TUMORS OF THE SALIVARY GLANDS

by

GARY L. ELLIS, D.D.S.
Armed Forces Institute of Pathology and
Department of Veteran Affairs Special Reference
Laboratory for Pathology, Washington, D.C.

PAUL L. AUCLAIR, D.M.D., M.S.
Captain, United States Navy, Dental Corps
Armed Forces Institute of Pathology
Washington, D.C.

Table of Contents 

1 The Normal Salivary Glands
   1.1 Development
   1.2 Gross Anatomy
   1.3 Histology
   1.4 Ultrastructure
   1.5 Immunohistochemistry
   1.6 Physiology
2 Classification
3 Salivary Gland Tumors: General Considerations
   3.1 Incidence
   3.2 Etiology
   3.3 Demographic and Clinical Features
   3.4 Site-Specific Tumor Differences
   3.5 Microscopic Grading
   3.6 Clinical Staging
   3.7 Diagnostic Imaging
4 Benign Epithelial Neoplasms
   4.1 Mixed Tumor (Pleomorphic Adenoma)
   4.2 Myoepithelioma
   4.3 Warthin's Tumor (Papillary Cystadenoma Lymphomatosum)
   4.4 Basal Cell Adenoma
   4.5 Canalicular Adenoma
   4.6 Oncocytoma
   4.7 Cystadenoma
   4.8 Ductal Papillomas
     4.8.1 Intraductal Papilloma
     4.8.2 Inverted Ductal Papilloma
     4.8.3 Sialadenoma Papilliferum
   4.9 Sebaceous Adenoma and Sebaceous Lymphadenoma
     4.9.1 Sebaceous Adenoma
     4.9.2 Sebaceous Lymphadenoma
   4.10 Sialoblastoma
5 Malignant Epithelial Tumors
   5.1 Mucoepidermoid Carcinoma
     5.1.1 Central Mucoepidermoid Carcinoma
   5.2 Adenocarcinoma, Not Otherwise Specified
   5.3 Acinic Cell Adenocarcinoma
   5.4 Adenoid Cystic Carcinoma
   5.5 Polymorphous Low-Grade Adenocarcinoma
   5.6 Malignant Mixed Tumors
     5.6.1 Carcinoma Ex Mixed Tumor (Carcinoma Ex Pleomorphic Adenoma)
     5.6.2 Carcinosarcoma
     5.6.3 Metastasizing Mixed Tumor
   5.7 Primary Squamous Cell Carcinoma
   5.8 Basal Cell Adenocarcinoma
   5.9 Epithelial-Myoepithelial Carcinoma
   5.10 Clear Cell Adenocarcinoma
   5.11 Cystadenocarcinoma
   5.12 Undifferentiated Carcinomas
     5.12.1 Small Cell Carcinoma
     5.12.2 Large Cell Undifferentiated Carcinoma
     5.12.3 Lymphoepithelial Carcinoma
   5.13 Oncocytic Carcinoma
   5.14 Salivary Duct Carcinoma
   5.15 Sebaceous Adenocarcinoma and Sebaceous Lymphadenocarcinoma
     5.15.1 Sebaceous Adenocarcinoma
     5.15.2 Sebaceous Lymphadenocarcinoma
   5.16 Myoepithelial Carcinoma
   5.17 Adenosquamous Carcinoma
   5.18 Mucinous Adenocarcinoma
6 Nonlymphoid Mesenchymal Neoplasms
   6.1 Benign Mesenchymal Tumors
     6.1.1 Hemangioma
     6.1.2 Lipoma
     6.1.3 Lymphangioma
   6.2 Malignant Mesenchymal Tumors
     6.2.1 Malignant Schwannoma
     6.2.2 Hemangiopericytoma
     6.2.3 Malignant Fibrous Histiocytoma
     6.2.4 Treatment and Prognosis of Mesenchymal Neoplasms
7 Malignant Lymphomas of the Major Salivary Glands
   7.1 Non-Hodgkin's Lymphoma
   7.2 Hodgkin's Disease
8 Secondary Tumors
9 Tumor-Like Conditions
   9.1 Benign Lymphoepithelial Lesion
   9.2 Necrotizing Sialometaplasia
   9.3 Chronic Sclerosing Sialadenitis
   9.4 Salivary Cysts
     9.4.1 Mucoceles
     9.4.2 Salivary Duct Cysts
     9.4.3 Lymphoepithelial Cyst
     9.4.4 Polycystic (Dysgenetic) Disease of the Parotid Gland
   9.5 HIV-Associated Salivary Gland Disease (Multiple Lymphoepithelial
       Cysts of the Parotid Gland)
   9.6 Sialadenosis
   9.7 Nodular Fasciitis
   9.8 Inflammatory Pseudotumor
   9.9 Adenomatoid Hyperplasia of Mucous Salivary Glands
10 Fine-Needle Aspiration Biopsy of Salivary Glands
   10.1 Accuracy of FNAB in Assessing Salivary Gland Lesions
   10.2 Clinical Utility
      10.2.1 Normal Gland
      10.2.2 Mixed Tumor
      10.2.3 Warthin's Tumor
      10.2.4 Basal Cell Adenoma
      10.2.5 Mucoepidermoid Carcinoma
      10.2.6 Acinic Cell Adenocarcinoma
      10.2.7 Adenoid Cystic Carcinoma
      10.2.8 Other Malignant Tumors
      10.2.9 Comparison with Frozen Section Interpretation
11 Index
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