pathology of oropharyngeal and salivary gland diseases

What are the main categories of diseases affecting the lips, mouth, and tongue?

Inflammatory diseases, tongue ulcers, and neoplastic diseases.

List the non-infective causes of inflammation of the lips (chelitis).

Vitamin B and iron deficiency, and dribbling of saliva.

List the infective causes of inflammation of the lips (chelitis).

Viral (herpes simplex), bacterial (syphilis, staph. Aureus), and fungal (Monilia).

What are the viral causes of inflammation of the mouth (stomatitis)?

Herpes simplex and Measles (Koplik’s spots).

What are some causes of catarrhal stomatitis?

Surface irritants like smoking and spices, and Vitamin A, B & C deficiencies.

What are the causes of chronic inflammation of the tongue (atrophic glossitis)?

Vitamin B2, B12, and iron deficiency, as well as Plummer-Vinson syndrome.

What are the causes of acute superficial inflammation of the tongue (glossitis)?

Syphilis, sharp tooth, smoking, and spices.

What are the causes of acute deep inflammation of the tongue (glossitis)?

Deep wound.

What are the causes of chronic deep inflammation of the tongue (glossitis)?

Granulomatous inflammation such as T.B. or Gumma.

What is a dental (traumatic) ulcer of the tongue and why is it important?

An ulcer due to teeth irritation, usually at the lateral edge of the tongue; it is precancerous.

Where are dyspeptic ulcers usually located on the tongue?

Near the tip of the tongue.

Where is a tuberculous ulcer typically located on the tongue?

At the tip of the tongue.

Describe the different stages of syphilitic ulcers.

Primary stage: ulcerated chancre; Secondary stage: ulcerated mucous patches; Tertiary stage: Gummatous ulcer on the dorsum of the tongue between the anterior 2/3 and posterior 1/3 (precancerous).

Describe the key features of a malignant ulcer of the tongue.

Common in the anterior 2/3 of the tongue at the lateral edges, with a raised everted edge, necrotic floor, and indurated fixed base.

What are the components of Plummer – Vinson syndrome?

Iron deficiency anemia, esophageal obstruction, pharyngitis, and atrophic glossitis.

List the benign tumors of the lips, mouth, and tongue.

Squamous cell papilloma, benign mixed salivary gland tumor, haemangioma, lymphangioma, and granular cell tumor.

List the malignant tumors of the lips, mouth, and tongue.

Squamous cell carcinoma, malignant salivary gland tumors, and sarcomas.

What are the predisposing factors for squamous cell carcinoma of the oral cavity?

Chronic irritation (smoking, alcohol, mechanical irritation), oncogenic viruses, and precancerous lesions (leukoplakia, squamous cell papilloma, dental and gummatous ulcers).

Where does squamous cell carcinoma of the tongue typically occur?

More common on the anterior 2/3 than the posterior 1/3, at the lateral edge.

How does squamous cell carcinoma spread from the tongue?

Local to surroundings, lymphatic to submental and submandibular lymph nodes (lip carcinoma) and cervical lymph nodes (oral and tongue carcinoma), and via blood to the lungs and other organs.

What are the common causes of death in patients with tongue carcinoma?

Aspiration bronchopneumonia and lung abscess, hemorrhage, and cachexia.

What are the main categories of salivary gland diseases?

Inflammatory diseases (sialadenitis), salivary gland duct stones (sialolithiasis), and tumors.

What is acute sialadenitis?

Inflammation of the salivary glands, often the parotid gland (parotitis), caused by mumps or acute suppurative infection.

What are the causes of chronic sialadenitis?

Non-specific causes or specific infections like T.B. or actinomycosis.

What is a cause of immune-mediated sialadenitis?

Mickulicz disease.

How does mumps affect the parotid glands?

Causes bilateral enlargement of the parotid glands with signs of acute inflammation (swelling, hotness, redness, painful).

What are the possible complications of mumps?

Orchitis, oophoritis, pancreatitis, mastitis, 8th nerve neuritis, and meningoenchephalitis.

How are salivary gland duct stones (sialolithiasis) formed?

A stone forms around a nucleus of food debris or desquamated cells, followed by calcium phosphate deposits.

What is the most common location for salivary gland duct stones?

The duct of the submandibular gland.

What is the most common benign salivary gland tumor?

Pleomorphic adenoma (benign mixed salivary gland tumor).

What cell type is the pleomorphic adenoma derived from?

Myoepithelial cells.

Describe the macroscopic appearance of a pleomorphic adenoma.

Rounded, well-demarcated masses with an incomplete capsule, firm, grayish white with areas of cartilaginous or osseous tissues.

What are the two components of pleomorphic adenoma?

Epithelial-myoepithelial and mesenchymal.

What are the indicators of malignant transformation in a pleomorphic adenoma?

Rapid rate of growth, facial nerve paralysis, becoming more hard and fixed, and enlarged regional lymph nodes.

What is another name for Papillary cystadenoma lymphomatosum?

adenolymphoma / Warthin’s tumor.

Describe the microscopic appearance of Papillary cystadenoma lymphomatosum.

Cystic spaces with papillary ingrowth, lined by two layers of epithelial cells (outer columnar secretory cells and inner oncocytic cells), and lymphoid aggregates in the stroma.

What are the key features of Oncocytoma?

Solid sheets of large cells with abundant red granular cytoplasm, scanty and hyalinized fibrous stroma.

List the malignant salivary gland tumors mentioned in the lecture.

Mucoepidermoid carcinoma, adenoid cystic carcinoma and Acinic adenocarcinoma.

Describe the macroscopic appearance of adenocarcinoma in the salivary glands.

Hard fixed mass with a grayish-white cut surface and areas of hemorrhage and necrosis.

How are Acinic adenocarcinoma, Mucoepidermoid carcinoma, and Adenoid cystic carcinoma graded in terms of prognosis?

Acinic adenocarcinoma (Less malignant), Mucoepidermoid carcinoma (Intermediate), Adenoid cystic carcinoma (Highly malignant).