pathology Salivary Glands

malignant tumors tend to grow more rapidly, infiltrate superficial and deep tissues and thus be fixed, and invade nerves producing pain and parasthesias

composed of parenchymal cells, basophilic granular cytoplasm, secrete things like amylase

mucinous

mixed- mucinous and granular basophilic

exocrine

parotid glands- vast majority are benign.

most common benign tumor of salivary gland parotid and submandibular.
Solid tumors with smooth edges and abundant myxoid EC material

AKA benign mixed tumor usu parotid gland tumor, and usu bilateral and in elderly men. cavitary structure within which you have polypoid projections. on palpation they feel softer. two major cell types- epithelium-neoplastic and lymphocytes(non neoplastic) reactive

most common neoplastic salivary gland tumor. Squamous and adenocarcinoma.

second most common, more common in submandibular than salivary

Xerostomia & Keratoconjunctivitis Sicca (corneal damage) from immunologically – mediated damage to salivary & lacrimal glands
90% middle aged or older women
*Bilateral parotid enlargement (Mikulicz’s)
SS-A & SS-B; RF; ANAs
Periductal & perivascular lymphocytic (CD4) infiltrates
Degenerative & hyperplastic ductal changes
Acinar atrophy; fibrosis & fat

mid and distal esophagus mostly involved. White plaque on surface of mucosa. Presence of yeast orpseudohyphae. neutrophils, damage to epithelium etc

clusters of well dileniated shallow ulcers with raised borders, Huge nuclei. ground glass. multinucleated squamous cells.

pathology is nonspecific, PMNs and eosinophils. hyperplasia of basal cells

Acquired condition secondary to GERD
2 Components
Endoscopic: Columnar epithelium proximal to
GEJ (saccular/tubular) into tubular esophagus (proximal SCJ or Z-line)
Histologic: Intestinal metaplasia (goblet cells)
Glandular dysplasia & adenocarcinoma

Idiopathic immune-mediated disorder of children & adults
Possibly related to food or aeroallergens. Possible roles of interleukin-5 & eotaxin-3
Clinical: heartburn, vomiting, food rerusal, dysphagia, unresponsive to PPIs.
Pathology: >20 eosinophils/HPF in mucosa
Rx: Corticosteroids, specific food elimination

Squamous cell carcinoma accounts for 80-90% cases worldwide
Highest incidence in China & Iran
Epidemic of adenocarcinoma, especially in low prevalence areas
Prognosis
Stage & depth of invasion
Nodal metastases
Overall, 30% 5 year survival

Squamous cell carcinoma
Food & water rich in nitrates & nitrosamines, alcohol, tobacco, vitamin deficiencies, achalasia, Plummer-Vinson syndrome, erosive esophagitis with strictures, HPV, black men
Adenocarcinoma:
BE, white men

Indefinite/low grade & high grade based on architectural and cytologic features
Problem of inflammation
5 year risk of adenocarcinoma:
Negative 4%
Indefinite/LG 8-12%
High grade 50-60%

At initial dx of HGD, 50-66% have adenocarcinoma
Surveillance