This document discusses non-neoplastic lesions of the salivary gland, including chronic sialadenitis and mumps. It describes the etiology, clinical features, and histopathological features of each condition. Chronic sialadenitis is more common in the parotid gland and is caused by lowered secretion over time leading to ductal damage and lymphocyte infiltration. Mumps is caused by a paramyxovirus and presents as acute bilateral swelling of the parotid glands, with possible complications of orchitis, meningitis, or deafness. Both conditions are examined histologically for features of inflammatory cell infiltration and ductal dilation.

1. Non neoplastic lesions of the
salivary gland
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

2. OBJECTIVES
At the end of the lecture student should be able to
•Describe the etiology, clinical features, histopathological
features of chronic sialadenitis
•Describe the etiology, clinical features, histopathological
features of mumps
www.indiandentalacademy.com

3. • Causative event is thought to be a lowered secretion
rate with subsequent salivary stasis.
• More common in parotid gland.
• Damage from bouts of acute sialadenitis over time
leads to sialectasis, ductal ectasia and progressive
acinar destruction combined with a lymphocyte
infiltrate
• Predisposing factor such as a calculus or a stricture
www.indiandentalacademy.com

4. • Purulent saliva should be
sent for culture.
– Staphylococcus aureus
is most common
– Streptococcus
pnemoniae and
S.pyogenes
– Haemophilus Influenzae
also common
www.indiandentalacademy.com

5. R/F
Consists of ductal dilatation proximal to an area of
obstruction
ductal
dilatation
www.indiandentalacademy.com

6. H/P
• Acute – accumulation of neutrophils within ductal
system and acini
• Chronic – scattered or patchy infiltration of the
salivary parenchyma by lymphocytes and
plasma cells
• Atrophy of acini is common alongwith ductal
dilatation
www.indiandentalacademy.com

7. Inflammatory cell infiltration
Ductal dilation
www.indiandentalacademy.com

8. • Reverse the medical condition that may have
contributed to formation
• Discontinue anti-sialogogues if possible
• Warm compresses, sialogogues (lemon drops)
• External salivary gland massage if tolerated
• Antibiotics
www.indiandentalacademy.com

9. • Mumps classically designates a viral parotitis caused
by the paramyxovirus
• However, a broad range of viral pathogens have
been identified as causes
• As opposed to bacterial sialadenitis, viral infections
of the salivary glands are systemic from the onset.
www.indiandentalacademy.com

10. • Mumps is a non-suppurative acute sialadenitis
• Is endemic in the community and spread by airborne
droplets
• Communicable disease
• Enters through upper respiratory tract
www.indiandentalacademy.com

11. • 2-3 week incubation after exposure (the virus
multiplies in the URI or parotid gland)
• Then localizes to biologically active tissues like
salivary glands, germinal tissues and the CNS
infection.
www.indiandentalacademy.com

12. • Occurs world wide and is highly contagious.
• Sporadic cases are observed today likely
resulting from non-paramyxoviral infection,
failure of immunity or lack of vaccination.
www.indiandentalacademy.com

13. • 30% experience prodromal symptoms prior to
development of parotitis
• Headache, myalgias, anorexia, malaise
• Onset of salivary gland involvement is heralded by
earache, gland pain, dysphagia and trismus
www.indiandentalacademy.com

14. • Glandular swelling (tense, firm) Parotid gland
involved frequently, SMG & SLG can also be
affected.
• May displace ispilateral pinna
• 75% cases involve bilateral parotids, may not begin
bilaterally (within 1-5 days may become bilateral)
….25% unilateral
• Low grade fever
www.indiandentalacademy.com

15. • Leukocytopenia, with relative lymphocytosis
• Increased serum amylase (normal by 2- 3 week of
disease)
• Viral serology essential to confirm
• Complement fixing antibodies appear following
exposure to the virus
www.indiandentalacademy.com

16. • “S” or soluble antibodies directed against the
nucleoprotein core of the virus appear within the first
week of infection, peak in 2 weeks.
• Disappear in 8-9 months and are therefore
associated with active or recent infection
• If the initial serology is noncontributory, then a non-
paramyxovirus may be responsible for the infection
www.indiandentalacademy.com

17. • Supportive
• Fluid
• Anti-inflammatories and analgesics
www.indiandentalacademy.com

18. • Orchitis, testicular atrophy and sterility in
approximately 20% of young men
• Oophoritis in 5% females
• Aseptic meningitis in 10%
www.indiandentalacademy.com

19. • Pancreatitis in 5%
• Sensorineural hearing loss <5.
• Usually permanent.
• 80% cases are unilateral
www.indiandentalacademy.com

20. Summary
–etiology, clinical features,
histopathological features of chronic
sialadenitis
– etiology, clinical features,
histopathological features of mumps
www.indiandentalacademy.com

21. BIBLIOGRAPHY
• Text book of oral pathology Shafer's, 5 & 6th
edition
• Surgical Pathology of Salivary Glands Ellis 1st
Edition
• Color Atlas of Oral Diseases Cawson, R. 2nd
edition
• Oral and Maxillofacial Pathology Neville, Brad
W. 2nd
• Lucas’s Pathology Of Tumor’s of the Oral
Tissues
• Cawson, R. A., Bennie, W. H 5th
edition
www.indiandentalacademy.com

22. THANK YOU !
www.indiandentalacademy.com