Diseases of the salivary glands:
|
|
- Godwin Blake
- 5 years ago
- Views:
Transcription
1 Diseases of the salivary glands: Sialoadenitis Sialolithiasis Mikulicz syndrome/disease
2 Sialolithiasis Most frequently occures in the submandibular duct, rarely in the parotid duct and in the ducts of the minor salivary glands Bright yellow stone, with dilatation of the ducts (ductectasia), the saliva is collected in the lumen, the stone frequently solitary Not linked to hyperparathyreoidism, dietary Genesis: detached epithelial cells+ Ca++ (calcium phosphate +glycoproteins) sialolith (stone) chronic obstruction chronic sialoadenitis, on the long run sialoadenitis chronica fibrosa (in the submandibular gland: Sialoadenitis chronica sclerotisans submandibularis Küttner tumor (it is also a tumor-like lesion). Symptomes: pain during eating when saliva excretes, palpable submandibular gland, enlarged, firm gland Mikroscopy: focal/diffuse lymphoid cell infiltrate, variable scarring, acinar degeneration
3
4
5 Sialoadenitis Causes: ductal occlusion (eg. stone) viral, or bacterial infection autoimmune disease: Sjögren syndrome Viral sialoadenitis: causes the mumps virus, which belongs to the paramyxoviridae, usually in children, infective disease, 2-3 months incubation, bilateral, rarely unilateral parotid swelling, fever, fatigue, headache, increased Se amylase-level, pain during salivation. Histology: interstitial oedema+mononuclear infiltration Bacterial/suppurative sialoadenitis: in elderly, after extensive chest or abdominal surgery, if the saliva production reduced, it predisposes a retrograde infection, bacterial invasion pathogen: Staphylococci, Streptococci Clinically unilateral swelling, pain, purulent ductal excretion
6 Autoimmune sialoadenitis (Sjögren synrome) Minor and major salivary glands and lacrimal glands are involved, keratoconjuctivitis sicca, corneal ulcers, xerostomia, parotid swelling, anti SSA/SSB+ Histology: LESA, lymphoepithelial sialoadenitis: periductal small lymphocytic (B+T) + plasmacytic sialoadenitis, ductctasia, acinar atrophy/destruction, (benign lymphoepithelial laesion-lel: condenzed-cohesive epithelial aggregates surrounded by hyalinized BM + lymphoid cell infiltrate), Dg.: from minor salivary gland biopsy (eg.: from the lower lip) High risk of malignant lymphoma (40:1) Sjögren syndrome may combine with other systemic autoimmun diseases (RA, SLE, Hashimoto thyreoiditis, CAH)
7
8
9
10
11 Mikulicz disease (MD) vs. Mikulicz syndrome 1888, first description of Mikulicz disease Symmetric, bilateral swelling of lacrimal and salivary gland (parotid, submandibular) Lymphocytic infiltration xerostomia and xerophthalmia J. von Mikulicz-Radecki: Über eine eigenartige symmetrische Erkrankung der Thränen- und Mundspeicheldrüsen. Beiträge zur Chirurgie. Festschrift gewidmet Theodor Billroth. Stuttgart, 1892:
12 J. von Mikulicz-Radecki: Über eine eigenartige symmetrische Erkrankung der Thränen- und Mundspeicheldrüsen. Beiträge zur Chirurgie. 1892: Oral Surg Oral Med Oral Path Oral Rad Endod Sep;100(3):334-9.
13
14 Mikulicz disease (MD) today (vs. Mikulicz syndrome) Mikulicz disease: idiopathic, painless, bilateral lacrimal and salivary gland swelling (at the beginings Sjögren syndrome belonged to this category) today this is the part of the IgG4-related systemic disease (IgG4 RSD) Mikulicz syndrome: similar/the same symptomes, but known background disease, like TB, sarcoidosis, HIV infection, lymphoma) A Sjögren syndrome and the Mikulicz disease are different diseases (see table below)
15 Tumour-like lesions of the salivary glands Sialoadenosis Oncocytosis Necrotizing sialometaplasia (salivary gland infarct) LESA (benign lymphoepithelial laesion, in relation to Sjögren s syndrome) Salivary gland cysts Chronic sclerozing sialoadenitis in the submandibular gland (Küttner s tumor) Cystic lymphoid hyperplasia (AIDS-related)
16 Sialoadenosis Recurrent, painless, bilateral salivary gland swelling, not an inflammatory process, related to endocrine diseases (Diabetes mellitus, chronic aethylismus, cirrhosis, malnutrition). It is a dysfunction of the autonom nerve system: prolonged storage phase (large zymogenic-secretory granules are stored in the cytoplasm of the acinic cells, the size of the acini are increased) EM: myoepithelial atrophy and axonal degeneration (axolysis, decrease in the number of the neurosecretory granules) Morphology: swollen, enlarged, serous acinar cells, (60μ instead of the normal 40-45μ) basally-placed nuclei, mild duct compression in minor salivary glands: adenomatoid hyperplasia
17 Oncocytosis The other name is focal adenomatous oncocytic hyperplasia, probably the precursor of the oncocytoma or multiple oncocytoma (oncocytomatosis), it is characterized by lesions below 1 cm in diameter, diffuse oncocytosis: rare, more frequent in women
18 Shellenberger T et al. AJNR Am J Neuroradiol 2008;29: Oncocytosis
19 Necrotizing sialometaplasia (salivary gland infarct) Localization: palate 20%, parotid 35%, submandibular gland 15%, other macroscopy: exulcerated mucosa microscopy: Intraductal metaplastic squamous cell proliferation (squamous metapl.), which contains entrapped mucinous cells, the lobular structure is preserved no true infiltrative pattern superficial pseudoepitheliomatous hyperplasia prominent inflammatory infiltrate vascular changes: thrombosis, obliteration, ischaemic lesion partial necrosis in the salivary gland zonality: squamous metaplasia in the centre, necrosis and inflammation at the periphery differential diagnosis: SCC, mucoepidermoid cc., postirradiation changes
20
21
22
23 Salivary gland cysts Epidermoid cyst: a cyst lined by keratinizing squamous epithelium, filled with laminated keratin Salivary duct cyst: mainly in the parotid gland, dilated duct filled with mucus, epithelial lining, (generally flattened cuboideal epithel), obstruction or narrowing of the duct plays important role in the pathogenesis, similar to that of the retention type of mucokele Lymphoepithelial cyst: branchial cyst, in the parotid and the soft tissues of the neck, lined by non-keratinizing or keratinizing squamous epithel with massive lymphoid stroma + follicles Mucokele (minor glands): 2 types, retention and extravasation types Retention type: in older ages (in the 6th, 7th, or 8th decade), mainly on the lower lip, may occure anywhere in the minor glands, epithelial lining in the cyst Extravasation type: more than 70% on the lower lip, 7% on the floor, 6% in the bucca, the rest in the palate. Mainly in youngs in their 2nd-3rd decadei, morphology: foamy histiocytes, macrophages and extravasated mucus to the extracellular space, no epithelial lining, there is a mechanical trauma in the background (damage in he minor gland duct) Ranula: mucus cyst on the floor beneath the tongue, due to the dysgenetic developement of the sublingual duct, characterized by mucus extravasation+ inflammatory reaction
24 Epidermoid cyst
25 Epidermoid cyst
26 Lymphoepithelial cyst
27
28 Mucokele/ranula mucokele ranula mucokele
29
30
31 Mucokele, retention type
32 Mucokele, retention type
33 Sialoadenitis chronica fibrosa submandibularis (Küttner tumor) , 4 cases, H. Küttner, slightly painful, firm submandibular gland swelling in mid-aged adults 2. Swollen, firm, tumour-like lesion in the submandibular gland 3. Focal, or diffuse inflammation with variable intensity, interstitial fibrosis (stages 1-4) acinar cell atrophy, duct cell metaplasia Pathogenesis: not fully understood ductal obstruction with sialolithiasis disorders of the ductal system secretion dysfunction irradiation (after head and neck irradiation) immune mechanism: part of the IgG4 RSD
34
35
36
37 Cystic lymphoid hyperplasia (AIDS-related) HIV-associated lymphoepithelial cyst Generally in the parotid, swelling of the gland beside the AIDS-related generalized lymphadenopathy mainly in young adults Histology Similar to the conventional lymphoepithelial cyst Diffuse or follicular lymphoid hyperplasia, polyclonal B-cell and mainly CD8+T-cell component, hypervascularisation Cyst in the middle of the lesion, lined by stratified squamous epithel (which is of duct epithel origin) HIV-associated antigenes in the lymphoid cells Not progress to lymphoma
38 Benign salivary gland tumours Monomorphic adenoma (trabecular, tubular, canalicular) Basal cell adenoma Pleomorphic adenoma Warthin tumour (cystadenoma lymphomatosum papillare) Oncocytoma Myoepithelioma
39 Monomorphic (canalicular) adenoma: Trabecular, tubular, canalicular types, benign, no mesenchymal component, 70%- in the parotid, the rest in the minor glands, mainly on the upper lip, bucca, palate Basal cell adenoma: Mainly in the parotid and in the minor glands, vast majority occures in elderly, solid-trabecular appearance, rarely tubular, the tumour cells show basal phenotype, they form cellular palisade, produce basal membrane-like material (PAS+) Oncocytoma: Rare, mainly in the parotid, 3-4 cm in size, encapsulated, brown, lobulated tumour, takes 1% of all salivary gland tumours Microscopy: solid microcystic growth pattern, fine fibrovascular stroma, consist of cells with large, granular, eosinophilic cytoplasm and pycnotic, hyperchromatic nuclei
40 Warthin tumour (cystadenoma lymphomatosum papillare) Forms 15% of all the salivary gland tumour, invovlves mainly the parotid, the submandibular and the minor salivary glands May appear as bilateral and multifocal tumour Tight relation to smoking Macroscopy: cystic-solid appearance, grayish, gelatinous consistency, fragile Microscopy: oncocytaer epithel in solid areas, lines the cysts, interstitial lymphoid stoma+ reactive lymphoid follicles, squamous metaplasia Myoepithelioma: 50% in the parotid, 40 % in the minor glands, mainly on the palate, grows slowly Microscopy: spindle cell, clear cell and plasmocytoid variants (debatable whether it is a true myoepithelial tu.), cytokeratin, SMA, GFAP, S100+
41
42 Pleomorphic adenoma 75-80% in the parotid, 5-10% in the submandibular gland, and 10% in the minor glands, slowly growing neoplasm, has a capsule, develops satellite nodules/pseudopods, painless swelling, occures most frequently between years of age Histology: trabecular, tubular, cystic growth, epithelial (areas with glandular or epidermoid differentiation+myoepithelial islands+ mesenchymal elements (cartilage, bone, primitive mesenchymal elements, myxoid/mucoid matrix) Malignant transformation: in 2-7%, true histological malignant transformation: adenocarcinoma, salivary duct carcinoma, spindle cell (myoepithelial) or sarcomatoid carcinoma Characteristics of the malignnancy: vascular invasion, perineural invasion, atypical mitoses Benign metastatizing pleomorphic adenoma: Histologically benign, but produce multiple organ involvement. Extremely rare.
43
44
45 Malignant salivary gland tumours Adenoid cystic carcinoma Mucoepidermoid carcinoma Acinic cell carcinoma Myoepithelial carcinoma Salivary duct carcinoma
46 Adenoid cystic carcinoma: Makes 10% of all the salivary gland tumour (first described by Billroth in 1859 as cylindroma) Localization: 17% in the parotid, 15% in the submandibular gland, ~60% in the minor salivary glands!!! (palate, antrum, tongue) Characteristically infiltrative growth, spread far away from the grossly palpable borders, perineural (facial nerve) infiltration paralysis, painful, long clinical course, tendency for recurrency, haematogenous spread to the lungs Histology: consist of cells with basaloid character, cells elaborate basament membrane-like material (PAS+), tumour shows cystic or crybriform appearance, perineural invasion, histology subtypes: crybriform/classical type, tubular type, solid basaloid type
47 Adenoid cystic carcinoma
48 Mucoepidermoid carcinoma: Takes 5% of all salivary gland tumours, 67% in the parotid, 33% in the minor glands eg. palate (this is the 3rd. Most frequent tumour of the minor salivary glands, 1. pleomorphic adenoma 2. adenoid cystic carcinoma 3. mucoepidermoid carcinoma, There are low- and high grade variants, low grade: grows slowly, has capsule, painless, involvement of the facial nerve is not characteristic, high grade: infiltrative, fixed to the surrounding tissues, produces LN metastases Microscopy: epidermoid cells+mucin producing PAS+ cells +intermedier cells
49 Mucoepidermoid carcinoma:
50 Acinic cell carcinoma: 2% of all the salivary gland tumours, 90% in the parotid, can be also multiple and bilateral, types: solid acinar, microcystic, papillary-cystic Biological behaviour: encapsulated, there s no vascular invasion, may show local recurrences, but have good prognosis, if the capsule is incomplete and the tumour is invasive, then it has poorer prognosis. Recurrence rate is 20%, chance for LN metastasis is 10%, 6% distant metastases. Microscopy: consists of serous, normal acinar cells, the tumour cells contain zymogenic granules, PAS+
51
52 Myoepithelial carcinoma: -on grounds of myoepithelioma or pleomorphic adenoma -spindle cell/plasmocytoid proliferation in a mucoid/myxoid background -cytologic atypia, infiltrative growth
53 Salivary duct carcinoma: -Occures mainly in the parotid gland (80%), 5% of them develop in the minor salivary glands -origin: de novo from the excretory ducts or from the ductal cells in pleiomorphic adenoma -facial nerve symptomes -in 50% local recurrence -frequent LN metastases -2/3rds of the patients develop brain, liver and adrenal metastases -histology: remarkable similarity to the ductal carcinoma of breast (papillary, comedo and crybriform pattern)
54
55 Salivary gland MALT lymphoma -MALT lymphoma (extranodal marginal zone lymphoma), most frequent -DLBCL, FL, CLL -origin: from the lymphoid tissue/node in the gland -good prognosis in MALT -pathogenesis: Sjögren, Syst. Scler., AIDS (chr. antigen presentation) -involves more than one gland, frequently bilateral -histology: consists of monocytoid B cells, malignant lymphoepithelial lesion, blastic areas (DLBCL-like) in the low grade tumor indicate high-grade transformation
56
57
Salivary Glands 3/7/2017
Salivary Glands 3/7/2017 Goals and objectives Focus on the entities unique to H&N Common board type facts Information for your future practice Salivary Glands Salivary Glands Major gland. Paratid. Submandibular.
More informationSALIVARY GLAND DISEASES. Omar alnoubani MD,MRCS
SALIVARY GLAND DISEASES Omar alnoubani MD,MRCS Salivary Glands Overview Parotid gland Sublingual gland Submandibular gland Salivary glands - Types 3 Major Salivary Glands Parotid Submandibular Sublingual
More informationSalivary Gland Cytology
Salivary Gland Cytology Diagnostic challenges and potential pitfalls Tarik M. Elsheikh, MD Professor and Medical Director Anatomic Pathology Cleveland Clinic FNA Salivary Gland Lesions Indications Distinguish
More informationMy Journey into the World of Salivary Gland Sebaceous Neoplasms
My Journey into the World of Salivary Gland Sebaceous Neoplasms Douglas R. Gnepp Warren Alpert Medical School at Brown University Rhode Island Hospital Pathology Department Providence RI Asked to present
More informationOncocytic-Appearing Salivary Gland Tumors. Oncocytic, Cystic, Mucinous, and High Grade Salivary Gland Tumors SALIVARY GLAND FNA: PART II
William C. Faquin, MD, PhD Professor of Pathology Harvard Medical School Director of Head and Neck Pathology Massachusetts Eye and Ear Massachusetts General Hospital SALIVARY GLAND FNA: PART II Oncocytic,
More informationDifferential Diagnosis of Oral Masses. Palatal Lesions
Differential Diagnosis of Oral Masses Palatal Lesions Palatal Masses Periapical Abscess Torus Palatinus Mucocele Lymphoid Hyperplasia Adenomatous Hyperplasia Benign Salivary Neoplasms Malignant Salivary
More informationSalivary Gland Pathology
IN THE NAME OF GOD Salivary Gland Pathology CHAPTER 11 Dr.kheirandish Oral and maxillofacial pathology Sialadenosis Adenomatoid Hyperplasia of the Minor Salivary Glands Necrotizing Sialometaplasia Pleomorphic
More informationLesions Mimicking Adenoid Cystic Carcinoma. Diagnostic Problems in Salivary Gland Pathology An Update 5/29/2009
Diagnostic Problems in Salivary Gland Pathology An Update Lesions Mimicking Adenoid Cystic Carcinoma Stacey E. Mills, M.D. W.S. Royster Professor of Pathology Director of Surgical and Cytopathology University
More informationFNA OF SALIVARY GLANDS: A PRACTICAL APPROACH
FNA OF SALIVARY GLANDS: A PRACTICAL APPROACH FNA of Salivary Glands: Challenges Wide range of neoplastic and non-neoplastic lesions Cytological overlap between the different benign and malignant tumors
More informationObjectives. Salivary Gland FNA: The Milan System. Role of Salivary Gland FNA 04/26/2018
Salivary Gland FNA: The Milan System Dr. Jennifer Brainard Section Head Cytopathology Cleveland Clinic Objectives Introduce the Milan System for reporting salivary gland cytopathology Define cytologic
More informationTYPES and FREQUENCY of SALIVARY GLAND TUMORS in MAJOR and MINOR. Karl Donath Department of Oral Pathology (Director:Prof. Dṛ Dr.
TYPES and FREQUENCY of SALIVARY GLAND TUMORS in MAJOR and MINOR SALIVARY GLANDS Karl Donath Department of Oral Pathology (Director:Prof. Dṛ Dr. Karl Donath) University of Hamburg, Salivary gland tumors
More informationARIZONA SOCIETY OF PATHOLOGISTS 13 TH APRIL 2013 HEAD AND NECK CYTOPATHOLOGY. F ZAHRA ALY, MD, PhD
ARIZONA SOCIETY OF PATHOLOGISTS 13 TH APRIL 2013 HEAD AND NECK CYTOPATHOLOGY F ZAHRA ALY, MD, PhD The main areas sites amenable for cytopathology include lymph nodes, thyroid, major salivary glands especially
More informationDISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV
DISORDERS OF THE SALIVARY GLANDS Neoplasms Dr.M.Baskaran Selvapathy S IV NEOPLASMS A) Epithelial I. Benign Pleomorphic adenoma( Mixed tumour) Adenolymphoma (Warthin s tumour) Oxyphil adenoma (Oncocytoma)
More informationEducational Cases EQA November T.J. Palmer Raigmore Hospital Inverness
Educational Cases EQA November 2013 T.J. Palmer Raigmore Hospital Inverness Case 2 Clinical Details Dob 11 February 1951 PMH: 1964 Extraction of 45 aet 13 yr 1966 Cyst between 44 and 46 enucleated 1973
More informationSalivary Gland Imaging. Mary Scanlon MD FACR October 2016
Salivary Gland Imaging Mary Scanlon MD FACR October 2016 Objectives Recognize normal and abnormal anatomy Discuss work up, management and differential diagnosis of commonly referred clinical scenarios
More informationUpdate in Salivary Gland Pathology. Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016
Update in Salivary Gland Pathology Benjamin L. Witt University of Utah/ARUP Laboratories February 9, 2016 Objectives Review the different appearances of a selection of salivary gland tumor types Establish
More informationLos Angeles Society Of Pathologists Dr. Shobha Castelino Prabhu
Los Angeles Society Of Pathologists Dr. Shobha Castelino Prabhu Loma Linda University Medical Center June 12, 2007 CASE 1 76 year-old gentleman Status post right parotidectomy 1 year ago for a rare tumor
More informationFNA Biopsy of Salivary Gland
FNA Biopsy of Salivary Gland Richard M. DeMay, MD Professor of Pathology Director of Cytopathology The University of Chicago Objective: To describe the use of FNA Bx to diagnose salivary gland lesions
More informationAcute bacterial sialadenitis:
Developmental anomalies: Aplasia Atresia Ectopic tissue Sialadenitis: Acute bacterial sialadenitis: Uncommon Parotid Xerostomia Seen in pts with: Sjogren s syndrome Tricyclic antidepressants Immunosuppression
More information04/09/2018. Salivary Gland Pathology in the Molecular Era Old Friends, Old Foes, & New Acquaintances
Salivary Gland Pathology in the Molecular Era Old Friends, Old Foes, & New Acquaintances Jennifer L. Hunt, MD, MEd Aubrey J. Hough Jr, MD, Endowed Professor of Pathology Chair of Pathology and Laboratory
More informationDiseases of the breast (1 of 2)
Diseases of the breast (1 of 2) Introduction A histology introduction Normal ducts and lobules of the breast are lined by two layers of cells a layer of luminal cells overlying a second layer of myoepithelial
More informationPRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies CYTOLOGIC DIAGNOSIS:
1 PRELIMINARY CYTOLOGIC DIAGNOSIS: Suspicious for Acinic Cell Carcinoma. Cell Block: Immunohistochemical Studies GCDFP-15 S-100 CYTOLOGIC DIAGNOSIS: Consistent with mammary analogue secretory carcinoma.
More informationSalivary gland tumor cytologic and histologic correlation: Algorithmic and risk stratification based approaches
Salivary gland tumor cytologic and histologic correlation: Algorithmic and risk stratification based approaches Christopher C. Griffith, MD, PhD Raja R. Seethala, MD 1. Salivary gland tumor cytology: A
More informationPLEOMORPHIC ADENOMA ( BENIGN MIXED TUMOR )
( BENIGN MIXED TUMOR ) Grossly, the tumor is freely movable, solid, sometimes lobulated and occasionally cystic. If recurrent, multinodular masses are common. Histologically, within a fibrous capsule,
More informationEpithelial tumors. Dr. F.F. Khuzin, PhD Dr. M.O. Mavlikeev
Epithelial tumors Dr. F.F. Khuzin, PhD Dr. M.O. Mavlikeev Epithelial tumors Tumors from the epithelium are the most frequent among tumors. There are 2 group features of these tumors: The presence in most
More informationDiseases of oral cavity
Diseases of oral cavity Diseases of Teeth and Supporting Structures Inflammatory/Reactive Lesions Infections Oral Manifestations of Systemic Disease Precancerous and Cancerous Lesions Odontogenic Cysts
More informationTHE NATURAL HISTORY OF TUMORS PECULIAR TO THE SALIVARY GLANDS
THE NATURAL HISTORY OF TUMORS PECULIAR TO THE SALIVARY GLANDS FRANK VELLIOS, M.D., AND DALE DAVIDSON, M.D. Departments of Clinical Pathology and Surgery, Indiana University School of Medicine Tumors of
More informationSalivary gland Workshop Trondheim 31th may 2012
Salivary gland Workshop Trondheim 31th may 2012 Peter Jebsen cytopathologist Oslo University Hospital Rikshospitalet Anna Bofin ass. Professor St. Olavs Hospital, Trondheim Drying artifacts Lymfocytes
More informationEnterprise Interest None
Enterprise Interest None What are triple negative breast cancers? A synopsis of their histological patterns Ian Ellis Molecular Medical Sciences, University of Nottingham Department of Histopathology,
More informationPancreas. Atrophy, acinar cell. Pathogenesis: Diagnostic key features:
Pancreas Atrophy, acinar cell Pathogenesis: Decrease in number and/or size of acinar cells may be due to spontaneous or experimentally induced degenerative changes, apoptosis, or a sequel of chronic inflammation.
More informationHistopathologic spectrum of salivary gland neoplasms
Original article Histopathologic spectrum of salivary gland neoplasms Dr. Dipkana Das 1, Dr.Subhasish Saha 1, Dr V Satyanarayana 2 Name & Address of Institution: Department of Pathology, Kamineni Institute
More informationSESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, :30am - 11:30am FACULTY COPY
SESSION 1: GENERAL (BASIC) PATHOLOGY CONCEPTS Thursday, October 16, 2008 9:30am - 11:30am FACULTY COPY GOAL: Describe the basic morphologic (structural) changes which occur in various pathologic conditions.
More information2007 June Cheng-Chung Lin Prof. in Oral Pathology Kaohsiung Med University
Salivary Gland Pathology 2007 June Cheng-Chung Lin Prof. in Oral Pathology Kaohsiung Med University E-mail: cclin99@hotmail.com Histological Classification of Salivary Gland Tumors (WHO) 1. Adenomas 2.13.
More information2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD
2018 Oregon Dental Conference Course Handout Denis Lynch, DDS, PhD Course 9120: Spit Happens (and Sometimes it Doesn t): The Diagnosis and Treatment of Salivary Gland Disease Thursday, April 5 9 am - 12
More informationBREAST PATHOLOGY. Fibrocystic Changes
BREAST PATHOLOGY Lesions of the breast are very common, and they present as palpable, sometimes painful, nodules or masses. Most of these lesions are benign. Breast cancer is the 2 nd most common cause
More informationSalivary gland cytology. Salivary gland cytology. Triage helps the clinician. Salivary gland tumors. Diagnostic difficulties
Salivary gland cytology Salivary Gland Cytology Pınar Fırat, MD Professor of Pathology İ.U. İstanbul Faculty of Medicine Çapa, İstanbul It is a reliable diagnostic test However, definitive subclassification
More informationBreast pathology. 2nd Department of Pathology Semmelweis University
Breast pathology 2nd Department of Pathology Semmelweis University Breast pathology - Summary - Benign lesions - Acute mastitis - Plasma cell mastitis / duct ectasia - Fat necrosis - Fibrocystic change/
More informationReview of the AP Part II Practical Examination. Dr David Clift Co Chief Examiner
Review of the AP Part II Practical Examination Dr David Clift Co Chief Examiner General Remarks The part II practical examination involved 15 cases which were presented with sufficient clinical data to
More informationSalivary gland neoplasms: an update 29th Annual Meeting of Arab Division of the International Academy of Pathology MUSCAT, OMAN 2017
Salivary gland neoplasms: an update 29th Annual Meeting of Arab Division of the International Academy of Pathology MUSCAT, OMAN 2017 Dr Mary Toner Consultant Pathologist St James Hospital Trinity College
More informationAn Integrated Cytologic and Histologic Approach to the Diagnosis of Salivary Gland Tumors
An Integrated Cytologic and Histologic Approach to the Diagnosis of Salivary Gland Tumors W.C. Faquin, M.D., Ph.D. Massachusetts General Hospital Massachusetts Eye and Ear Infirmary Boston, MA An Integrated
More informationPapillary Lesions of the breast
Papillary Lesions of the breast Emad Rakha Professor of Breast Pathology The University of Nottingham Papillary lesions of the breast are a heterogeneous group of disease, which are characterised by neoplastic
More informationCase Report An IgG4-Related Salivary Gland Disorder: A Case Series Presenting with a Different Clinical Setting
Case Reports in Immunology Volume 2011, Article ID 236079, 4 pages doi:10.1155/2011/236079 Case Report An IgG4-Related Salivary Gland Disorder: A Case Series Presenting with a Different Clinical Setting
More informationNeoplasias Quisticas del Páncreas
SEAP -Aproximación Práctica a la Patología Gastrointestinal- Madrid, 26 de mayo, 2006 Neoplasias Quisticas del Páncreas Gregory Y. Lauwers, M.D. Director, Service Massachusetts General Hospital Harvard
More informationGross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of
Tiền liệt tuyến Tiền liệt tuyến Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas.
More information2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow, Necrotic Mass with a Pseudocapsule
GENITOURINARY PATHOLOGY Kathleen M. O Toole, M.D. Renal Cell Carcinoma 2 to 3% of All New Visceral Cancers Peak Incidence is 6th Decade M:F = 2:1 Grossly is a Bright Yellow Necrotic Mass Grossly is a Bright
More information(CYLINDROMA) ATLAS OF HEAD AND NECK PATHOLOGY ADENOID CYSTIC CARCINOMA
(CYLINDROMA) This malignant tumor is poorly encapsulated and while seemingly well defined within the affected gland, there is usually infiltration of surrounding tissue on closer examination. The cut surface
More information4/17/2015. Case 1. A 37 year old man with a 2.2 cm solitary left thyroid mass.
Case 1 A 37 year old man with a 2.2 cm solitary left thyroid mass. Case 1 Case 1 1 Case 1: Diagnosis? A. Benign B. Atypia of undetermined significance/follicular lesion of undetermined significance C.
More informationdoi: /j.anl
doi: 10.1016/j.anl.2006.07.001 Synchronous unilateral parotid gland neoplasms of three different histological types Shuho Tanaka 1, Keiji Tabuchi 1, Keiko Oikawa 1, Rika Kohanawa 1, Hideki Okubo 1, Dai
More informationBreast Pathology. Breast Development
Breast Pathology Lecturer: Hanina Hibshoosh, M.D. Reading: Kumar, Cotran, Robbins, Basic Pathology, 6th Edition, pages 623-635 Breast Development 5th week - thickening of the epidermis - milk line 5th
More informationFine-needle aspiration (FNA) has been used increasingly
Worrisome Histologic Alterations Following Fine-Needle Aspiration of Benign Parotid Lesions Shiyong Li, MD, PhD; Zubair W. Baloch, MD, PhD; John E. Tomaszewski, MD; Virginia A. LiVolsi, MD Objective. To
More informationCytomorphological study of major salivary gland lesions: a 5-year experience at a tertiary care center
Original article Cytomorphological study of major salivary gland lesions: a 5year experience at a tertiary care center Aruna S, Prathiksha Pai, Shreekant K. Kittur Department of Pathology, Belagavi Institute
More informationAnatomy of the biliary tract
Harvard-MIT Division of Health Sciences and Technology HST.121: Gastroenterology, Fall 2005 Instructors: Dr. Jonathan Glickman Anatomy of the biliary tract Figure removed due to copyright reasons. Biliary
More informationPolymorphous Low-Grade. December 5 th, 2008
Polymorphous Low-Grade Adenocarcinoma December 5 th, 2008 Epidemiology Represents 2 nd or 3 rd most common minor salivary gland malignancy (17-26%) 1 st mucoepidermoid carcinoma Rare in reported Asian
More informationImaging Technique. Ultrasound Imaging of the Salivary Glands. Parotid Gland. The Major Salivary Glands. Parotid Gland: Stenson s Duct.
Ultrasound Imaging of the Salivary Glands Edward G. Grant MD Professor & Chairman, Dept of Radiology USC Keck School of Medicine edgrant@usc.edu edgrant@usc.edu Imaging Technique Linear array transducer
More informationSee the latest estimates for new cases of salivary gland cancers in the US and what research is currently being done.
About Salivary Gland Cancer Overview and Types If you have been diagnosed with salivary gland cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to
More informationLYMPHATIC DRAINAGE AXILLARY (MOSTLY) INTERNAL MAMMARY SUPRACLAVICULAR
BREAST LYMPHATIC DRAINAGE AXILLARY (MOSTLY) INTERNAL MAMMARY SUPRACLAVICULAR HISTOLOGY LOBE: (10 in whole breast) LOBULE: (many per lobe) ACINUS/I, aka ALVEOLUS/I: (many per lobule) DUCT(S): INTRA- or
More informationOncocytic carcinoma: A rare malignancy of the parotid gland
ISPUB.COM The Internet Journal of Pathology Volume 8 Number 2 Oncocytic carcinoma: A rare malignancy of the parotid gland K Mardi, J Sharma Citation K Mardi, J Sharma.. The Internet Journal of Pathology.
More informationINFECTION. HIV Infection DWI
HIV Infection INFECTION DWI Fig Axial CT and MRI images show multiple enlarged lymph nodes in the neck as well as in the parotid gland bilaterally. These nodes were suppurative with positive diffusion.
More information04/10/2018. Intraductal Papillary Neoplasms Of Breast INTRADUCTAL PAPILLOMA
Intraductal Papillary Neoplasms Of Breast Savitri Krishnamurthy MD Professor of Pathology Deputy Division Head The University of Texas MD Anderson Cancer Center 25 th Annual Seminar in Pathology Pittsburgh,
More informationSalivary ultrasound. Dr T J Beale Royal National Throat Nose & Ear and UCLH Hospitals London UK
Salivary ultrasound Dr T J Beale Royal National Throat Nose & Ear and UCLH Hospitals London UK Two main groups of patients with presenting symptoms of: Obstructive or chronic inflammatory symptoms (salivary
More informationPapillary Lesions of the Breast A Practical Approach to Diagnosis. (Arch Pathol Lab Med. 2016;140: ; doi: /arpa.
Papillary Lesions of the Breast A Practical Approach to Diagnosis (Arch Pathol Lab Med. 2016;140:1052 1059; doi: 10.5858/arpa.2016-0219-RA) Papillary lesions of the breast Span the spectrum of benign,
More informationNon Small Cell Lung Cancer Histopathology ד"ר יהודית זנדבנק
Non Small Cell Lung Cancer Histopathology ד"ר יהודית זנדבנק 26.06.09 Lecture outlines WHO histological classification Macro/Micro assessment Early diagnosis Minimal pathology Main subtypes SCC, AdCa, LCLC
More informationCLINICAL SIGNIFICANCE OF BENIGN EPITHELIAL CHANGES
Papillomas. Papillomas are composed of multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells ( Fig. 23-11 ). Growth occurs within a dilated
More informationCarcinoma of Unknown Primary site (CUP) in HEAD & NECK SURGERY
Carcinoma of Unknown Primary site (CUP) in HEAD & NECK SURGERY SEARCHING FOR THE PRIMARY? P r o f J P P r e t o r i u s H e a d : C l i n i c a l U n i t C r i t i c a l C a r e U n i v e r s i t y O f
More informationRare Breast Tumours. 1. Breast Tumours. 1.1 General Results. 1.2 Incidence
Rare Breast Tumours 1. Breast Tumours 1.1 General Results Table 1. Epithelial Tumours of Breast: Incidence, Trends, Survival Flemish Region 2001-2010 Incidence Trend Survival Females EAPC Relative survival
More informationSelect problems in cystic pancreatic lesions
Disclosure Select problems in cystic pancreatic lesions Five Prime Therapeutics shareholder Adicet Bio shareholder Bristol-Meyer Squibb advisory board grace.kim@ucsf.edu Pancreatic cystic lesions Intraductal
More informationUltrasound Interpretation of Non-Thyroid Neck Pathology
Ultrasound Interpretation of Non-Thyroid Neck Pathology Kevin T. Brumund, M.D., F.A.C.S. Associate Professor of Surgery Head and Neck Surgery University of California, San Diego Health Sciences VA Medical
More informationSlide seminar. Asist. Prof. Jože Pižem, MD, PhD Institute of Pathology Medical Faculty, University of Ljubljana
Slide seminar Asist. Prof. Jože Pižem, MD, PhD Institute of Pathology Medical Faculty, University of Ljubljana Case 5 A 57-year-old man with a dermal/subcutaneous lesion on the scalp, which was interpreted
More informationSlide Seminar of the Head and Neck Session of the European Congress of Pathology Bilbao, Spain, 2018.
Slide Seminar of the Head and Neck Session of the European Congress of Pathology Bilbao, Spain, 2018. Prof Sulen Sarioglu, MD Dokuz Eylul University Faculty of Medicine Department of Pathology Graduate
More informationZubair W. Baloch, MD, PhD: Consultant for Veracyyte, INC Tarik M. Elsheikh, MD: Nothing to disclose
Cytology Works shop #8 Zubair W. Baloch, MD, PhD: Consultantt for Veracyte, INC Tarik M. Elsheik kh, MD: Nothing to disclose Controversies and Diagnostic Challenges in Head and Neck Cytopathology Zubair
More informationProblem diagnoses. Current issues in Anatomic pathology. Problem Diagnoses in Tumors of the Oral Cavity 5/29/2009
Current issues in Anatomic pathology Problem Diagnoses in Tumors of the Oral Cavity Richard Jordan DDS PhD FRCPath Professor of Oral Pathology & Pathology Director, UCSF Oral Pathology Diagnostic Laboratory
More informationGastrointestinal pathology 1. Upper GI tract
Gastrointestinal pathology 1. Upper GI tract Tumors of The Salivary Glands Benign Malignant Pleomorphic adenoma (50%) Mucoepidermoid cc (15%) Warthin tumor (5%) Adenocarcinoma NOS (6%) Oncocytoma (2%)
More informationSalivary Glands. The glands are found in and around your mouth and throat. We call the major
Salivary Glands Where Are Your Salivary Glands? The glands are found in and around your mouth and throat. We call the major salivary glands the parotid, submandibular, and sublingual glands. They all secrete
More informationBen Witt, MD University of Utah/ARUP Laboratories Assistant Professor of Anatomic Pathology
Ben Witt, MD University of Utah/ARUP Laboratories Assistant Professor of Anatomic Pathology Review some of the more common cytodiagnoses of the Head and Neck Establish an approach to some of the diagnostic
More information4Ps LUMPS AND BUMPS B.L.&T. BUMPS, LUMPS, AND TATTOOS. Most Common BUMP in the oral cavity Fibroma INTERDENTAL PAPILLAE LESIONS
B.L.&T. BUMPS, LUMPS, AND TATTOOS LUMPS AND BUMPS DIFFERENTIAL DIAGNOSIS FOR LUMPS AND BUMPS Traumatic Fibroma Papilloma Epulis Fissuratum Inflammatory Papillary Hyperplasia Lesions of Attached Gingiva
More informationEQA Circulation 43 Educational Cases
EQA Circulation 43 Educational Cases E1-E2 Monica Agarwal Monklands Hospital E1 38 yrs male Submandibular gland tumour E1 Formal excision following diagnosis of poorly differentiated carcinoma on core
More informationBasal cell carcinoma 5/28/2011
Goal of this Presentation A practical approach to the diagnosis of cutaneous carcinomas and their mimics Thaddeus Mully, MD University of California San Francisco To review common non-melanoma skin cancers
More information!! 2 to 3% of All New Visceral Cancers.!! Peak Incidence is 6th Decade!! M:F = 2:1
!! Kathleen M. O Toole, M.D.!! 2 to 3% of All New Visceral Cancers!! Peak Incidence is 6th Decade!! M:F = 2:1!! Grossly is a Bright Yellow, Necrotic Mass with a Pseudocapsule 1 !!Conventional RCC! Clear
More informationPSA. HMCK, p63, Racemase. HMCK, p63, Racemase
Case 1 67 year old male presented with gross hematuria H/o acute prostatitis & BPH Urethroscopy: small, polypoid growth with a broad base emanating from the left side of the verumontanum Serum PSA :7 ng/ml
More informationNormal endometrium: A, proliferative. B, secretory.
Normal endometrium: A, proliferative. B, secretory. Nội mạc tử cung Nội mạc tử cung Cyclic changes in endometrium.. Approximate relationship of useful microscopic changes. Arias-Stella reaction in endometrial
More informationPathology of Selected Head and Neck Lesions. Adel Assaad MD Department of Pathology
Pathology of Selected Head and Neck Lesions Adel Assaad MD Department of Pathology 1 NOSE Infections 2 Zygomycosis (Mucormycosis) Opportunistic infection caused by "bread mold fungi," including Rhizopus,
More informationPancreatitis: A Potential Pitfall in Endoscopic Ultrasound Guided Pancreatic FNA
Pancreatitis: A Potential Pitfall in Endoscopic Ultrasound Guided Pancreatic FNA Jack Yang, MD Department of Pathology, Medical University of South Carolina Objectives Understand the indication of EUS
More informationBiliary tract tumors
Short Course 2010 Annual Fall Meeting of the Korean Society for Pathologists Biliary tract tumors Joon Hyuk Choi, M.D., Ph.D. Professor, Department of Pathology, Yeungnam Univ. College of Medicine, Daegu,
More informationChapter 10: Salivary Gland Disorders. Raymond P. Wood. History
Chapter 10: Salivary Gland Disorders Raymond P. Wood Dysfunction of the salivary glands is usually manifested in one of two ways: swelling of the gland, either diffuse or discrete, or by dry mouth (xerostomia).
More informationNormal thyroid tissue
Thyroid Pathology Overview Normal thyroid tissue Normal thyroid tissue with follicles filled with colloid. Thyroid cells form follicles, spheres of epithelial cells (always single layered in health, usually
More informationReview and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors
Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors. Monophasic tumors : myoepithelioma, acinic cell carcinoma, and salivary duct carcinoma. Biphasic tumors includes
More informationACCME/Disclosures. Cribriform Lesions of the Prostate. Case
Cribriform Lesions of the Prostate Ming Zhou, MD, PhD Departments of Pathology and Urology New York University Langone Medical Center New York, NY Ming.Zhou@NYUMC.ORG ACCME/Disclosures The USCAP requires
More informationWorkshop 2. Controversies and Diagnostic Challenges in Head and Neck Cytopathology. Zubair Baloch, MD,PhD. Veracyte, Inc: Consultant
Workshop 2 Controversies and Diagnostic Challenges in Head and Neck Cytopathology Zubair Baloch, MD,PhD Veracyte, Inc: Consultant Tarik Elsheikh, MD There are no disclosures necessary. Controversies and
More informationMicrocystic Squamous Cell Carcinoma of the Lung A Clinicopathologic Study of Three Cases
Anatomic Pathology / Microcystic SCC of the Lung Microcystic Squamous Cell Carcinoma of the Lung A Clinicopathologic Study of Three Cases Annikka Weissferdt, MD, and Cesar A. Moran, MD Key Words: Squamous
More informationBasement membrane in lobule.
Bahram Memar, MD Basement membrane in lobule. Normal lobule-luteal phase Normal lobule-follicular phase Lactating breast Greater than 95% are adenocarcinomas in situ carcinomas and invasive carcinomas.
More informationthe urinary system pathology Dr. Fairoz A Eltorgman
the urinary system pathology Dr. Fairoz A Eltorgman Tumors of the renal pelvis & kidney Benign tumors of the renal pelvis: Hemangioma Leiomyoma Malignant tumors: Transitional cell carcinoma Squamous cell
More informationHistopathological Study of Lacrimal Gland Tumors
ORIGINAL ARTICLE Pratikkumar B. Desai 1, Ami Shah 2 1 4 th Year Resident, Pathology Department, B.J.Medical College, Civil Hospital, Ahmedabad 2 Associate Professor, M. J. Institute of Ophthalmology, Civil
More informationCutaneous Adnexal Tumors
Cutaneous Adnexal Tumors Lesions with Predominant Follicular Differentiation Special Emphasis on Basal Cell Carcinoma 2014-04-01 Prof. Dr. med. Katharina Glatz Pathologie Cutaneous Adnexal Tumors Hair
More informationLesion Imaging Characteristics Mass, Favoring Benign Circumscribed Margins Intramammary Lymph Node
Lesion Imaging Characteristics Mass, Favoring Benign Circumscribed Margins Intramammary Lymph Node Oil Cyst Mass, Intermediate Concern Microlobulated Margins Obscured Margins Mass, Favoring Malignant Indistinct
More informationAbid Irshad, MD Director Breast Imaging. Medical University of South Carolina Charleston
Abid Irshad, MD Director Breast Imaging Medical University of South Carolina Charleston Cases Financial disclosure: I or my family have no financial interest related to the material discussed in this presentation
More informationBenign, Reactive and Inflammatory Lesions of the Breast
Benign, Reactive and Inflammatory Lesions of the Breast Marilin Rosa, MD Associate Member Section Head of Breast Pathology Department of Anatomic Pathology Program Director, Breast Pathology Fellowship
More informationXX. Tumours of the nasal cavity *
XX. Tumours of the nasal cavity * H. STONZI 1 & B. HAUSER2 Tumours of the nasal cavity are rare in domestic animals, most cases occurring in the dog. Epithelial tumours are the most common type in carnivores
More informationPleomorphic adenoma of breast - a case report and distinction with metaplastic carcinoma D Gupta, S Agrawal, N Trivedi, A Tewari
of breast - a case report and distinction with metaplastic carcinoma D Gupta, S Agrawal, N Trivedi, A Tewari Introduction, also known as mixed tumour, is a benign tumour which typically presents as a painless,
More informationUniversity Journal of Pre and Para Clinical Sciences
ISSN 2455 2879 Volume 2 Issue 1 2016 Metaplastic carcinoma breast a rare case report Abstract : Metaplastic carcinoma of the breast is a rare malignancy with two distinct cell lines described as a breast
More informationCase year female. Routine Pap smear
Case 1 57 year female Routine Pap smear Diagnosis? 1. Atypical glandular cells of unknown significance (AGUS) 2. Endocervical AIS 3. Endocervical adenocarcinoma 4. Endometrial adenocarcinoma 5. Adenocarcinoma
More information