Salivary glands

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Salivary glands Dr. Arjun Singh Associate Professor Department of Pathology Index Medical College Hospital and Research Centre, Indore Down load this ppt from


Objectives Xerostomia Inflammation (sialadenitis) Neoplasm

Xerostomia :

Xerostomia Dry mouth Features of Sjogren syndrome Because of lack of secretion of salivary glands and complication of radiation therapy Leads to dry mucosa , atrophy of papilla of tongue , Fissuring and ulceration of mouth

Inflammation (sialadenitis) :

Inflammation (sialadenitis) Inflammation of salivary glands May be traumatic, viral, bacterial, or autoimmune origin Associated with involvement of lacrimal glands produced dry eyes “ keratoconjuctivitis sicca ” Mucocele result from blockage or rupture of salivary gland ducts Sialolithiasis formation of stone in salivary gland leads to inflammation mainly due to S. aureus and Streptococcus viridans

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Sialolithiasis with secondary chronic sialadenitis. A large stone is blocking a major salivary duct

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Cyst like cavity filled with mucinous material and lined by organizing granulation tissue Fluctuant fluid filled lesion on the lower lip due to trauma mucocele


Neoplasm Parotid 65-80% (15-30% malignant) Submandibular gland 10% (30-40% malignant) Minor salivary glands rest of the (70-90% malignant)

Tumors of salivary glands:

Tumors of salivary glands Benign Malignant Pleomorphic adenoma (50%) (mixed tumor) Mucoepidermoid carcinoma (15%) Warthin tumor (5%-10%) Adenocarcinoma (NOS) (10%) Oncocytoma (1%) Acinic cell carcinoma (5%) Other adenomas (5%-10%) Adenoid cystic carcinoma (5%) Basal cell adenoma Malignant mixed tumor (3%-5%) Canalicular adenoma Squamous cell carcinoma(1%) Ductal papillomas Other carcinomas (2%)

Pleomorphic adenoma :

Pleomorphic adenoma Most common tumor of major (60-75%) & minor (50%) salivary glands. Commonest tumor in the parotid gland Common in women at 3 rd to 5 th decades of life Solitary, smooth-surfaced but sometimes nodular, painless and slow-growing Characterized by pleomorphic or ‘mixed’ appearance Epithelial elements present in a matrix of mucoid, myxoid and chondroid tissue (1) Epithelial component like ducts, acini, tubules, sheets and strands of cells of ductal or myoepithelial origin. (2) Mesenchymal elements are present as loose connective tissue and as myxoid, mucoid and chondroid matrix

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Gross appearance of benign mixed tumors of parotid gland, the sharply outlined character and predominantly solid cut surface. The glistening surface indicative of cartilaginous differentiation

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Microscopic appearance of benign mixed tumor, epithelial and myoepithelial cells can be easily distinguished

Warthin tumor :

Warthin tumor Benign tumor of the parotid gland comprising about 8% of parotid neoplasm Develops from parotid ductal epithelium present in lymph nodes adjacent to or within parotid gland Encapsulated , round or oval with smooth surface Cut surface shows characteristic slit-like or cystic spaces, containing milky fluid , with papillary projections Tumor shows 2 components (1) Epithelial parenchyma is composed of glandular and cystic structures having papillary arrangement and lined by characteristic Eosinophilic epithelium (2) Lymphoid stroma is present under the epithelium in the form of prominent lymphoid tissue with germinal centers

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Gross appearance of Warthin’s tumor of parotid gland. The presence of multiple large cystic spaces is characteristic of this lesion

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Low-power appearance of Warthin’s tumor, Germinal centers are very prominent

Mucoepidermoid carcinoma :

Mucoepidermoid carcinoma Common malignant salivary gland tumor (both in the major and minor glands) Mainly in Children and adolescents Most common example of radiation-induced malignant tumor Circumscribed but not encapsulated Varies in size from 1 to 4 cm Classified into low, intermediate and high grade depending upon the degree of differentiation and tumor invasiveness Composed of combination of epidermoid cells and mucus-secreting cells with intermediate differentiation between these two cell types and clear cells

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Gross appearance of mucoepidermoid carcinoma. This particular tumor is entirely solid, without the cystic formations commonly seen in low-grade lesions

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Mucoepidermoid carcinoma Mucous, squamous, and intermediate cells can be seen.

Adenoid cystic carcinoma :

Adenoid cystic carcinoma Highly malignant tumor due to its typical infiltrative nature, especially along the nerve sheaths Histologically characterized by cribriform appearance Epithelial tumor cells of duct-lining and myoepithelial cells are arranged in duct like structures or masses of cells, having typical fenestrations or cyst-like spaces and hence the name ‘adenoid cystic’

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Adenoid cystic carcinoma. Typical low-power appearance

Acinic cell carcinoma :

Acinic cell carcinoma Rare tumor composed of Acinic cells Resemble serous cells of normal salivary gland Cells are arranged in sheets or acini and with characteristic basophilic granular cytoplasm

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Acinic cell carcinoma. The cells have an abundant cytoplasm filled with basophilic zymogen granules

Summary :

Summary Xerostomia Inflammation (sialadenitis) Neoplasm

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