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[Accumulation of 67Ga in diseases of the large salivary glands].

In a prospective study (59 patients) the pattern of 67Ga-uptake of the large salivary glands (LSG) in the course of typical disorders of the glands was investigated. Inflammatory and granulomatous disorders revealed--dependent on their acuity--an identical pattern of Ga-uptake. Extraglandular uptake was found in some instances of tuberculosis, sarcoidosis and myoepithelial sialadenitis. Among the benign LSG tumors all cystadenolymphomas showed intensive uptake while all pleomorphic adenomas did not. In 75% of the malignant LSG tumors Ga-uptake was pathologically increased, particularly in all adenocarcinomas of the series. 67Ga scintigraphy seems to be useful in the follow-up of inflammatory and granulomatous LSG disorders and in the differential diagnosis of pleomorphic adenoma versus cystadenolymphoma. Extraglandular uptake may give valuable hints for diagnostic work-up.

Adult↗

Kimura's disease with salivary gland involvement.

Fourteen cases of Kimura's disease involving parotid and submandibular glands in Chinese patients are described to draw attention to this unique lesion which has been reported mainly in the Chinese and Japanese literature. Blood eosinophilia is almost always present, there is a male preponderance and the aetiology is unknown. Surgical excision is recommended though irradiation and steroid therapy have also been used.

Adolescent↗

[Non-neoplastic changes in the salivary glands].

Non-neoplastic disorders of the salivary glands are divided into the following groups: malformations, salivary gland cysts, sialadenosis, sialolithiasis, sialadenitis, HIV-associated salivary gland disease, oncocytosis and necrotizing sialometaplasia (salivary gland infarction). Clinically, an etiological classification of sialadenitis is mandatory. Sialadenosis is distinguishable from sialadenitis by its clinical, radiological, and morphological characteristics. Non-neoplastic cysts make up about 6% of diseases of the salivary glands. Mucoceles represent the majority of these cysts (75%). HIV-associated salivary gland disease includes lymphoepithelial lesions and cysts involving the salivary gland tissue and/or intraglandular lymph nodes, and Sjögren's syndrome-like conditions, diffuse interstitial lymphocytosis syndrome, and other reported lesions of the major salivary glands. The diagnosis, differential diagnosis, symptoms and treatment of different non-neoplastic salivary gland disorders are discussed.

Diagnosis, Differential↗

The incidence of neoplastic versus inflammatory disease in major salivary gland masses diagnosed by surgery.

What is the incidence of non-neoplastic diseases when dealing with masses of the major salivary glands? A knowledge of this information would aid the physician in making decisions relative to the management of the masses. Furthermore, the expected malignancy rate may need to be adjusted according to the findings of this study. Many reported series of salivary gland neoplasms show the relative incidence of benign vs. malignant neoplasms; however, not every patient with a mass of the salivary gland who comes to surgery is finally diagnosed as having had a neoplasm. Knowing the relative incidence of neoplastic vs. non-neoplastic salivary gland diseases has important diagnostic, therapeutic, and prognostic implications. Records of all patients who underwent either a parotidectomy or submandibular gland excision from 1975 to the present at the Eye and Ear Hospital of Pittsburgh were reviewed; 73% of the parotidectomies performed were done for neoplastic disease. A patient with a parotid mass has a likelihood of 1:10 of having a malignancy. Similarly, on a population basis, 1 submandibular mass in 12 will be malignant.

Diagnosis, Differential↗

Salivary glands and lesions: evaluation of apparent diffusion coefficients with split-echo diffusion-weighted MR imaging--initial results.

The authors investigated the feasibility of performing diffusion-weighted (DW) magnetic resonance (MR) imaging with split acquisition of fast spin-echo signals (hereafter, split echo) for the assessment of salivary glands and salivary lesions. Eighteen patients without salivary disease and 10 patients with Sjögren syndrome, chronic parotitis, or focal salivary masses underwent split-echo and echo-planar DW MR imaging. DW MR images and apparent diffusion coefficient maps of the salivary gland had higher quality with split-echo rather than with echo-planar DW MR imaging.

Adult↗

Expression of the adenocarcinoma-related antigen recognized by monoclonal antibody 44-3A6 in salivary gland neoplasias.

The monoclonal antibody 44-3A6 detects a cell-surface protein that has been shown to be a useful marker in distinguishing adenocarcinomas from other histologic tumor types in a variety of tissues. The objective of this study was to determine whether 44-3A6 could be used as a tool in the classification of salivary gland neoplasms. These complex tumors share overlapping pathologic features but distinct clinical outcomes. This study used 44-3A6 to immunohistochemically describe the pattern and frequency of this antigen in salivary gland neoplasms. Formalin-fixed, paraffin-embedded tissue sections of 22 benign and 26 malignant salivary tumors were evaluated. The patient population consisted of 25 (52.1%) women and 23 (47.9%) men selected from archival pathology files to reflect a range of salivary gland diseases. Normal surrounding salivary glands were found to have intense focal staining almost exclusively localized to ductal luminal cells. There was little staining of either myoepithelial or acinar cells. A wide spectrum of expression was found between and within tumor types, but a trend toward more expression of this antigen with decreasing differentiation was seen. A significant increase in staining was also seen in those tumors with ductal differentiation (n = 41) as opposed to those with predominantly acinar (i.e., acinic cell carcinoma) or myoepithelial (i.e., myoepithelioma; n = 8) differentiation (2.6 vs. 1.3, p < 0.05). No correlation was found between staining intensity and facial paralysis, pain, skin involvement, TNM stage, residual disease, or disease-free or total survival. Therefore this antigen appears to designate a duct luminal phenotype in normal and neoplastic salivary tissues.

Adenocarcinoma↗