Module 4 - Saliva > Disorders > Flashcards

Disorders Flashcards

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1
Q

what is the failure to develop normally?

A

Aplasia

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2
Q

what is atresia?

A

failure of ducts to be tubular

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3
Q

what duct is most affected by aterisa?

A

submandibular

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4
Q

what does heterotopic mean?

A

out with normal region

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5
Q

what is a mucocoele?

A

cystic cavity filled with mucus

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6
Q

what are the 2 types of mucocoeles?

A

extravasation
retention

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7
Q

what is the clinical term for an extravasation mucocoele?

A

mucous extravasation cyst

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8
Q

what is the clinical term for a retention mucocoele?

A

mucous retention cyst

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9
Q

what are clinical features of a extravasation mucocoele?

A

bluish/ transparent swelling
asymptomatic

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10
Q

where would you normally find extravasation mucocoeles?

A

minor glands especially lower lip
children and young adults

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11
Q

aetiology of extravasation mucocoele?

A

trauma associated lesion
ruptured duct with leakage of saliva into surrounding connective tissue
leaked saliva elicits inflammation

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12
Q

what is the histopathology of a extravasation mucocoele?

A
  • Cystic cavity filled with mucin in connective tissue.
  • Mucin surrounding by inflamed granulation tissue, typically with lots of macrophages.
  • Not classed as a true cyst as no epithelial lining.
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13
Q

what is the treatment for a extravasation mucocoele?

A

removal of all mucocoele by excision with associated ruptured duct and gland where possible to prevent recurrence.

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14
Q

what are clinical features of a retention mucocoele?

A

similar to extravasation
rare on lower lip

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15
Q

aetiology of retention mucocoele?

A

cystic dilation of duct due to obstruction
affects minor and major glands

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16
Q

what is the histopathology of a retention mucocoele?

A
  • Mucin retained with a dilated duct.
  • Cyst lining is epithelial lining of the duct.
  • As saliva is retained within the duct and doesn’t escape, there is less inflammation.
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17
Q

what is the treatment of a retention mucocoele?

A

excision

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18
Q

clinical features of a ranula?

A

painless soft blush swelling on FOM
can present as swelling in the neck

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19
Q

what is it called when a ranula presents as swelling in the neck?

A

plunging ranula

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20
Q

what is treatment for a ranula?

A

drainage of the cystic cavity and removal of sublingual gland

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21
Q

what is sialadenitis?

A

inflammation of salivary glands

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22
Q

what glands are mostly affected by acute bacterial sialadenitis?

A

parotid

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23
Q

clinical features of acute bacterial sialadenitis?

A

pain
swelling
tenderness
exudation of pus
redness overlying skin

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24
Q

what is a predisposing factor of acute bacterial sialadenitis?

A

decreased salivary flow

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25
what pathogens are associated with acute bacterial sialadentitis?
Staphylococcus aureus, Streptococci, and oral anaerobes.
26
clinical features of chronic bacterial sialadentitis?
swelling, pain, redness, and tenderness unilateral asymptomatic or intermittent painful swelling (usually mealtimes)
27
what gland is most affected by chronic bacterial sialadentitis?
submandibular
28
what are salivary calculi known as?
sialoliths/ stones
29
what is chronic bacterial sialadenitis secondary to?
duct obstruction caused by stones
30
what glands are most affected by salivary calculi?
submandibular
31
aetiology of salivary calculi?
mineralisation of phosphates from supersaturated saliva being deposited around central nidus of cell debris.
32
where may calculi form?
within ducts main excretory duct
33
presentation of salivary calculi?
vary in size round or ovoid rough or smooth yellow
34
how is inflammation elicited with salivary calculi?
bacteria grow on surface
35
clinical features of salivary calculi?
no symptoms until stone obstructed: unilateral swelling/ pain often at mealtimes
36
predisposing factors of salivary calculi?
dry mouth dehydration
37
treatment of salivary calculi?
remove or breakdown some stones or remove the gland if it has become damaged with longstanding infection
38
histopathology of sialadenitis?
- Salivary acini become atrophic and are replaced by fibrous scar tissue. - Salivary ducts within gland dilate and there is often hyperplasia of duct epithelium. - Chronic inflammatory infiltrate with plasma cells and lymphocytes is seen in the gland.
39
in sialadenitis, what results in a mass in the gland commonly mistaken for a neoplasm?
progressive chronic inflammation resulting in replacement of salivary parenchyma by fibrous tissue
40
treatment of sialadenitis?
is mild the gland may recover if extensive excise the gland
41
what is mumps?
viral sialadenitis - Acute, contagious infection caused by paramyxovirus which spreads via saliva
42
clinical features of mumps?
- Painful swelling of parotids and other exocrine glands. - Fever, headache, and malaise.
43
vaccine for mumps?
MMR vaccine
44
complications of mumps?
orchitis, oophoritis, nephritis
45
what may be the first sign of HIV from the mouth?
HIV-associated salivary gland disease
46
clinical features of HIV associated SGD?
- Inflammation of major glands (parotid) - May be bilateral. - Painful and soft to palpate. - Multiple cysts are seen on imaging of glands.
47
histopathology of HIV-associated SGD?
multiple large cysts and dense lymphoid tissue.
48
Clinical features of necrotising sialometaplasia?
- Large, deep ulcer. - Painful
49
what does necrotising sailometaplasia affect?
minor salivary glands hard palate
50
aetiology of necrotising sailometaplasia?
uncertain but likely to be due to ischaemia. Infarction secondary to trauma
51
histopathology of necrotising sailometaplasia?
- Necrosis of salivary acini - Inflammation and hyperplasia/ metaplasia of salivary ducts.
52
why may sailometaplasia be mistaken for cancer?
change in duct epithelium
53
treatment for necrotising sailometaplasia?
none - heals on own
54
what is Sjogrens syndrome?
Autoimmune disease of unknown cause characterised by lymphocytic infiltration and acinar destruction of lacrimal and salivary glands (and other exocrine glands).
55
symptoms of primary SS?
dry eyes and mouth with no associated connective tissue disease.
56
symptoms of secondary SS?
dry eyes and mouth and a connective tissue disease e.g., Rheumatoid Arthritis.
57
Whos most affected by SS?
Middle aged females
58
clinical features of SS?
fatigue, joint pain, peripheral neuropathy
59
complications of SS?
dry mouth - caries, perio disease, swallowing and speech difficulty eye problems
60
what does SS increase risk of?
developing lymphoma in affected glands
61
diagnostic test for SS?
labial gland biopsy from lower lip
62
how many glands are sampled for SS biopsy?
5-8 minor glands
63
what is sialadenosis?
Non-inflammatory, non-neoplastic, bilateral symmetrical swelling of salivary glands.
64
what glands are most affected by sialadenosis?
parotid
65
symptoms of sialadenosis?
painless bilateral salivary gland swelling
66
what is sialadenosis associated with?
malnutrition, anorexia, bulimia, alcoholism, DM, certain drugs and hormone disturbance
67
what does sialadenosis result in?
hypertrophy or serous acini
68
where is salivary gland tumours most common?
major glands - parotid
69
in salivary gland tumours in minor glands, where are most found?
palate upper lip
70
where is the proportion of carcinomas highest?
minor salivary glands
71
what are the diagnostic techniques for determining oral cancer?
fine needle aspiration core biopsy open biopsy excision
72
what are the WHO classifications of salivary gland tumours?
1. Malignant tumours 2. Benign tumours 3. Non-neoplastic epithelial lesions 4. Benign soft tissue lesions 5. Haematolymphoid tumours
73
what are mucoepidermoid carcinomas?
epithelial salivary gland malignant tumours
74
where are mucoepidermoid carcinomas common?
parotids females
75
what do 80% of mucoepidermoid carcinomas have?
MAML2 gene fusions
76
histopathology of mucoepidermoid carcinomas?
Tumour is encapsulated and displays an infiltrative pattern of growth, consisting of variable proportions of 3 types of tumour cells. Tumours with high mucous cells numbers tend to be cystic whereas mainly epidermoid lesions tend to be more solid and aggressive.
77
what are the 3 types of tumour cells in mucoepidermoid carcinomas?
- Mucous secreting cells - Epidermoid (squamoid) cells - Intermediate cells.
78
treatment of mucoepidermoid carcinoma?
complete excision of tumour
79
what is the most common salivary gland tumour?
pleomorphic adenoma
80
clinical features of pleomorphic adenoma?
benign painless slow growing rubber lump
81
what gene rearrangements is pleomorphic adenoma associated with?
PLAG1 HMGA2
82
Histopathology of pleomorphic adenoma?
- Well-circumscribed tumour - Incomplete fibrous capsule (tumour nodules can extend through capsule). - May be cystic. - Complex intermingling of epithelial and myoepithelial components. - Tumour epithelial cells differentiate to connective tissue type and can form connective tissue e.g., cartilage, bone.
83
treatment of pleomorphic adenoma?
complete excision (highly recurrent if not completely).
84
what is a carcinoma ex pleomorphic adenoma?
malignant transformation in pleomorphic adenoma in long standing lesion
Module 4 - Saliva
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