Chapter 8: Salivary Gland Diseases

Test Bank
MULTIPLE CHOICE
1. A 15-year-old patient had a biopsy of a lower lip mass that was diagnosed as mucous
extravasation phenomenon. This was probably related to which of the following?
a. A sialolith
b. Trauma
c. Bacterial infection
d. Viral infection
e. Congenital malformation
ANS: B
REF: Chap 8 (Mucous extravasation phenomenon/Etiology and pathogenesis), p 187
2. A biopsy of the lower lip salivary glands showed replacement of parenchymal tissue
by lymphocytes. The patient also had xerostomia and keratoconjunctivitis sicca.
These findings suggest which of the following?
a. Lymphoma
b. Crohns disease
c. Mumps
d. Sjgrens syndrome
e. None of the above
ANS: D

REF: Chap 8 (Sjgrens syndrome), pp 196-199

3. The 5-year survival rate of one of the following salivary gland tumors is fair, but at 15
years it is very poor. Which of the following exhibits this slow, but unrelenting
behavior?
a. Mucoepidermoid carcinoma
b. Mixed tumor
c. Adenoid cystic carcinoma
d. Monomorphic adenoma
e. Polymorphous low-grade adenocarcinoma
ANS: C

REF: Chap 8 (Adenoid cystic carcinoma), pp 216-218

4. An asymptomatic fluctuant mass in the floor of the mouth of a 25-year-old man was
biopsied. Microscopically, it was a dilated duct containing mucin. This is a _____
cyst.
a. Dermoid
b. Lymphoepithelial
c. Branchial
d. Thyroglossal tract
e. Mucous retention
ANS: E
REF: Chap 8 (Mucous retention cyst [obstructive sialadenitis]/Etiology and
pathogenesis), p 188
Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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5. Mucosal neuroma, pheochromocytoma, and medullary carcinoma of the thyroid

constitute which of the following syndromes?
a. Albrights syndrome
b. Sjgrens syndrome
c. von Recklinghausens disease of skin
d. Peutz-Jeghers syndrome
e. None of the above
ANS: E
REF: Chap 5 (Caf-au-lait macules), p 138 | Chap 8 (Sjgrens syndrome), pp 196199 | also Clinical Overview
6. A 24-year-old patient presents with a persistent firm asymptomatic submucosal mass
(1 1 cm) in her lower lip. The mass fluctuates in size and occasionally drains a
cloudy, sticky fluid. This would most likely be which of the following?
a. Mucous extravasation phenomenon
b. Necrotizing sialometaplasia
c. Traumatic fibroma
d. Soft tissue myxoma
e. Ectopic lymphoid tissue
ANS: A
REF: Chap 8 (Mucous extravasation phenomenon/Clinical features), p 187
7. Mixed tumors of minor salivary glands present as asymptomatic lumps most
commonly in which of the following locations?
a. Lower lip
b. Upper lip
c. Buccal mucosa
d. Tongue
e. Palate
ANS: E
REF: Chap 8 (Mixed tumor [pleomorphic adenoma]; Box 8-14), pp 204-206
8. A 33-year-old patient presents with an asymptomatic swelling of her right
submandibular space. Which of the following should be considered in a clinical
differential diagnosis?
a. Chronic lymphadenitis
b. Salivary gland tumor
c. Lymphoepithelial cyst
d. Lymphoma
e. All the above
ANS: E
REF: Chap 8 (Benign neoplasms), pp 203-211 | Chap 9 (Hodgkins
lymphoma/Lymphoma/Lymphoepithelial cyst), pp 228-239
9. Although mucous extravasation phenomenon can potentially occur where salivary
glands are present, it is most commonly seen in which of the following intraoral sites?

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank
a.
b.
c.
d.
e.

Buccal mucosa
Upper lip
Lower lip
Gingiva
Lateral tongue

ANS: C
REF: Chap 8 (Mucous extravasation phenomenon/Clinical features), p 187
10. Biopsy of minor salivary gland of the lip shows a lymphocytic infiltrate that has
replaced salivary gland parenchyma without evidence of scar. The patient is 58 years
old and has dry eyes and rheumatoid arthritis. She very likely has which of the
following?
a. Sarcoidosis
b. Adenoid cystic carcinoma
c. Sjgrens syndrome
d. Chronic sialadenitis
e. Gorlin-Goltz syndrome
ANS: C

REF: Chap 8 (Sjgrens syndrome), pp 196-199

11. Which of the following benign lesions is known to have potential to undergo
malignant transformation?
a. Traumatic fibroma
b. Ectopic lymphoid tissue
c. Denture-related papillary hyperplasia
d. Granular cell tumor
e. Mixed tumor
ANS: E
REF: Chap 8 (Mixed tumor [pleomorphic adenoma]/Treatment and prognosis), pp
205-206
12. Which of the following salivary conditions occurs because of traumatic or surgical
cutting of the excretory duct of a salivary gland?
a. Mixed tumor
b. Sialolithiasis
c. Mucous retention cyst
d. Mucous extravasation phenomenon
e. Ranula
ANS: D
REF: Chap 8 (Mucous extravasation phenomenon/Etiology and pathogenesis), p 187
13. The cell that replaces salivary and lacrimal gland parenchyma, resulting in dryness
seen in association with Sjgrens syndrome, is the:
a. Macrophage
b. Lymphocyte
c. Langerhans cell
d. Neutrophil

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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e. Mast cell
ANS: B

REF: Chap 8 (Sjgrens syndrome), pp 196-199

14. Minor salivary gland malignancies are most commonly seen in which of the following
sites?
a. Lower lip
b. Upper lip
c. Palate
d. Tongue
e. Gingiva
ANS: C

REF: Chap 8 (Mixed tumor/Clinical features), pp 204-205

15. A patient presents with a chronic palatal ulcer. On biopsy there is evidence of salivary
gland infarction and squamous metaplasia of salivary ducts. This is:
a. Benign lymphoepithelial lesion
b. Necrotizing sialometaplasia
c. Cytomegalic disease
d. Lymphoma
e. Mucous extravasation phenomenon
ANS: B
REF: Chap 8 (Necrotizing sialometaplasia/Etiology and pathogenesis), p 191
16. A patient presents with a lump in the palate that is covered by normal epithelium.
Microscopy shows that the mass is an infiltrative neoplasm composed of glandular
epithelium. Tumor nests have a cribriform pattern and can be seen surrounding nerve.
This describes which of the following?
a. Mixed tumor
b. Monomorphic adenoma
c. Mucocele
d. Adenoid cystic carcinoma
e. Mucoepidermoid carcinoma, low grade
ANS: D
REF: Chap 8 (Adenoid cystic carcinoma/Histopathology), pp 217-218
17. A 45-year-old woman developed soft bilateral swelling of her parotids. Her salivary
flow was reduced and she had keratoconjunctivitis sicca (dry eyes). She also recently
developed painful joints. She should be evaluated for:
a. Chronic alcoholism
b. MEN III
c. Sjgrens syndrome
d. Neurofibromatosis
e. Diabetes
ANS: C

REF: Chap 8 (Sjgrens syndrome), pp 196-199

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

18. Cells with bright pink cytoplasm that contain abundant mitochondria that are seen in
aging salivary glands and in some salivary gland tumors are known as:
a. Myoepithelial cells
b. Acinar cells
c. Macrophages
d. Oncocytes
e. Basal keratinocytes
ANS: D

REF: Chap 8 (Oncocytic tumors), pp 208-210

19. A 16-year-old patient complained of a 1 1 cm nontender mass in his upper lip. The
lesion was nonulcerated and was composed of a dilated duct containing a sialolith.
This would be which of the following?
a. Focal fibrous hyperplasias
b. Traumatic neuroma
c. Fibromatosis
d. Mucous extravasation phenomenon
e. None of the above
ANS: E
REF: Chap 7 (Focal fibrous hyperplasia/Traumatic neuroma/Fibromatosis), pp 164165, 170-171, 175 | Chap 8 (Mucous extravasation phenomenon), pp 187-188
20. A biopsy of the minor salivary gland of the lower lip was taken to evaluate for the
salivary component of Sjgrens syndrome. The tissue showed a diffuse lymphocytic
and plasma cell infiltrate in the gland parenchyma, extensive scarring of the gland
with acinar atrophy, and ductal dilatation. This is most suggestive of which of the
following?
a. Sarcoidosis
b. Adenoid cystic carcinoma
c. Pleomorphic adenoma
d. Chronic sialadenitis
e. Sjgrens syndrome
ANS: D

REF: Chap 8 (Mucous retention cyst), pp 188-189

21. All the following may develop in minor salivary gland tissue. However, one is rarely
seen in major glands. It is:
a. Mixed tumor
b. Mucoepidermoid carcinoma
c. Adenoid cystic carcinoma
d. Polymorphous low-grade adenocarcinoma
e. Monomorphic adenoma
ANS: D
REF: Chap 8 (Polymorphous low-grade adenocarcinoma/Clinical features), pp 214215

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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22. The circumscribed salivary gland tumor that is composed of a benign mixture of
neoplastic ductal epithelium and myoepithelium-derived connective tissue is known
as:
a. Pleomorphic adenoma (mixed tumor)
b. Monomorphic adenoma
c. Mucoepidermoid carcinoma
d. Adenoid cystic carcinoma
e. Polymorphous low-grade adenocarcinoma
ANS: A
REF: Chap 8 (Mixed tumor [pleomorphic adenoma]/Histopathology), p 205
23. Ranula is the clinical designation of a salivary gland lesion that occurs in which of the
following locations?
a. Parotid
b. Lower lip
c. Buccal mucosa
d. Floor of mouth
e. Ventral tongue
ANS: D

REF: Chap 8 (Reactive lesions), pp 187-192

24. Necrotizing sialometaplasia:

a. Occurs in the palate
b. May be confused with carcinoma clinically
c. May be confused with carcinoma microscopically
d. Is related to ischemic necrosis
e. All the above
ANS: E

REF: Chap 8 (Necrotizing sialometaplasia), pp 191-192

25. The management of maxillary sinus retention cysts that are typically discovered
during routine panoramic radiographic examinations is:
a. Endodontic therapy of the adjacent teeth
b. Antibiotic therapy
c. Surgical removal
d. Observation
e. None of the above
ANS: D
REF: Chap 8 (Maxillary sinus retention cyst [pseudocyst]/Treatment), p 190
26. A biopsy of a nodular lesion of the tongue showed several noncaseating granulomas.
The patient was found to have similar lesions in the hilar regions of his lungs. He
most likely has which of the following?
a. Benign lymphoepithelial lesion
b. Sarcoidosis
c. Lymphoma
d. Necrotizing sialometaplasia
e. Mumps

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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ANS: B

REF: Chap 8 (Sarcoidosis), pp 194-195

27. Patients with Sjgrens syndrome have increased risk for developing which of the
following?
a. Oral cancer (squamous cell carcinoma)
b. Lymphoma
c. Mixed tumors
d. Melanoma
e. Anemia
ANS: B

REF: Chap 8 (Sjgrens syndrome/Clinical features), p 197

28. Basal cell adenoma:

a. Is an aggressive neoplasm
b. Is more common in the upper lip than in the lower lip
c. Often transforms into adenocarcinoma
d. Has a relatively high recurrence potential
e. None of the above
ANS: B

REF: Chap 8 (Basal call adenomas), pp 206-207

29. Mixed tumor of salivary glands:

a. Is caused by smoking
b. Contains epithelial elements plus connective tissue of varied appearance,
sometimes resembling cartilage
c. Frequently metastasizes to local lymph nodes
d. All the above
e. B and C only
ANS: B
206

REF: Chap 8 (Mixed tumor [pleomorphic adenoma]), pp 204-

30. A labial salivary gland biopsy showed the replacement of normal parenchyma with
granulomas. There was no scarring and no ductal dilatation. This biopsy suggests:
a. Necrotizing sialometaplasia
b. Salivary lymphoepithelial lesion
c. Mucous extravasation phenomenon
d. Mucous retention cyst
e. Sarcoidosis
ANS: E

REF: Chap 8 (Sarcoidosis/Histopathology), pp 206-207

31. Sialoliths are associated with which of the following?

a. Pain
b. Duct obstruction
c. Secondary gland infection
d. Mucous retention
e. All the above

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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ANS: E
189

8
REF: Chap 8 (Mucous retention cyst [sialadenitis]), pp 188-

32. Which of the following is a common cause of xerostomia in the elderly?

a. Bacterial infection
b. Mumps
c. Systemic drugs
d. Allergic reactions
e. None of the above
ANS: C

REF: Chap 8 (Xerostomia/Etiology), pp 200-201

33. An adult patient complained of a 1 1 cm slightly tender nonulcerated mass in his

lower lip. The patient believes that the lesion developed after he bit his lip several
weeks ago. This would most likely be which of the following?
a. Traumatic fibroma
b. Granular cell tumor
c. Squamous cell carcinoma
d. Mucocele
e. Traumatic granuloma
ANS: D

REF: Chap 8 (Reactive lesions), pp 187-192

34. Sialolithiasis is a phenomenon that most likely would be associated with which of the
following glands?
a. Parotids
b. Submandibular glands
c. Sublingual glands
d. Minor salivary glands
e. None of the above
ANS: B
REF: Chap 8 (Mucous retention cyst [obstructive sialadenitis]/Etiology/Box 8-1), pp
188-189
35. Trauma is the cause of which of the following?
a. Static (Stafne) bone cyst
b. MEN III-associated mucosal neuroma
c. Mucous extravasation phenomenon
d. Dermoid cyst
e. None of the above
ANS: C
REF: Chap 8 (Mucous retention cyst [obstructive sialadenitis]/Etiology and
pathogenesis), p 188
36. Which of the following disorders places the patient at risk for the appearance or
development of a malignancy?
a. Primary Sjgrens syndrome
b. Proliferative verrucous leukoplakia

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

c. Neurofibromatosis
d. MEN III
e. All the above
ANS: E
REF: Chap 3 (Preneoplastic and neoplastic lesions), pp 90-95 | Chap 7
(Neurofibroma/Mucosal neuromas of MEN III), pp 178-181 | Chap 8 (Sjgrens
syndrome), pp 196-199
37. Which of the following is the most likely clinical presentation of mixed tumor of
minor salivary gland?
a. Painful exudative lesion
b. Ulcerative plaque
c. Rapidly growing mass
d. Red plaque
e. Firm submucosal mass
ANS: E

REF: Chap 8 (Mixed tumor/Clinical features), p 205

38. On routine panographic examination, a uniform round opacity measuring 1.5 cm in

diameter was noted in the floor of the maxillary sinus of a 24-year-old man. All
normal landmarks in the maxilla appeared intact. The patient had no symptoms and no
history of sinus problems. This lesion most likely represents which of the following?
a. Variation of normal
b. Necrotizing sialometaplasia
c. Sjgrens syndrome
d. Maxillary sinus retention cyst
e. Carcinoma of the maxillary sinus
ANS: D
REF: Chap 8 (Maxillary sinus retention cyst/Pseudocyst/Clinical features), p 190

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.