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Benign Salivary Gland Tumors

Pleomorphic adenoma is a benign mixed salivary gland tumor, primarily affecting the parotid gland, with a higher incidence in females and individuals aged 30-50. It exhibits a biphasic structure of epithelial and mesenchymal cells, characterized by a firm, circumscribed mass with a variegated cut surface. Warthin's tumor, the second most common benign tumor, is associated with smokers and features a mixed ductal and lymphoid stroma with a double-layered epithelium.

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17 views16 pages

Benign Salivary Gland Tumors

Pleomorphic adenoma is a benign mixed salivary gland tumor, primarily affecting the parotid gland, with a higher incidence in females and individuals aged 30-50. It exhibits a biphasic structure of epithelial and mesenchymal cells, characterized by a firm, circumscribed mass with a variegated cut surface. Warthin's tumor, the second most common benign tumor, is associated with smokers and features a mixed ductal and lymphoid stroma with a double-layered epithelium.

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raihan.n0678
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PLEOMORPHIC ADENOMA

WARTHIN S TUMOUR
PLEOMORPHIC ADENOMA
• Benign tumor of salivary gland.

• Also known as mixed salivary gland tumor.

• Parotid gland - most commonly affected salivary gland.

• Female > male

• Occurs mostly in 3rd to 5th decades of life

• Common location - below and infront of ear.


PLEOMORPHIC ADENOMA Cont ..
• GROSS FEATURES
Outer surface:-
Circumscribed
Pseudoencapsulated
Rounded,at times multilobulated
Firm mass
2-5 cm in diameter
Bosselated surface.
Cut surface :-
Grey-white or bluish
Variegated
Semitranslucent
Solid with small cystic spaces
Soft and mucoid.
PLEOMORPHIC ADENOMA Cont…

• MICROSCOPIC FEATURES

• Has a mixed feature in which has epithelial elements in stromal matrix.

Epithelial elements :-

• Ductal cells - cuboidal or columnar.


• Myoepithelial cells - polygonal or spindle-shaped resembling smooth muscle
cells
• Ductal or myoepithelial origin -patterns like ducts, acini, tubules, sheets and
strands .
• Lumina of duct-like structures may contain PAS-positive epithelial mucin.
• Focal areas of squamous metaplasia and keratinisation may be present.
PLEOMORPHIC ADENOMA Cont ..

Stromal matrix:-

• loose connective tissue.

• Has myxoid, mucoid and chondroid matrix, which simulates


cartilage(pseudocartilage & true cartilage and even bone).

• The epithelial and mesenchymal(Stromal) elements are intermixed.

• Either of the two components may be dominant in any tumour.


PLEOMORHIC ADENOMA
Biphasic population of
epithelial cells and
mesenchymal cells;
Ducts with luminal and
Myoepithelial cells
PLEOMORPHIC ADENOMA
Warthins tumor
• Papillary Cystadenoma Lymphomatosum or Adenolymphoma
• 2nd most common benign tumor..
• Pathogenesis is uncertain.
• Believed to arise from heterotrophic salivary gland tissue found within the
parotid lymph nodes.
• Proliferation of salivary gland ductal epithelium that is associated with
secondary formation of lymohoid tissue.
• Risk factor - Smokers have (8 fold greater risk)
-EBV
- EBV
Warthin s tumor
• GROSS PATHOLOGY

Outer surface - Encapsulated.

- Smooth/lobulated surface.

Cut surface - Cystic spaces of variable size, with turbid fluid, caseous debris,

& tenaceous mucoid material with shaggy epithelium.

- Solid areas with white nodules representing lymphoid follicles.


Warthins
tumor
Warthin s tumor
• MICROCSOPY

• Mixed ductal with lymphoid stroma.

• Epithelium- Double cell layer ( Oncocytic in nature.)

Luminal cells = tall columnar, centrally placed, palisaded

Basal cells = cuboidal, with more vesicular nuclei.

• Lining epithelium demonstrates papillary projections into cystic spaces surrounded by


lymphoid stroma…

• Stroma: mature lymphoid follicles with germinal centers

• Focal areas of metaplsia may be seen.


Warthims
tumor
Warthin’s tumor
showing papillary
cystic tumor with dense
lymphoid
stroma
THANK YOU….

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