SALIVARY GLANDS Major: Ducts: Parotid 14 gm Submaxillary 7-8gm Sublingual 3gm Stensens (parotid) Whartins (submaxillary) Bartholins (sublingual)

al) OXYPHILIC ADENOMA Oncocytoma Benign; composed exclusively of oncocytic cells Due to radiation exposure Gross: brownish/yellowish consistency secondary to oxyphilic cells Cells clusters/sheets; cytoplasm deeply eosinophilic; chromatin component: compact Encapsulated; benign-looking WHARTINS TUMOR Cystadenoma lymphomatosum papilleferum (papilliferum?) M>F 70% bilateral Lobulated mass, may be fixed to the overlying skin and simulate malignancy Overlying skin: erythematous Papillary projections Biphasic tumor Oncocytic cells with lymphoid elements in stroma forming germinal centers Columnar cells with deeply eosinophilic cytoplasm Lymphocytes BASAL CELL ADENOMA Adult, F Tumors are encapsulated, sometimes cystic Picket fence appearance of cells; basaloid MUCOEPIDERMOID CARCINOMA Most common malignant salivary gland tumor in kids 4 cells: mucin-producing, squamous, intermediate, clear - Low-, intermediate-, high-grade Based on squamoid cells 98% survival for low-grade 56% survival for high-grade Grading: intracystic, neural invasion, necrosis, >4 mitoses/10hpf, anaplasia ACINIC CELL CARCINOMA Most common tumor in patients M>F Encapsulated round mass Solid, friable, grayish white Sheets of acinar cells FNAB not very sensitive; cells look benign; better to do excision ADENOID CYSTIC CARCINOMA Slowly growing, highly malignant Most common malignant tumor in minor salivary glands Growth patterns: cribriform, tubular, solid Excision Cells look very bland

Exocrine glands with ductal and acinar portion Parotid: serous Submaxillary: mixed (predominantly serous) Sublingual: mixed (predominantly mucinous) SIALOLITHIASIS Calculi More common in submaxillary gland - Crystalline compound carbonate apatite Consequences: obstruction and inflammation SIALADENITIS Acute: viruses (paramyxovirus, ) Acute suppurative o S. aureus, Strep sp., gram negative bacteria o PMNs Predisposing factors: dehydration, malnutrition, immunosuppression, sialolithiasis BENIGN MIXED TUMOR A.k.a. pleomorphic adenoma Most common neoplasm F>M 10x more common in parotid tail Well-circumscribed, solid on cut section, slippery Has a capsule; hemorrhagic area secondary to enlargement (pressure necrosis) Not painful; movable - Biphasic tumor: stromal elements, epithelial elements, chondromyxoid background bluish; hyaluronic acid component Can become malignant mixed tumor o 5-10% of BMT o Carcinoma expleomorphic adenoma o Long-standing tumor with sudden pain and facial paralysis Recurrence most likely is malignant SSx due to nerve compression/invasion of the nerve