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PubMed2000

[Differential diagnosis of lymphoepithelial lesions of salivary glands. With particular reference to characteristic duct lesions].

Several salivary gland diseases present with the histomorphological features of a lymphoepithelial lesion with or without cyst formation. Some of the most important differential diagnoses (Sjögren's syndrome, marginal zone B-cell lymphoma, HIV-associated cystic lymphoepithelial lesion) are systemic diseases and require further investigation and therapy. However, in small biopsy specimens and in cases without relevant clinical information an exact diagnosis may be difficult to obtain. We have recently determined that the characteristic lymphoepithelial duct lesions develop by proliferation of basal cells of striated ducts, while we could not confirm the previously postulated participation of myoepithelial cells ("epimyoepithelial lesion/sialadenitis"). Although these duct lesions are typical of Sjögren's syndrome, they manifest in several diseases of salivary glands, exhibiting characteristic patterns concerning frequency and localization. This review discusses the most important lymphoepithelial diseases of salivary glands with respect to clinical presentation and histomorphology. Particular emphasis is placed on the lymphoepithelial duct lesions.

Diagnosis, Differential↗
PubMed2002

[Sialodiagnostika-2000, an automated system for differential diagnosis of the salivary glands chronic diseases].

Automated system for differential diagnosis of chronic diseases of the salivary glands Sialodiagnostika-2000 is based on an original differential diagnostic algorithm. Complex differential diagnosis of chronic diseases of the salivary glands can be carried out using this software. Tentative and final clinical diagnosis can be made on the basis of the results of examinations using the optimal complex of accessory methods. The authors claim that Sialodiagnostika-2000 makes the experience gained by the leading specialists available for practicing dentists and thus improves the diagnosis of diseases of the salivary glands.

Algorithms↗
PubMed2006

Sialoendoscopy: A new approach to salivary gland obstructive pathology.

BACKGROUND: During the last 13 years, there has been a growing interest in and use of minimally invasive treatment techniques. Salivary gland endoscopes provide an accurate means of diagnosing and providing minimally invasive surgical treatment for salivary gland diseases. METHODS: The authors review the relevant literature and provide the history of sialoendoscopy. They also report on the treatment methods they use, including instruments and techniques, and their experiences. RESULTS: The authors' overall success rate for parotid endoscopic sialolithotomy is 86 percent, and their overall success rate for submandibular endoscopic sialolithotomy is 89 percent. Their success rate for treating strictures is 81 percent. CLINICAL IMPLICATIONS: The endoscopic technique opens new horizons in the field of salivary gland diseases. Salivary gland stones and sialadenitis no longer are absolute indications for sialadenectomy. Owing to growing experience and surgical skills, new endoscopic techniques are in clinical use, and there is constant improvement in endoscopic treatment success rates. CONCLUSIONS: Sialoendoscopy is a promising new method for use in the diagnosis, treatment and postoperative management of sialadenitis, sialolithiasis and other obstructive salivary gland diseases.

Constriction, Pathologic↗
PubMedDate not supplied

Lymphoepithelial lesion and Sjögren's syndrome.

The lymphoepithelial lesion of salivary glands, which begins with a focal, periductal lymphoreticular reaction and progresses to partial or total replacement of functioning acinar parenchyma, is associated with several clinical disorders. The lesion may be solely a salivary gland disease without systemic manifestations or may be a tissue manifestation of autoimmune disease--primary or secondary Sjögren's syndrome. Besides its own morbidity, the lesion is associated with the development of lymphomas.

Autoimmune Diseases↗
PubMed1976

Classification of the pathohistology of diseases of the salivary glands - review of 2,600 cases in the Salivary Gland Register.

Three major disease groups emerge from a classification of the pathohistology of 2,600 salivary gland preparations in the salivary gland register (from 1965 to 1974): salivary gland tumors (41%), salivary gland inflammations (26%), and sialadenosis (6%). Mucoceles (2%) and salivary gland cysts (1.5%) are seen less often. It is diagnostically important that lymph node changes in the area of the salivary glands (lymphadenitis, lymphomas, etc.) are worked up under suspicion of a primary salivary gland disease. Sialadenosis involves a primary, vegetative neuropathy, which is accompanied by enlargement of acinar cells. Under the heading of chronic sialdenitis, we fine 50% socalled Küttner tumors of the submandibular gland, 21% chronic relapsing parotitis, 14% chronic inflammations of the minor salivary glands and the sublingual gland, and 12% immune sialadenitis (myoepithelial sialadenitis in Sjögren's syndrome and epitheloid cell sialadenitis in Heerfordts syndrome). A more than average number of immune sialadenitis cases develop into malignant lymphomas (4 cases in the salivary gland register). The 1,067 tumor cases containing of 929 epithelial tumors (87%), 89 mesenchymal tumors (hemangiomas, lymphangiomas, lipomas, neurofibromas, sarcomas) and 49 metastases or periglandular tumors. Epithelial tumors were grouped on the basis of the World Health Organization (WHO) classification. Benign tumors (71.5%) consisted of pleomorphic adenomas (51.5%) and monomorphic adenomas (50%). After the pleomorphic adenomas, cystadenolymphomas (over 10%) represented the most frequent benign salivary gland tumor. On the basis of epithelial and stromal differentiation, pleomorphic adenomas were subdividied into four subtypes (stroma-rich and stroma-poor adenomas). The malignant tumors consisted of acinar cell tumors (2.5%), mucoepidermoid tumors (6%), and carcinomas at various levels of differentiation (adenoid-cystic carcinomas, 6.5%; adenocarcinomas, 2%; squamous cell carcinomas, 2%; carcinomas in pleomorphic adenomas, 4%; miscellaneous carcinomas - salivary duct carcinomas, clear-cell carcinomas, undifferentiated carcinomas, 5.5%). Differences in age and sex distribution, localization, malignity metastases, recidivism, et

Adenoma↗
PubMed2000

Long-term experience with endoscopic diagnosis and treatment of salivary gland inflammatory diseases.

OBJECTIVES: To assess the efficacy of the sialoendoscopic technique for treatment of inflammatory salivary gland diseases. This report documents the authors' long-term experience with sialoendoscopy and discusses the long-term results of the procedure, technical issues, and varieties that they have utilized, as well as the advantages and limitations of this modality. STUDY DESIGN: Retrospective clinicopathologic study of 236 patients who were endoscopically treated from 1994 to 1999 for suspected salivary gland obstructive disease. METHODS: Endoscope employed was the third generation sialoendoscope (Nahlieli Sialoendoscope, Karl Storz, Tuttlingen, Germany). RESULTS: Ten sialoendoscopies were immediate failures as a result of technical problems. In the remaining 226 glands, 170 had obstructions and 56 had sialadenitis without evidence of obstructions. The success rate was 83%. Multiple endoscopic findings were encountered. No severe complications were noted. CONCLUSION: This report demonstrates the efficacy and safety of sialoendoscopy as a promising new method for use in the diagnosis, removal, and postoperative management of sialolithiasis, sialadenitis, and other obstructive salivary gland diseases.

Adolescent↗
PubMed1994

Pathology of the salivary glands: the contribution of electron microscopy.

Electron microscopy has a limited role in the diagnosis of primary salivary gland tumors, although it can be helpful in metastatic lesions of possible salivary gland origin. The diversity of subtypes in salivary gland tumors, as well as the range of histomorphology within any one subtype, is unparalleled in any other human tumor. This and their relative infrequency causes diagnostic problems for pathologists. Ultrastructural techniques have been of major importance in determining the inter-relationship of these tumors for classification purposes, revealing the subtle variations in common cellular differentiation pathways, determining the organization of tumor cells, and displaying the importance of extracellular matrix materials in establishing diagnostic criteria for each of the many subtypes. Electron microscopy has also been valuable in non-neoplastic salivary gland disease and has an increasing role in experimental studies involving tissue from human and animal salivary parenchyma.

Animals↗
PubMedDate not supplied

[Clinico-statistical observations on 292 cases of salivary gland pathologies].

292 cases of salivary gland diseases have been observed and treated at the Oral and Maxillo-Facial Surgery Department of the Faculty of Medicine II Naples University. The statistical results concerning age, sex, localization, histological characteristics and therapy are analysed and compared with other references.

Acute Disease↗