[A simple technique for accessory salivary gland biopsy].
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Cheilitis glandularis (CG) has been attributed to hyperplasia of labial salivary glands. We studied labial biopsy specimens of five patients with clinical CG and compared their salivary tissue with that seen in patients without CG. The labial glands from patients with CG did not differ in size, depth, or histologic appearance from those seen in the controls. They showed little or no inflammation and no hyperplasia. We also reviewed forty-eight cases of CG described in the literature. The accompanying photomicrographs nearly always depicted normal-appearing labial salivary glands. The case histories and clinical descriptions suggested that many examples of CG were manifestations of actinic cheilitis, whereas others may have been unusual presentations of atopic or factitious cheilitis. We believe CG represents an unusual reaction pattern in response to chronic irritation of the lips and is unrelated to labial salivary gland hyperplasia.
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Two cases of necrotizing sialometaplasia are reported together with a review of the literature. This self-limiting benign lesion is easily confused with malignant tumors. The lesions are characterized histologically by an extensive necrosis of the salivary gland tissue together with squamous metaplasia of the ducts. The present report of two females who had intense pain in the initial phase differs from previous reports concerning age and symptoms. The importance of rather extensive biopsy specimens is stressed. Antibiotic treatment appears to be insignificant. A clinical history of allergy and a dominance of eosinophilic granulocytes in the inflammatory exudate in both cases may indicate an allergic etiology.
The value of all the procedures which have been described for the investigation of disorders of the major salivary glands is discussed in so far as they aided the management of one bizarre case of obstructive submandibular sialadenitis. In particular an unusual indication for salivary gland scanning is also suggested.
Fine needle aspiration (FNA) of the salivary glands was carried out on 97 patients. Diagnosis was confirmed by histological findings in 93 patients. There were 75 benign lesions (including 52 benign tumours) and 18 malignant lesions. In our series "positive predictive value" of FNA was 0.900 and the negative predictive value was 0.963. Thus, the probability of a false positive is 0.100 and of a false negative 0.037.
CT and MRI have greatly facilitated evaluation of pathology of the three pairs of major salivary glands and the hundreds of minor salivary glands. Imaging can frequently offer a specific histological diagnosis for benign and malignant neoplasms of the parotid, submandibular, and sublingual glands. Obstruction, infection, autoimmune processes, and congenital anomalies also are readily diagnosed. CT and MRI studies assess the anatomic extent of minor salivary gland neoplasms. Sialography continues to provide useful information about intrinsic abnormalities of the parotid and submandibular ducts.
This paper reports a case of hemochromatosis with sicca symptom. The patient was a 59-year-old female who had been received a series of intravenous iron injections and blood transfusions because of anemia owing to side-effects of a chemotherapeutic agent. She complained of dry mouth and dry eyes in addition to symptoms of hemochromatosis. The histological appearance of the labial salivary gland, with heavy deposition of iron in acinar and duct epithelial cells and absence of focal lymphoid cell infiltration, did not support a diagnosis of Sjögren's syndrome but suggested functional damage of the salivary glands related to iron. The patient was given desferrioxamine, and clinical symptoms improved; re-examined labial salivary gland biopsy showed no iron deposition in any parenchymal cells after the treatment.
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OBJECTIVE: There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study's purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population. STUDY DESIGN: Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated (age range, 54-90 years). Diabetic status was determined by a glycosylated hemoglobin (HbA(1c)) test and a 2-hour glucose tolerance test. Poor glycemic control was defined as HbA(1c) >9%. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire. RESULTS: Persons with poorly controlled diabetes had lower (P =.01) stimulated parotid flow rates than persons with well-controlled diabetes and nondiabetic control subjects. There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. CONCLUSIONS: These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.
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OBJECTIVES: To investigate the topography of E-cadherin and its possible correlation with the histological phenotype of salivary gland tumours. MATERIAL AND METHODS: Archival formalin-fixed, paraffin-embedded sections of 54 benign and 56 malignant tumours and 24 samples of normal and inflamed salivary gland tissue were studied immunohistochemically using an Envision/horseraddish peroxidase (HRP) technique. RESULTS: In normal and inflamed salivary gland samples, E-cadherin was expressed at the membrane of acinar, myoepithelial and ductal cells located at cell-cell contact points. Reduction and/or absence of E-cadherin was only observed in pleomorphic adenoma at the peripheral cells of the duct-like or island structures, or in the cells exhibiting plasmacytoid or stromal differentiation. Neoplastic epithelium in Warthin's tumours and in myoepithelial and oncocytic adenomas was strongly positive. Furthermore, a weak to moderate loss of expression which was related to tissue tumour subtype was seen in malignant tumours such as: adenoid cystic carcinomas; polymorphous low-grade adenocarcinomas; acinic cell carcinomas; and mucoepidermoid low-grade, epithelial-myoepithelial, lymphoepithelial and squamous low-grade carcinomas. Moderate to extreme loss or alternative cytoplasmic non-functional expression were observed in cases of salivary ductal carcinoma, carcinosarcoma, myoepithelial carcinoma, oncocytic adenocarcinoma, unspecified adenocarcinoma and squamous high-grade carcinomas. CONCLUSION: This study suggests a direct association of E-cadherin expression with neoplastic histologic phenotype, which is lost in the more undifferentiated and invasive epithelial salivary gland tumours.
BACKGROUND: Chronic alcoholism has been associated with structural and physiological changes in salivary glands. Studies on a variety of pathologies have suggested that variation in number of nucleolar organizer regions (NORs) reveals conditions of cellular activity. The aim of this work was to examine, through the AgNOR technique, changes in number and size of NORs in lingual salivary glands of chronic alcoholics. METHODS: Samples of mucous and serous lingual salivary glands were obtained from tongues from autopsies of individuals whose cause of death was hepatic alcoholic cirrhosis. Lingual organs from individuals whose cause of death was accidental were used as controls. Number and size of the AgNORs and nuclear area, in ductal and acinar cells, were evaluated through a digital image analyzer. RESULTS: Statistical analysis revealed differences (P < or = 0.05) in number of AgNORs in mucous acini and ductal cells. Also, we observed changes in the area of the NORs. CONCLUSION: These results suggest that in alcoholics the activity of glandular cells, mainly in ductal epithelium, could be affected, modifying synthesis, transport and salivary secretions.
Saliva has multiple essential functions in relation to the digestive process taking place in the upper parts of the gastrointestinal (GI) tract. This paper reviews the role of human saliva and its compositional elements in relation to the GI functions of taste, mastication, bolus formation, enzymatic digestion, and swallowing. The indirect function of saliva in the digestive process that includes maintenance of an intact dentition and mucosa is also reviewed. Finally, pathophysiological considerations of salivary dysfunction in relation to some GI functions are considered.
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Adenomatoid hyperplasia is a rare idiopathic non-inflammatory, non-neoplastic and benign lesion of minor salivary glands, that typically presents with a tumour-like mass in the palate. A 77-year-old patient is described.