Salivary Glands

1. List the tumours of salivary glands.

a. Benign epithelial neoplasm
● Pleomorphic adenoma
● Monomorphic adenomas
● Warthin's tumour

b. Malignant epithelial neoplasms

● Mucoepidermoid carcinoma
● Adenoid cystic carcinoma

2. Describe the clinicopathological features of

a. Pleomorphic adenoma
● Commonest tumour that involve parotid gland
● Origin is epithelial and myoepithelial cells
● Also called mixed tumor because have mixture of stromal
and epithelial elements

● Clinical features:
○ Slow growing tumour
○ Has risk of recurrence
○ Rarely has high risk of malignant transformation with
long term

● Complication: Bell's palsy

● Gross appearance:
○ Circumscribed, capsulated
○ Grey white to bluish
○ Soft, mucoid semi translucent

● Microscopy:
○ Mixture of epithelial and myoepithelial
○ Epithelial: duct like structures
○ Myoepithelial: myxoid, hyaline, chondroid stroma
b. Warthin tumour
● Also called as adenolymphoma
● Common site: parotid gland

● Microscopy:
○ Tall columnar epithelial cells line convoluted cystic
spaces separated by a dense lymphoid stroma

c. Mucoepidermoid carcinoma
● Most common malignant neoplasm in glands
● Common site: parotid gland
● Tumour cells derived from ductal epithelial cells
● Tumour cells are mucus secreting,epidermoid(squamous
like), clear or intermediate cells
● Characterised by t(11;19)(q14-21;p12-13) translocation
that generates fusion protein MECT1-MAML2

d. Adenoid cystic carcinoma

● Formerly known as cylindroma
● Slow growing but aggressive malignancy and more
common in minor salivary glands
● Composed of epithelial cells arranged in islands showing
microcystic change
● Has perineural spread and difficult to eradicate surgically