the palate and has a female predilection is?
Sialadenoma papilliferum
A papilloma more common on the lips where it appears as submucosal swelling is?
Intraductal papilloma
A papilloma seen on the lip/mandibular vestibule area as an asymptomatic submucosal nodule is?
Inverted ductal papilloma
The most common malignant salivary gland neoplasm in the U.S. is?
Mucoepidermoid Carcinoma
A mucoepidermoid carcinoma found in the submandibular glands or at the base of the tongue would have a good or poor prognosis?
Poor
A Carcinoma found in the molar-ramus region of the mandible, with cortical swelling and possible pain, trismus, and paresthesia is?
Intraosseous (central) Mucoepidermoid Carcinoma
One of the more common and best recognized salivary gland malignances, it presents with a slow-growing mass and low-grade, dull pain is?
Adenoid Cystic Carcinoma
The most common site for an Adenoid Cystic Carcinoma is?
The Palate
The nerve most likely to experience paralysis in parotid tumors is?
Facial Nerve
In palatal tumors and tumors of the maxillary sinus what might appear in a radiograph?
Bony destruction
A pathology that shows a swiss cheese histological pattern is?
Adenoid Cystic Carcinoma
A malignant neoplasm occurring in the minor salivary glands (often on hard and soft palate followed by upper lip and buccal mucosa) commonly presenting as a slow-growing mass occasionally accompanied by bleeding or discomfort is?
Polymorphous Low-Grade Adenocarcinoma
A malignant tumor most common in the parotid gland that has a good prognosis (compared to other salivary gland malignancies) is?
Acinic Cell Adenocarcinoma
A malignant transformation of the epithelial component of a previously benign pleomorphic adenoma occurs in?
Malignant Mixed Tumor (specifically carcinoma ex. Pleomorphic adenoma)
A malignant salivary gland neoplasm that cannot be further classified as one in the existing classification schemes is?
Salivary Adenocarcinoma, NOS
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