salivary glands

Pathology of the oral cavity, pharynx,
salivary glands and esophagus
Attila Zalatnai
MALFORMATIONS
Cleft lip
Cheilognathopalatoschisis
Cleft palate
INFLAMMATIONS
Stomatitis
Labial herpes (HSV-1)
Candidiasis (oral thrush)
Follicular tonsillitis
Pemphigus
Ulcerative/necrotizing
gingivitis
INFLAMMATIONS
Stomatitis
Labial herpes (HSV-1)
Candidiasis (oral thrush)
Follicular tonsillitis
Pemphigus
Ulcerative/necrotizing
gingivitis
Hairy leukoplakia (EBV)
Ulcerative gingivitis
NEOPLASMS
Benign: squamous cell papilloma
Malignant: squamous cell carcinoma
Premalignant: leukoplakia
Normal
Mild dysplasia
Intermediate dysplasia
Severe dysplasia / CIS
(European Cancer Observatory)
Cigarette smoke:
Category 1 (carcinogenic to humans)
sufficient evidence of carcinogenicity
in humans
Over 4700 chemicals
(60 carcinogens, >20 promoters)
Tar
Polyclic aromatic hydrocarbons (PAH)
Benz(a)pyrene
Dimethyl-benzanthracene
Benzo(b,j)fluorantrene
5-methylchrysene
3-methylcholantrene
NNK (nicotine-derived nitrosamine keton)
Nitrosamines (DEN, DMN…)
Aromatic amines
Metals (chromium, cadmium, nickel subsulfid, arsenic)
Relative risk of oropharyngeal cancer in males by alcohol/tobacco
consumption using US measures
(alcohol: a good solvent for absorption of carcinogens + adducts)
HPV (16, 18)
– identified in more than 50 % in oropharyngeal cancers
– 25-30% of mouth and throat cancers are caused by it
– 5-year survival is much better than the virus-negative cases
(80% vs. 60%)
(Hungary: 40%)
distinct entity
SALIVARY GLANDS - INFLAMMATIONS
Sialoadenitis
- purulent
- non-suppurative (mumps, CMV)
- autoimmune (Sjögren-syndrome,
benign lymphoepithelial lesion)
SALIVARY GLANDS - TUMORS
Benign
Malignant
Pleiomorphic adenoma (mixed tumor)
Mucoepidermoid carcinoma
Warthin-tumor
Adenoid cystic carcinoma
Onkocytoma
Acinic cell carcinoma
Monomorphic adenomas
Adenocarcinoma (from pleiomorphic
adenoma)
B-cell non-Hodgkin lymphomas
Pleiomorphic adenoma
Pleiomorphic adenoma
Pleiomorphic adenoma
Warthin tumor
Onkocytoma
Mucoepidermoid carcinoma
Adenoid cystic carcinoma
ESOPHAGUS
Malformations:
Tracheo-esophageal fistule
Diverticula:
- pharyngo-esophageal
(Zenker)
- traction
- epiphrenic
ESOPHAGITIS
1. Reflux esophagitis (gastric juice)
 Stricture
 Leukoplakia
 Barrett-esophagus  adenocarcinoma
2. Infective esophagitis (Candidiasis)
3. Chemical (corrosive)
ESOPHAGEAL BLEEDING
Portal hypertension - esophageal varices – rupture – hematemesis/melena
Mallory-Weiss syndrome
ESOPHAGEAL CANCER
Etiology:
Smoking + alcohol; reflux
Histology:
Squamous cell carcinoma
Adenocarcinoma (w/Barrett)
Complications:
Mechanical obstruction (cachexia)
Tracheo-esophageal fistule
Ichorous mediastinitis