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2. Pathology of the salivary glands: Difference between revisions
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(Created page with "''Written by ms. worldwide, edited by Nikolas.'' Another topic where there’s a lot of listing of different diseases, yay… Salivary glands can be enlarged for multiple reasons: * Sialadenitis – inflammation * Sialolithiasis – stones in the salivary glands * Tumorlike lesions * Salivary gland tumors Let’s take a closer look at all of them = Sialadenitis – inflammation of the salivary glands = Inflammations of the salivary glands come in many different type...") |
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Inflammations of the salivary glands come in many different types. | Inflammations of the salivary glands come in many different types. | ||
=== | === Bacterial sialadenitis === | ||
Bacterial sialadenitis is an acute purulent inflammation, which is mostly found in the elderly patients. Risk factors for this are: | Bacterial sialadenitis is an acute purulent inflammation, which is mostly found in the elderly patients. Risk factors for this are: | ||
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The bacteria which are the cause for these inflammations are ''Staphylococcus aureus'', ''streptococcus viridians'' and ''intestinal bacteria''. | The bacteria which are the cause for these inflammations are ''Staphylococcus aureus'', ''streptococcus viridians'' and ''intestinal bacteria''. | ||
=== | === Viral sialadenitis === | ||
Unlike the bacterial type, Viral sialadenitis is much more common and seen in children. Mumps is the most famous reason and causes hamster cheek because of the swelling of the parotid glands. | Unlike the bacterial type, Viral sialadenitis is much more common and seen in children. Mumps is the most famous reason and causes hamster cheek because of the swelling of the parotid glands. | ||
[[File:Word-image-13.jpg|thumb|Viral sialadenitis]] | [[File:Word-image-13.jpg|thumb|Viral sialadenitis]] | ||
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Complications from this can be deafness and if the mumps is the cause, recall from micro that the testis may also become inflamed. | Complications from this can be deafness and if the mumps is the cause, recall from micro that the testis may also become inflamed. | ||
=== | === Autoimmune sialadenitis – Sjögren syndrome === | ||
[[File:Word-image-14.jpg|thumb|The many symptoms of Sjögren syndrome.]] | [[File:Word-image-14.jpg|thumb|The many symptoms of Sjögren syndrome.]] | ||
Sjögren syndrome is associated with anti-SSA and SSB antibodies and is typically found in middle-aged women. The syndrome makes the both parotid glands swell, and it’s pretty painful too. In addition to attack the salivary and lacrimal glands, it also manifests by dry mouth dry eyes and rheumatoid arthritis. | Sjögren syndrome is associated with anti-SSA and SSB antibodies and is typically found in middle-aged women. The syndrome makes the both parotid glands swell, and it’s pretty painful too. In addition to attack the salivary and lacrimal glands, it also manifests by dry mouth dry eyes and rheumatoid arthritis. | ||
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To make a diagnosis, a biopsy from the lip can be taken. | To make a diagnosis, a biopsy from the lip can be taken. | ||
=== | === Mikulicz syndrome === | ||
This rare autoimmune disease leads to bilateral swelling of the salivary and lacrimal glands which is painless. The etiology is unknown. | This rare autoimmune disease leads to bilateral swelling of the salivary and lacrimal glands which is painless. The etiology is unknown. | ||
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* HIV-infection | * HIV-infection | ||
=== | === Heerfordt syndrome === | ||
Heerfordt syndrome is a rare manifestation of sarcoidosis in the salivary glands. | Heerfordt syndrome is a rare manifestation of sarcoidosis in the salivary glands. | ||
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[[File:Word-image-27.png|thumb|Sialolithiasis]] | [[File:Word-image-27.png|thumb|Sialolithiasis]] | ||
=== | === Sialolithiasis === | ||
The stones of the salivary glands occur mostly in the main duct of the submandibular glands, and the etiology of them is unknown. | The stones of the salivary glands occur mostly in the main duct of the submandibular glands, and the etiology of them is unknown. | ||
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The stone itself is bright yellow with granular surface. | The stone itself is bright yellow with granular surface. | ||
=== | === Chronic sclerosing sialadenitis === | ||
This condition is rare and occurs due to long-term inflammations of the salivary glands. It’s considered benign, but presents as hard, indurated and big masses that are clinically impossible to distinguish from salivary neoplasms and tumors. | This condition is rare and occurs due to long-term inflammations of the salivary glands. It’s considered benign, but presents as hard, indurated and big masses that are clinically impossible to distinguish from salivary neoplasms and tumors. | ||
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[[File:Word-image-28.png|thumb|Mucocele]] | [[File:Word-image-28.png|thumb|Mucocele]] | ||
=== | === Mucocele === | ||
Mucoceles are small, painless cysts of a salivary gland which exists in two forms: The retention/obstructive type and the extravasation/pseudocystic type. | Mucoceles are small, painless cysts of a salivary gland which exists in two forms: The retention/obstructive type and the extravasation/pseudocystic type. | ||
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[[File:Word-image-15.jpg|thumb|Ranula]] | [[File:Word-image-15.jpg|thumb|Ranula]] | ||
=== | === Ranula === | ||
This is basically an extravasation type mucocele of the sublingual gland which is found in the base of the mouth. It looks like the sack of a frog. | This is basically an extravasation type mucocele of the sublingual gland which is found in the base of the mouth. It looks like the sack of a frog. | ||
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Most of the salivary gland tumors are from epithelial origin, and they dominate in women. They are also mostly benign, but as with everything, they can be malignant as well. The usual location is parotid gland (80 %), followed by submandibular gland. | Most of the salivary gland tumors are from epithelial origin, and they dominate in women. They are also mostly benign, but as with everything, they can be malignant as well. The usual location is parotid gland (80 %), followed by submandibular gland. | ||
=== | === Pleomorphic adenoma === | ||
Pleomorphic adenoma is the most frequent benign tumor, and usually appears in the parotid gland at any age. | Pleomorphic adenoma is the most frequent benign tumor, and usually appears in the parotid gland at any age. | ||
It is a slow-growing painless neoplasm with unknown etiology. Since it usually grows in the parotid gland and can get pretty big, so it can compress the facial nerve and cause palsy. The close location to the facial nerve makes also removal of the tumor very hard, and if it’s not removed completely, there is a high risk for it to reoccur. However, only 6 % of all cases turn into a malignant type. | It is a slow-growing painless neoplasm with unknown etiology. Since it usually grows in the parotid gland and can get pretty big, so it can compress the facial nerve and cause palsy. The close location to the facial nerve makes also removal of the tumor very hard, and if it’s not removed completely, there is a high risk for it to reoccur. However, only 6 % of all cases turn into a malignant type. | ||
=== | === Whartin-tumor (adenolymphoma) === | ||
The Warthin tumor is also known as ''papillary cystadenoma lymphoatosum'' and is a benign cystic tumor of the salivary glands which contains lymphocytes and germinal centres, hence the name adenolymphoma. It much less frequent than the pleomorphic adenoma, but they both occur almost always in the parotid gland. | The Warthin tumor is also known as ''papillary cystadenoma lymphoatosum'' and is a benign cystic tumor of the salivary glands which contains lymphocytes and germinal centres, hence the name adenolymphoma. It much less frequent than the pleomorphic adenoma, but they both occur almost always in the parotid gland. | ||
This tumor dominates in men and has a strong connection to smoking. | This tumor dominates in men and has a strong connection to smoking. | ||
=== | === Mucoepidermoid carcinoma === | ||
This carcinoma is the most frequent malignant tumor in the salivary glands, and in appears in the parotid gland in 2/3 cases. | This carcinoma is the most frequent malignant tumor in the salivary glands, and in appears in the parotid gland in 2/3 cases. | ||
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The risk factor is radiation, and the prognosis depends of the differentiation grade. If the tumor is poorly differentiated, the prognosis for survival is very low. Morphology they appear to be circumscribed but the tumor lacks well-defined capsules and are often infiltrative. | The risk factor is radiation, and the prognosis depends of the differentiation grade. If the tumor is poorly differentiated, the prognosis for survival is very low. Morphology they appear to be circumscribed but the tumor lacks well-defined capsules and are often infiltrative. | ||
=== | === Adenoid cystic carcinoma === | ||
This is a rare cancer, and can occur in the breasts, lacrimal glands, lung and brain as well, but most commonly in the salivary glands. | This is a rare cancer, and can occur in the breasts, lacrimal glands, lung and brain as well, but most commonly in the salivary glands. | ||
It can be found in all salivary glands and appears in middle-aged patients. The prognosis is however poor. | It can be found in all salivary glands and appears in middle-aged patients. The prognosis is however poor. | ||
[[Category:Pathology 2 - Theoretical exam topics]] | [[Category:Pathology 2 - Theoretical exam topics]] | ||