Salivary Gland Diseases and Tumors

These question-and-answer flashcards review inflammatory, autoimmune, and neoplastic disorders of the salivary glands, emphasizing definitions, etiologies, clinical features, morphology, and key statistics relevant for exam preparation.

What are the two broad categories of salivary-gland disorders discussed in the lecture?

Inflammatory conditions (sialadenitis, sialadenosis, granulomatous disease) and neoplastic conditions (benign and malignant tumors).

Which three major forms of inflammatory sialadenitis were specifically listed?

Acute sialadenitis, chronic sialadenitis, granulomatous sialadenitis.

Define sialadenosis and describe its typical presentation.

Non-inflammatory hypertrophy/hyperplasia of acinar cells that presents as bilateral, painless, recurrent gland swelling.

What is the basic definition of sialadenitis?

Inflammation of the major salivary glands.

List the four main etiologic groups of sialadenitis.

Traumatic, viral, bacterial, and autoimmune.

What condition most often predisposes to bacterial sialadenitis?

Ductal obstruction by sialolithiasis (salivary stones).

Name at least three risk factors for bacterial sialadenitis besides stones.

Acute postoperative parotitis, general debility, old age, dehydration.

Which viral infection is the most common cause of viral sialadenitis?

Mumps (epidemic parotitis).

What classic triad can accompany mumps infection?

Parotitis, orchitis/oophoritis, and pancreatitis.

What is the most common cause of chronic sialadenitis and is it usually unilateral or bilateral?

Sjögren syndrome; it is usually bilateral.

What is a mucocele and where is it most often found?

A mucus-retention cyst caused by duct rupture or blockage; most commonly on the lower lip after trauma.

Define ranula and state the glands from which it usually arises.

A large mucocele on the floor of the mouth, usually arising from the sublingual or submandibular glands.

Describe the gross appearance of a ranula.

A large bluish, fluctuant swelling in the floor of the mouth.

What are the two named autoimmune diseases that can involve the salivary glands?

Sjögren's syndrome and Mikulicz's syndrome.

State the classic triad of primary Sjögren’s syndrome.

Dry eyes (keratoconjunctivitis sicca), dry mouth (xerostomia), and often rheumatoid arthritis.

Differentiate primary from secondary Sjögren’s syndrome.

Primary (sicca) involves only dry eyes and mouth; secondary is associated with another connective-tissue disease such as rheumatoid arthritis or lupus.

Which autoantibody is more common in primary than in secondary Sjögren’s syndrome?

SS-B (La) antibodies.

Which patient demographic is most commonly affected by Sjögren’s syndrome?

Middle-aged or elderly females.

What microscopic feature characterizes the salivary glands in Sjögren’s syndrome?

Polyclonal CD4+ lymphocytic infiltration with acinar destruction.

What serious hematologic complication can arise from Sjögren’s syndrome?

Development of MALT-type salivary gland lymphomas.

What is Mikulicz’s syndrome?

Combined inflammatory enlargement of salivary and lacrimal glands with xerostomia.

Approximately what percentage of all salivary tumors arise in the parotid gland?

About 80%.

How does the chance that a salivary-gland tumor is malignant relate to gland size?

It is inversely proportional—the smaller the gland, the higher the likelihood of malignancy.

In the parotid gland, what proportion of tumors are benign versus malignant?

Roughly 70–80% are benign; the rest are malignant.

Which tumor accounts for over 90% of benign salivary-gland neoplasms?

Pleomorphic adenoma (mixed tumor).

What two cellular components give pleomorphic adenoma its "mixed" designation?

Ductal (epithelial) cells and myoepithelial cells showing epithelial and mesenchymal differentiation.

Describe the typical clinical presentation of pleomorphic adenoma.

A slow-growing, painless, mobile, well-circumscribed mass in the affected gland.

Why must pleomorphic adenomas be widely excised?

Adequate margins are needed to prevent recurrence and malignant transformation into carcinoma ex pleomorphic adenoma (malignant mixed tumor).

Which benign tumor is confined almost exclusively to the parotid gland and is linked to smoking?

Warthin tumor (papillary cystadenoma lymphomatosum).

What embryologic explanation is proposed for the origin of Warthin tumor?

Heterotopic salivary tissue trapped within a lymph node during embryogenesis.

What percentage of pleomorphic adenomas undergo malignant transformation?

Approximately 5–10%.

Which malignant salivary tumor often shows a cribriform (Swiss-cheese) pattern microscopically?

Adenoid cystic carcinoma.

Which glands and symptom are classically associated with adenoid cystic carcinoma?

Minor glands (especially submandibular) and potential pain due to perineural invasion.

What is the most common malignant tumor of the salivary glands overall and in children?

Mucoepidermoid carcinoma.

Give the typical anatomic distribution of mucoepidermoid carcinoma.

Parotid 60–70%, oral cavity 15–20%, submandibular 6–10%.

Contrast low-grade with high-grade mucoepidermoid carcinoma grossly.

Low-grade tumors are well-circumscribed, cystic, and mucinous (<3 cm); high-grade tumors are poorly circumscribed, infiltrative, and solid of variable size.

What causes granulomatous sialadenitis?

Duct obstruction or rupture of a mucocele with mucus leakage and subsequent granuloma formation; or association with systemic granulomatous diseases.

What term describes stone formation within salivary ducts and what condition can it precipitate?

Sialolithiasis, which can precipitate bacterial sialadenitis.