Salivary glands produce saliva and are composed of major and minor glands. The major glands are the parotid, submandibular, and sublingual glands. Salivary gland cytology can detect both benign and malignant lesions. Common benign findings include pleomorphic adenoma, Warthin's tumor, and basal cell adenoma cells. Malignant lesions include adenoid cystic carcinoma, mucoepidermoid carcinoma, and adenocarcinoma. Fine needle aspiration cytology allows diagnosis of salivary gland lesions with high sensitivity and specificity to guide treatment.
This is a presentation on the topic of cytology of the breast, prepared by Dr Ashish Jawarkar, he is MD in pathology and a teacher at Parul institute of Medical sciences and research Vadodara.
This is a presentation on the topic of cytology of the breast, prepared by Dr Ashish Jawarkar, he is MD in pathology and a teacher at Parul institute of Medical sciences and research Vadodara.
Histopathological Grossing of Kidney Tumors with the common gross differentials encountered,
reference - TATA memorial grossing techniques , Rosai and ackerman surgical pathology , Fletcher , Springer histopathology Specimen
Fluid cytology in serous cavity effusionstashagarwal
The intrathoracic and intraperitoneal organs are covered by a single layer of mesothelial cells, which is continuous with the lining of the thoracic and peritoneal cavities. The potential space between the two layers of epithelium contains a small amount of lubricating fluid.
Serous fluid lies between the membranes lining the body cavities(parietal) and those covering the organs within the cavities(visceral).
Production and reabsorption are normally at a constant rate. They are influenced by
Changes in osmotic and hydrostatic pressure in the blood.
Concentration of chemical constituents in the plasma
Permeability of blood vessels and membranes.
An accumulation of fluid, called an effusion, results from an imbalance of fluid production and reabsorption. This fluid accumulation in the pleural, pericardial, and peritoneal cavities is known as serous effusion.
Histopathological Grossing of Kidney Tumors with the common gross differentials encountered,
reference - TATA memorial grossing techniques , Rosai and ackerman surgical pathology , Fletcher , Springer histopathology Specimen
Fluid cytology in serous cavity effusionstashagarwal
The intrathoracic and intraperitoneal organs are covered by a single layer of mesothelial cells, which is continuous with the lining of the thoracic and peritoneal cavities. The potential space between the two layers of epithelium contains a small amount of lubricating fluid.
Serous fluid lies between the membranes lining the body cavities(parietal) and those covering the organs within the cavities(visceral).
Production and reabsorption are normally at a constant rate. They are influenced by
Changes in osmotic and hydrostatic pressure in the blood.
Concentration of chemical constituents in the plasma
Permeability of blood vessels and membranes.
An accumulation of fluid, called an effusion, results from an imbalance of fluid production and reabsorption. This fluid accumulation in the pleural, pericardial, and peritoneal cavities is known as serous effusion.
Presentation about the the second most common type of ovarian tumors which have a very unique property of being similar to the testicular germ cell tumors.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Benign salivary gland tumor part 1 / dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
2. INTRODUCTION
DEFINITION:
• SALIVARY GLANDS ARE COMPOUND, TUBULOACINAR,
MEROCRINE, EXOCRINE GLANDS THE DUCTS OF WHICH
OPEN INTO ORAL CAVITY.
• THE ORAL CAVITY IS KEPT MOIST BY A FILM OF FLUID
CALLED SALIVA THAT COATS THE TEETH AND
MUCOSA.
• SALIVA IS A COMPLEX FLUID PRODUCED BY THE
SALIVARY GLANDS.
3. ANATOM
Y
Salivary glands are the exocrine glands that are responsible for secretion of
the saliva. There are two groups of salivary glands:
1. Major salivary glands: Major salivary glands consist of pair of parotid
glands, submandibular glands and sublingual salivary glands.
2. Minor salivary glands: There are large number of minor salivary glands
in the mucosa of the oral cavity, nasal sinuses, larynx and bronchial tree.
4. Parotid glands are mainly serous glands. Each gland weighs about 15–25
gm.
• The parotid gland is situated in the angle of mandible.
• The gland is divided into superficial and deep compartment and facial
nerve with its branches passing in between these two compartments.
Submandibular salivary gland is located in the submandibular triangle
which is bounded anteriorly by anterior belly of digastric, posteriorly by
posterior belly of digastric and superiorly by mandible.
• This is a seromucous gland and weighs 7–8 gm.
• The gland has two lobes: (1) superficial and (2) deep lobes.
• The secretion of the gland flows through the Wharton’s duct that opens
into the floor of the mouth.
The sublingual gland is the smallest salivary gland and weighs only 3 gm.
• This is a mucinous gland.
• The gland is located in the sublingual fossa and the secretion of the
gland flows through multiple excretory ducts to open into the oral cavity.
5. HISTOLOGY
• The major salivary gland is composed of secretory part and duct part.
• The secretory part is made of acini which are lined by serous, mucinous or
mixed (seromucinous) type of cells.
• The cells in acini are arranged as lobules encircled by myoepithelial cells.
• Each acini opens into the intercalated ducts that further joins with each
other and forms larger excretory duct.
6. Main function of Salivary Gland-secretion of
saliva
Daily secretion -800 to 1500 ml
pH :6-7
PHYSIOLOGY
COMPOSITION
:
7. Control of secretion
• Parasympathetic stimulation- profuse secretion of watery
saliva
• Sympathetic stimulation- scanty viscid secretion
.Sympathetic supply comes from cervical sympathetic chain
along the blood vessels
Functions of Saliva
Keep the mouth moist
Aids in swallowing
Aids in speech
Keeps the mouth and teeth
clean
Antimicrobial action
Digestive function
8. SPECIMEN COLLECTION FOR CYTOLOGICAL
EXAMINATION
Indications: Any palpable swelling of the salivary gland.
Advantages:
• Rapid
• Safe
• High sensitivity and specificity
• Cheap
• Avoids any unnecessary surgery
• Helps in planning of surgery in case of neoplasm
• Various ancillary investigations can be done: Microbiological examination,
flow cytometry, cell block
INDICATIONS OF FINE NEEDLE ASPIRATION CYTOLOGY OF THE SALIVARY
GLANDS
• FNAC is indicated in any space occupying lesion of the salivary glands
Fine needle aspiration cytology of the salivary gland is done preferably
by thin needle with 23 gauze diameter & both May-Grünwald-Giemsa
(MGG) and Papanicolaou’s stains should be done.
10. NORMAL SALIVARY GLAND CELLS
Fine needle aspiration cytology of the normal salivary gland usually yields
scanty material.
Benign ductal cells:
• Ductal cells are usually present in tight small clusters or
honeycombed like monolayered sheets.
• The individual cells are round with scanty cytoplasm having
monomorphic round nuclei.
Acinar cells :
• These cells are commonly present as loose grape-like clusters or
discretely.
• The individual cells are pyramid in shape with abundant foamy
cytoplasm and small eccentrically placed round nuclei.
• Due to cytoplasmic fragility, the acinar cells often present as bare
nuclei and these cells should be distinguished from the
background lymphocytes.
ROUND TO OVAL
MONOMORPHIC BENIGN
DUCTAL CELLS [MAY-
GRÜNWALDGIEMSA (MGG)
STAIN × MEDIUM POWER (MP)]
LOOSE GRAPE LIKE CLUSTER
OF BENIGN SALIVARY ACINAR
CELLS [HEMATOXYLIN AND
EOSIN (H & E) STAIN × MP)
11. Myoepithelial cells: Myoepithelial cells are oval to spindle
shaped with scanty indistinct cytoplasm.
• Oval plasmacytoid myoepithelial cells may also be seen.
Other Components Fragments of fibrous and adipose tissue may also be
seen in the background of the normal salivary aspirate.
• Due to the presence of intraparotid lymph node, lymphoid cells are
often noted in the normal salivary aspirate..
12.
13. NON MALIGNANT CONDITIONS(Benign Neoplasm):
Pleomorphic Adenoma
• Pleomorphic adenoma is the most common tumor of the salivary gland and constitutes about 60% of
all tumors of the salivary gland.
• About 80% cases of PA develop in parotid gland, 10% in submandibular gland and the rest 10% cases
in the paranasal sinuses, oral cavity, upper respiratory tract and skin.
ROUND TO OVAL CELLS WITH MODERATE
AMOUNT OF CYTOPLASM IN PLEOMORPHIC
ADENOMA. THE CELLS ARE EMBEDDED IN
THE STROMAL MATERIAL
[PAPANICOLAOU’S STAIN × HIGH POWER
(HP)]
Cytology:
• Pinkish fibrillar chondromyxoid matrix
material with frayed indistinct margins.
• Clusters of round, ovoid or plasmacytoid
epithelial cells
• Moderate amount of dense cytoplasm.
• Central to eccentric monomorphic nucleus
• Bland chromatin.
• Clusters and discrete spindle shaped
myoepithelial cells embedded in mesenchymal
stroma.
14. Warthin Tumor
WARTHIN TUMOUR-THE ONCOCYTIC CELLS
HAVE
ABUNDANT CYTOPLASM WITH ECCENTRIC
NUCLEI. WHICH ARE ROUND AND
MONOMORPHIC (H & E STAIN × HP)
Clinical
• Second common tumors of
salivary gland tumors
• Mean age 62 years
• Exclusively within the parotid
gland
• One-fifth cases are bilateral
• Doughy feel on palpation
• Probably developmental, not
neoplastic
Cytology
• Thin dirty mucoid or greenish-
brown fluid
15. Basal Cell Adenoma
• BCA accounts for 1–3% of all salivary gland tumors.
• It predominantly affects older individuals.
• Majority of the BCAs (more than 75%) occur in the parotid gland and
rarely other salivary glands are involved.
• This tumor usually presents as solitary, firm, well-defined, mobile
nodules. MULTIPLE CLUSTERS OF BASALOID CELLS
WITH SCANTY CYTOPLASM AND ROUND
MONOMORPHIC NUCLEI IN BASAL CELL
ADENOMA (MGG STAIN × MP)
• Cohesive groups of cells
• Peripheral palisading arrangement
• Round nucleus, bland nuclear
chromatin and scanty cytoplasm
• Squamous morules
• Scanty homogenous acellular stromal
material
Cytolog
y:
16. Oncocytoma
• Oncocytoma represents 1% of all salivary gland tumors.
• This tumor is rarely seen below the age of 50 years
• More than 80% of the tumor arises from the parotid gland and the rest of
the tumor develops from the submandibular gland.
• The tumor predominantly presents as well-circumscribed painless mobile
mass.
• Polygonal cells
• Fine chromatin
• Small nucleoli
• Three-dimensional clusters of oncocytes
• Abundant densely granular eosinophilic
cytoplasm
• Monomorphic round nucleus
cytology LARGE, POLYGONAL CELLS WITH ABUNDANT
DENSELY GRANULAR EOSINOPHILIC
CYTOPLASM AND WELL-DEFINED CELL
BORDER OF ONCOCYTES IN ONCOCYTOMA
(MGG STAIN × OIL IMMERSION
17. Myoepithelial Tumors
• Myoepithelial tumor is a rare benign neoplasm .
• The mean age of the patient is 44 years.
• Myoepithelioma may occur both in major and minor salivary gland.
• The patients usually present with a slow growing painless mass.
Cytology
• Rich in cells
• Lack of chondromyxoid stroma
• Spindle cell type
• Cohesive clusters and dissociated spindle cells
• Elongated nuclei, fine nuclear chromatin and inconspicuous
nucleoli
• Nuclear grooves
• Scanty pale cytoplasm
• Plasmacytoid (hyaline) myoepithelial cells
• Dissociated round to oval cells.
• Plasmacytoid cells with abundant cytoplasm and eccentric
nucleus
• Fine nuclear chromatin.
INDIVIDUAL CELL MORPHOLOGY OF
MYOEPITHELIAL CELLS IS BETTER VIEWED
IN HIGHER MAGNIFICATION IN
MYOEPITHELIAL TUMOR (H & E STAIN ×
HP)
18. MALIGNANT TUMOUR
Adenoid Cystic Carcinoma
• Adenoid cystic carcinoma is a slow growing tumor .
• It comprises about 10–20% of salivary gland malignancies.
• ACC commonly affects parotid, submandibular gland and minor salivary glands in
the palate.
• ACC may also occur in nasal cavity and sinuses, tongue, buccal mucosa and lip.
CRIBRIFORM APPEARANCE OF
ADENOID CYSTIC CARCINOMA ON
CYTOLOGY
SMEAR (MGG STAIN × MP)
• Multiple variables sized globular, spherical or tubular
homogenous, acellular magenta colored matrix material
• Globules are surrounded by cells
• Clusters and dissociated small cells
• Scanty cytoplasm
• Round monomorphic nuclei
• Hyperchromatic
• Coarse chromatin
CYTOLOGY
19. Acinic Cell Carcinoma
• About 80–90% of tumor arises in the parotid gland and a small group of tumor develops from the
minor salivary glands.
• The patient classically presents as a single, mobile and painless mass. The duration of the symptoms
is usually few months.
• Females are slightly more affected by acinic cell carcinoma than male and the peak incidence of the
tumor is in third decades of life.
• Abundant cohesive clusters of acinar cells
• Acinar like arrangement
• Large polygonal cells
• Abundant finely vacuolated cytoplasm
• Naked tumor nuclei
• Occasionally lymphocytes and psammoma bodies
• Clean background
CYTOLOG
Y
HIGHER MAGNIFICATION OF THE ACINIC CELL CARCINOMA
SHOWING ABUNDANT EOSINOPHILIC CYTOPLASM AND
ROUND CENTRAL TO ECCENTRIC NUCLEI (MGG STAIN ×
OIL IMMERSION)
20. • This tumor represents 17% of all salivary gland malignancies
and predominantly involves the parotid gland.
• The tumorcells exhibits ductal differentiation.
• FNAC smears show recognizable malignant cells with features of
adenocarcinoma but there is lack of definitive evidence of other
specific
subtypes.
Adenocarcinoma
ADENOCARCINOMA OF THE PAROTID
GLAND(H&E-40X)
21. Mucoepidermoid Carcinoma
• Mucoepidermoid carcinoma is the commonest malignant tumors of the salivary gland
• MEC occurs in age groups from children to old age, and mean age of the patient is 45
years.
• About 50% of MEC arises from the major salivary gland and rest of the tumor arises
from buccal mucosa and palate.
• The patients usually present with painless, firm, fixed, mass.
• Clusters and dissociated cells with vacuolated
cytoplasm
• Intermediate squamous cells
• Gradual transition of squamoid to mucus producing
cells
• Dirty background produced by debris and mucus
• Histiocytes and background lymphocytes
• Mucus secreting cells are positive for mucicarmine
or Alcian blue stain.
CYTOLOG
Y
EPIDERMOID CELLS WITH ENLARGED
HYPERCHROMATIC NUCLEI IN
MUCOEPIDERMOID CARCINOMA (H & E STAIN ×
HP)
22. Polymorphous Low-grade Adenocarcinoma
• Females are more commonly affected than male. The age range of the patient varies from second
decade to ninth decade.
• However, majority of the patients are in between 50 years and 70 years of age. Mean age of the
patient is 59 years.
• PLGA commonly affects the minor salivary glands and 60% of the tumor develops in palate.
Cell arrangement:
• Papillary
• Ductal
• Trabecular
• Discrete
Morphology:
• Scanty to moderate pale cytoplasm
• Round to oval nucleus
• Fine stippled nuclear chromatin
• Inconspicuous nucleoli
• Scanty matrix material
LONG PAPILLARY LIKE
CLUSTER IN POLYMORPHOUS
LOW GRADE
ADENOCARCINOMA (MGG
STAIN × MP)
23. Epithelial-Myoepithelial Carcinoma
• Majority of the epithelial-myoepithelial carcinomas (60–80%) arise in the parotid
gland and rest of the tumors arise in the minor salivary glands of the oral cavity.
• The patient usually presents as painless slowly growing mass in the parotid gland
for months to even years.
Biphasic pattern
• Myoepithelial cells:
– Loose cohesive cluster
– Large polygonal clear cell
– Round, monomorphic nuclei
– Mild nuclear enlargement
– Fine chromatin
• Epithelial cells:
– Scanty
– Small cuboidal
– High N/C ratio
• Stromal material:
– Spherical hyaline globules
– Acellular
LARGE POLYGONAL CLEAR
CELL OF EPITHELIAL-
MYOEPITHELIAL
CARCINOMA (H&E STAIN -
HP)
Cytology:
24. Carcinoma Ex-pleomorphic Adenoma
• History of pre-existing Pleomorphic adenoma
• It is also known as malignant mixed tumor.
• High-grade carcinoma of ductal type
• Metachromatic fibrillar matrix with myoepithelial cells
• Ca Ex-PA commonly involves the parotid
gland.
• The patient usually presents with
history of a sudden rapid enlargement of
a longstanding swelling of theparotid gland.
CARCINOMA EX-
PLEOMORPHIC
ADENOMA(H&E STAINED-
HP)