Salivary Gland Pathology

no

are the salivary glands present in:

- Gingiva

- attached alveolar mucosa

- mid-palatine raphe

- dorsum of tongue anterior to CV papillae

salivary gland aplasia

condition where there is lost or missing salivary gland tissue

sialorrhea

- excessive salivation

- often secondary to another condition

sialadentitis

- inflammation of the salivary glands

- may be caused by:

- infection,

- recent surgery,

- dehydration,

- debilitation,

- medication

sialadenosis

- noninflammatory salivary gland enlargement

- may be caused by endocrine disorders, pregnancy, nutritional conditions, or neurogenic medications

mucocele

what reactive salivary gland pathology:

- damage or severing of a salivary gland duct

- not a true cyst because no epithelium lining

- most commonly on the lower lip

- fluctuates in size

- non-blanching

- usually related to some trauma

histology:

- granulation tissue

- spilled mucin

- inflamed salivary gland tissue

treatment:

- local surgical excision

- necessary to remove adjacent salivary gland tissue

- excellent prognosis

salivary duct cyst

what reactive salivary gland pathology:

- mucous retention cyst

- true cyst

- similar to mucocele in appearance

- in any major or minor salivary gland

treatment:

- surgical excision

ranula

what reactive salivary gland pathology:

- in the floor of the mouth

- involves sublingual gland or submandibular gland

- blue dome shaped mass

- usually lateral to midline

treatment:

- marsupialization

- removal of feeder gland

plunging ranula

what reactive salivary gland pathology:

- specific type of ranula that dissects through the mylohyoid and presents as swelling in the neck

sialolith

what reactive salivary gland pathology:

- deposits of calcium salts in salivary gland/duct

- associated with decreased salivary flow or increased viscosity

- most common in the submandibular gland

- round and radiopaque mass on radiograph best scene on occlusal films

histology:

- calcified mass

- surrounded by inflamed and fibrotic salivary glands

treatment:

- increase fluid intake

- surgical removal (may need to remove gland too)

necrotizing sialometaplasia

what reactive salivary gland pathology:

- ischemia of the salivary glands of the hard palate

- often bilateral and symmetrical

- can mimic squamous cell carcinoma

- usually starts as a swelling that ulcerates

histology:

- pseudoepitheliomatous hyperplasia

- sialometaplasia

- coagulative necrosis of salivary glands

treatment:

- resolves on its own

sjogrens syndrome

what reactive salivary gland pathology:

- autoimmune disease

- female predilection

- enlargement of. salivary glands

- most commonly parotid glands

primary:

- dry eyes and mouth

secondary:

- dry eyes and mouth and CT disease such as RA or SLE

diagnosis:

- increased anti-SSA and anti-SSB antibodies

- minor salivary gland biopsy showing foci of lymphocytes

treatment:

- supportive for dryness

- shows increased risk for lymphoma especially MALT lymphoma

benign; parotid

most salivary gland tumors are ... and occur in the ....

malignant

the smaller the salivary gland, the more likely the salivary gland tumor is ....

palate

the most common location for minor salivary gland tumors is the ...

malignant

minor salivary gland tumors of the lower lip, tongue, floor of mouth, and retromolar pad are majority .....

pleomorphic adenoma

what benign salivary gland tumor:

- most common salivary gland neoplasm

- mix of epithelial and mesenchymal elements

histology:

- various patterns within tumor

- encapsulated

- double layered ductal structures and myoepithelial cells

treatment:

- sugical removal

- good prognosis

canalicular adenoma

what benign salivary gland tumor:

- most commonly in the upper lip

- common in middle aged females

- painless slow growing mass

histology:

- well encapsulated

- cells are similar in appearance

treatment:

- surgical removal

- good prognosis

basal cell adenoma

what benign salivary gland tumor:

- uncommon

- primary tumor of parotid

- slow growing and movable

- 2x as likely in females

histology:

- encapsulated

- jigsaw pattern

treatment:

- surgical removal

- recurrence is common

ductal papilloma

what benign salivary gland tumor:

- exophytic and papillary

- mimics squamous papilloma

- in minor salivary glands

histology:

- papillary projections

- inflammation

- intraductal

treatment:

- surgical removal

warthin tumor

what benign salivary gland tumor:

- more common in males

- commonly occurs at the tail of the parotid gland

histology:

- cyst lined by uniform rows on oncocytic cells

- cyst wall is composed of abundant lymphocytes

treatment:

- surgical removal

oncocytoma

what benign salivary gland tumor:

- rare tumor

- common in older females

- mostly occurs in the parotid

histology:

- large polyhedral cells with abundant granular cytoplasm

- cells are separated by thin fibrous septal

treatment:

- surgical excision

mucoepidermoid carcinoma

what malignant salivary gland tumor:

- most common malignant salivary gland tumor

- most commonly in the parotid gland followed by hard palate

- can be intraosseous

- can be symptomatic or asymptomatic

- may mimic mucocele

histology:

- epidermoid cells

- mucous cells

- CRCT1-MAMl2 translocation

- mucicarmine stain helpful for visualization

treatment:

- surgical excision

- radiation

adenoid cystic carcinoma

what malignant salivary gland tumor:

- made present with facial paralysis

- 50% occur in glands

- most common in the hard palate

Histology:

- swiss cheese pattern

- islands with cribifrom pattern

- myoepithelial and ductal cells

- perineural and perivascular invasion

treatment:

- surgical excision

- radiation

- relentless tumor

polymorphous adenocarcinoma

what malignant salivary gland tumor:

- tumor of the minor salivary glands

- may infiltrate bone

histology:

- various histologic patterns

- cells lined up in single file line

- perineural and perivascular invasion

treatment:

- surgical excision

- rare recurrence

acinic cell carcinoma

what malignant salivary gland tumor:

- low grade malignant tumor made up of serous acinar cells

- most common in the parotid gland

histology:

- well circumscribed

- may show infiltration

- serous acinar cells

treatment:

- surgical excision

- radiation

- about 1/3 have recurrence

secretory carcinoma

what malignant salivary gland tumor:

- most commonly in parotid gland

- slow growing and painless

- zymogen poor

histology

- varying appearances

- hobnail cells

- ETV6-NTRK3 translocation

treatment:

- surgical removal

carcinoma ex PA

what malignant salivary gland tumor:

- malignant transformation of pleomorphic adenoma

- history of a lesion present for many years

- most common in parotid

- rapidly growing

histology:

- benign and malignant components

treatment:

- surgical removal with wide margins

- neck disection

- lymph node removal

are present

salivary glands .... in the buccal mucosa, soft palate, and floor of the mouth