3. Pleomorphic Adenoma
Benign Tumor
Represent 60% of tumors in parotid –
Most common tumor of major salivary glands.
Mixed Tumor – Derived from a mixture of Ductal
[ epithelial] and myoepithelial cells, showing
epithelial and mesenchymal differentiation.
Radiation – A risk factor!!
6. Pleomorphic Adenoma -
Histology
HETEROGENEITY
Epithelial cells resembling ductal cells or
myoepithelial cells arranged as ducts,
acini , tubules, strands, sheets…
Dispersed within mesenchyme – loose
myxoid tissue of chondroid, foci of bone.
There is no epithelial dysplasia/ mitotic
activity.
7.
8. Carcinoma Ex Pleomorphic
Adenoma
Malignant mixed tumor
Incidence of malignant transformation increases with
duration of tumor.
Adenocarcinoma / Undifferentiated carcinoma
Overgrows preexisting pleomorphic adenoma.
Diagnosis- traces of pleomorphic adenoma must be
there.
Most aggressive of all salivary gland neoplasms!!!!!
10. Warthin’s Tumour
Second most common salivary gland
neoplasm.
Benign tumour
Only tumour virtually restricted to parotid.
More common in males
Smoking - A risk factor!!
10% multifocal , 10% Bilateral.
11. Warthin’s Tumour - Gross
Round to Oval
Encapsulated
Mostly arises in superficial parotid
Cut section – Pale grey surface
punctuated by cystic spaces filled with
mucinous/ serous secretions.
12.
13. Warthin’s Tumour -
Histology
Cystic spaces lined by double layer of
neoplastic epithelial cells –
surface palisade by oncocytic columnar
cells resting on a layer of cuboidal cells
these layers rest on a dense lymphoid
stroma
Papillary projections of lymphoepithelial
elements into the cystic spaces
Papillary Cystadenoma Lymphamatosum
14.
15.
16. Mucoepidermoid Carcinoma
Malignant tumor
Most common form of primary malignant
tumour of salivary glands.
Variable mixtures of squamous cells,
mucus secreting cells, intermediate
cells.
Divided into Low , intermediate and high
grade tumors.
Radiation – A Risk factor !!
17. Mucoepidermoid Carcinoma - Gross
• Grow up to 8cms
• Though apparently
circumscribed, lack well
defined margins
• On cut section.
- Pale and grey white
- Small mucin
containing cysts.
20. Adenoid cystic carcinoma
•Relatively Uncommon tumor
•Most common tumor of
minor salivary glands
•Gross – poorly encapsulated
, grayish pink on cut section.
•Histology – small cells with
dark compact nuclei arranged
in tubular, solid , cribriform
pattern.
21. Adenoid cystic carcinoma
Tendency to invade perineural spaces!!
Stubbornly recurrent!!
>50% disseminate to bone, liver ,brain
22. Acinic cell Carcinoma
Relatively uncommon
Mostly arise in parotids
Sometimes bilateral and multicentric.
Gross – small discrete lesions, appears
encapsulated.
Histology – cells resemble normal serous
acinar cells of salivary gland, clear
cytoplasm arranged in solid , microcystic ,
papillary cystic patterns etc..
24. Non Hodgkin’s Lymphoma
uncommon tumor
most often occurs in the parotid gland (70%) and
belongs to MALT type
Lymphoid proliferation of salivary gland
REACTIVE MALIGNANT
Lymphoepithelial sialadenitis of NHL-MALT type cases derived from
Sjogren Syndrome lymphoepithelial sialadenitis
25.
26. Squamous cell carcinoma
• True salivary gland primaries of squamous cell
carcinoma are very rare
• Most tumors of parotid gland are metastases to
intraparotid lymph nodes from primaries in oral
cavity, upper aerodigestive tract or skin
• May represent malignant component of malignant
mixed tumor or high grade mucoepidermoid
carcinoma
• Rapid growth with infiltration of surrounding
structures, regardless of origin
27.
28. To conclude…..
Most common tumour
1. Of major salivary glands?? Pleomorphic Adenoma
2. Of minor salivary glands?? Adenoid Cystic Ca
3. Malignant tumour of salivary glands.?? Mucoepidermoid
Salivary gland tumour
1. with strong predilection to invade nerves??
Adenoid Cystic Ca
2. associated with smoking?? Warthin’s tumor
3. with double layer of epithelial cells and
lymphoid stroma?? Warthin’s tumor