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PubMed1989

Digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography in the diagnosis of salivary gland diseases.

Forty-one patients with salivary gland disorders have been evaluated by digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography, and the results compared with clinical, surgical and pathomorphological data. In the case of salivary gland masses, the sensitivity of ultrasonography, CT and digital subtraction sialography was 100%, 82% and 71%, respectively, while in the case of sialadenitis, the respective figures were 54%, 69% and 85%. The image quality of digital subtraction sialography was superior to that of conventional sialography in 80%, equal in 16%, and inferior in 3% of the examinations. We conclude that in all cases of salivary gland diseases ultrasound should be the first imaging procedure. If a tumour is not confirmed, digital subtraction sialography should be employed to visualise inflammatory changes, while in most cases of salivary gland masses no further imaging will be necessary.

Humans↗

PubMed2005

Multiple bilateral parotid sialoliths in a patient with mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the salivary glands.

Multiple sialoliths in the major salivary glands is uncommon. Sjogren's syndrome (SS) is a chronic autoimmune disorder characterized by lymphocyte-mediated destruction of exocrine glands. There is an increased incidence of malignant lymphoma in patients with Sjogren's syndrome. We present a patient with MALT lymphoma of the salivary glands who also had multiple calculi in the parotid glands. Multiple sialoliths in the major salivary glands in the presence of MALT lymphoma has not previously been reported.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1999

Salivary gland P2 nucleotide receptors.

The effects of ATP on salivary glands have been recognized since 1982. Functional and pharmacological studies of the P2 nucleotide receptors that mediate the effects of ATP and other extracellular nucleotides have been supported by the cloning of receptor cDNAs, by the expression of the receptor proteins, and by the identification in salivary gland cells of multiple P2 receptor subtypes. Currently, there is evidence obtained from pharmacological and molecular biology approaches for the expression in salivary gland of two P2X ligand-gated ion channels, P2Z/P2X7 and P2X4, and two P2Y G protein-coupled receptors, P2Y1 and P2Y2. Activation of each of these receptor subtypes increases intracellular Ca2+, a second messenger with a key role in the regulation of salivary gland secretion. Through Ca2+ regulation and other mechanisms, P2 receptors appear to regulate salivary cell volume, ion and protein secretion, and increased permeability to small molecules that may be involved in cytotoxicity. Some localization of the various salivary P2 receptor subtypes to specific cells and membrane subdomains has been reported, along with evidence for the co-expression of multiple P2 receptor subtypes within specific salivary acinar or duct cells. However, additional studies in vivo and with intact organ preparations are required to define clearly the roles the various P2 receptor subtypes play in salivary gland physiology and pathology. Opportunities for eventual utilization of these receptors as pharmacotherapeutic targets in diseases involving salivary gland dysfunction appear promising.

Adenosine Triphosphate↗

PubMed1994

[Salivary gland tumors. Clinical aspects and therapy].

Salivary gland tumors are rare. One-fifth are malignant. The parotid is the gland most often affected, particularly in adenomas. Adenomas and carcinomas are tumors that occur in adulthood; angiomas are the tumors that occur most frequently in childhood. Other than their localization, salivary gland tumors have few specific signs. In the clinical examination the locoregional and functional presentation is evaluated. Imaging studies refine or correct the clinical diagnosis, primarily by visualizing the deeper planes. Morphological diagnosis in benign lesions depends on resection results; in malignant lesions additional intraoperative frozen section is needed, and in questionable cases incisional biopsy. Fine-needle aspiration cytology may provide valuable knowledge when planning therapy. Limited parotid tumors are resected by lateral or subtotal parotidectomy. Carcinomas are resected as needed, with neck dissection added in case of lymph-node involvement. Small adenoid cystic carcinomas can be treated curatively by very wide resection. Aggressive and extensive tumors are irradiated postoperatively. Malignancies not operated upon are irradiated primarily. Facial nerve paralysis can be rehabilitated by different nerve repair or static surgical techniques.

Adult↗

PubMed1995

Murine autoimmune exocrinopathy: the minor salivary gland network shows a dichotomous pattern of histopathologic involvement.

The minor salivary gland network of the MRL/l mouse was investigated in a kinetic study and compared with the major submandibular gland. We report that minor salivary glands adopt two mutually exclusive patterns of inflammatory lesions depending on the gland. The first pattern is characteristic of human Sjogren's syndrome. It developed during the second month, affected 89% of the animals over 20 weeks old, and consisted of an accumulation of mononuclear cells around the duct system. Only the anterior buccal gland (ABG) showed this pattern, which is shared by the major salivary glands. The ratio of CD4+ to CD8+ cells was the same in lesions and in healthy tissue. No neutrophils were found in these lesions. The second pattern affected all the minor salivary glands except the ABG. These lesions were never observed before the age of 20 weeks and affected 38% of MRL/l mice between the ages of 10-32 weeks. In this pattern, neutrophils were frequently found, but mainly gathered at the periphery of the gland lobules. That a systemic immunoregulatory defect may be expressed as two different patterns of histopathology in the minor salivary glands suggest that the network behaves as a dichotomous entity depending on particular microenvironmental influences.

Animals↗

PubMed1980

Acinic cell carcinoma arising in ectopic salivary gland tissue.

Two cases of a rare entity, acinic cell carcinomas, which apparently arose primarily from ectopic salivary gland tissue, are presented. Salivary gland ducts and acini frequently may be found incorporated within intraparotid lymph nodes and less commonly within extraglandular cervical nodes. Ectopic salivary glands may also be seen, although rarely, elsewhere in the head and neck area. The most common tumor to arise from intranodal salivary gland tissue is papillary cystadenoma lymphomatosum; however, other salivary gland-type neoplasms rarely may do so. In our cases, one tumor apparently originated primarily within a paraparotid lymph node and the other in the lateral mid- to low-neck area. Neither of our patients had a demonstrable lesion of a major or minor salivary gland; thus their tumors are presumed to have originated primarily from ectopic salivary gland tissue. The clinician and the pathologist should consider the possibility of a neoplasm arising in ectopic tissue when a salivary gland type tumor is identified away from sites where major and minor salivary glands normally are found.

Adolescent↗

PubMed1997

Lipomatous infiltration of the canine salivary gland.

Benign connective tumours of the canine salivary glands are rare. This report describes lipomatous infiltration of parotid or submandibular salivary glands in seven dogs in which the glands were enlarged as a result of infiltration by fat cells; they appeared to have been successfully treated by local excision. The precise cause of the lipomatous infiltration in the dogs is unclear but different causes of similar lesions in humans are discussed.

Animals↗

PubMed1992

[Nuclear morphometry and DNA cytometry in the grading of malignant tumors of the salivary gland].

Nuclear morphometry and DNA cytometry were performed in 6 normal salivary glands and 37 malignant tumors of the salivary gland. Multivariate discrimination analysis was used to grade the malignant salivary gland tumors. The discrimination rate was 100% for normal salivary gland, benign tumor, high malignant carcinoma and low malignant carcinoma. It was 66.7% for borderline malignancies. These results indicate that quantitative cytological analysis is effective and reproducible in the grading of salivary gland tumors. Stepwise multivariate regression analysis showed that there was a very complicated correlation between DNA content and nuclear morphometric parameters of salivary gland tumors.

Adenocarcinoma↗

PubMed1998

Regulation and formation of the Drosophila salivary glands.

The homeotic gene, Sex combs reduced (Scr), is a master regulator of Drosophila salivary gland formation. Embryos in which Scr function is missing do not form salivary glands, and embryos in which SCR protein is expressed everywhere form extra salivary glands. However, other known proteins, including the homeotic protein Abdominal-B, the unusual zinc finger protein Teashirt, and the secreted signaling molecule Decapentaplegic (a TGF-beta family member), limit the recruitment of SCR-expressing cells to salivary glands. To learn the molecular details of how salivary gland gene expression is controlled and as a first step toward understanding how the SCR transcription factor controls salivary gland morphogenesis, we screened for genes expressed in the developing salivary gland. Among our best candidates for potential direct downstream targets of SCR in the salivary gland are the genes trachealess (trh), dCREB-A, jalapeño, and Semaphorin II (SemaII). Our genetic studies suggest distinct and important roles for each of these genes in salivary gland morphogenesis. Current work includes studying the molecular interactions between SCR and these downstream target genes and asking how target genes coordinate their activities to effect the cell biological changes required to build functional salivary glands.

Animals↗

PubMed1988

Salivary gland lymph nodes. The site of lymphadenopathies and lymphomas associated with human immunodeficiency virus infection.

Normally, lymph nodes are intimately associated with the salivary glands, particularly the parotid gland. Several lymph nodes are embedded in the parotid gland, other lymph nodes are adjacent to the submaxillary gland, and ectopic salivary gland acini and ducts are commonly present in cervical lymph nodes. These salivary gland lymph nodes may become the primary site of the benign lymphadenopathy and the malignant lymphomas characteristically associated with human immunodeficiency virus (HIV) infection. This report of a series of HIV-associated lymphatic lesions originating in salivary gland lymph nodes comprises nine cases of salivary gland masses that were surgically excised, it includes six cases of lymphadenitides and three cases of lymphoma--all originating in salivary gland lymph nodes and showing the histologic lesions known to occur in association with the acquired immunodeficiency syndrome. The HIV-related infections and neoplasias located in the salivary gland lymph nodes raise interesting questions about the possible etiologic role of an oral portal of entry and of the virus-infected saliva. The recognition of their clinical and pathologic features is indispensable to enable correct diagnosis and treatment.

Acquired Immunodeficiency Syndrome↗

PubMed1988

[Ultrasonic diagnosis of the salivary glands].

Sonography of the salivary glands is a valuable diagnostic tool in acute and chronic sialadenitis, sialadenoses, lymphadenopathies and tumours lesions. A new examination technique is presented: ultrasound-guided fine needle biopsy. We report on our experience in 308 patients with parotid and in 47 patients with submaxillary gland diseases examined between 1982 and 1987. The diagnostic accuracy and limitations of sonography are discussed compared with sialography, computed tomography and magnetic resonance imaging.

Biopsy, Needle↗

PubMed1993

c-fos oncogene underexpression in salivary gland tumors as measured by in situ hybridization.

Tissue from 35 salivary gland tumors and 14 normal salivary glands was analyzed by in situ hybridization and computer-assisted morphometry for the expression of the c-fos oncogene. The normal salivary gland tissues were found to express c-fos focally, mainly in the acinar secretory cells. The majority of the cells in the normal tissues showed a high level of expression (47.74 +/- 5.31% of cells had 46 to 60 grains per cell and another 45.79 +/- 2.18% showed > 60 grains per cell). All the tumors examined exhibited a relatively low, uniform distribution of c-fos expression. For example, in the poorly differentiated adenocarcinomas, 96.83 +/- 04% of the cells were found to have < 15 grains per cell. A general linear model for multivariate analysis showed a significant difference between the various tumor types and the normal salivary gland tissues (P = 0.0001). These data support the hypothesis that salivary gland tumors belong to a group of epithelial neoplasias in which the loss of cellular differentiation is linked with underexpression of the c-fos oncogene.

Autoradiography↗

PubMedDate not supplied

Malignant salivary gland tumors: squamous cell carcinoma of the submandibular gland in a child.

PURPOSE: Malignant neoplasms of the salivary glands are extremely unusual in the pediatric age group. METHODS: We report an 11-year-old boy who presented with a mass in the left submandibular region and a second mass in the jugularfacial venous angle. RESULTS: Histologic evaluation determined that this was a squamous cell carcinoma of the submandibular gland with metastasis to a cervical node. Review of the literature was undertaken to identify the rate of malignant salivary gland tumors in children. Malignant salivary gland tumors are extremely rare in children. When malignancy does occur, nearly 90% are present in the parotid gland. The submandibular gland is effected in 7.7% of cases. The most common malignancy in salivary glands of children is the mucoepidermoid carcinoma. Squamous cell carcinoma occurs in less than 2% of cases. CONCLUSIONS: Salivary gland tumors are very rare in children in contrast to adults. The proportion of malignant tumors in children is higher than that observed in adults; however, it is not possible to draw conclusions concerning treatment from the few case reports that exist. A higher rate of local recurrence and cervical lymph node metastasis may be expected in children.

Carcinoma, Squamous Cell↗

PubMed1982

Computed tomography of the major salivary glands.

Forty-eight patients with proven disease of the salivary glands were evaluated by computed tomography (CT). Twenty-seven patients had salivary gland neoplasm and all were identified by CT. Fifteen benign tumors appeared as discrete, sharply marginated, high-density masses embedded in an otherwise normal gland. All 15 were correctly identified as benign by CT. There were 12 malignant tumors; 10 were invasive and presented as poorly defined, relatively dense lesions which obliterated and/or transgressed adjacent fat and fascial planes. Two malignant tumors presented as discrete masses and were incorrectly considered to be benign by CT. Twenty-one patients with inflammatory disease of the salivary glands were studied. A variety of patterns were noted, the most common a relatively diffuse, irregular area of increased density in an enlarged gland. Salivary duct calculi, diffuse sialectasis, and enlarged lymph nodes were well demonstrated. Differentiation between focal and inflammatory disease and malignant neoplasm was difficult. Computed tomography may be augmented by coincident sialography, although it is seldom necessary.

Adolescent↗

PubMed1985

Cancer of the minor salivary glands of the larynx.

Minor salivary gland carcinomas of the larynx are rare and few large series have been reported from a single institution. Eighteen patients were treated for this disease at M.D. Anderson Hospital between 1944 and 1982. Of these, 8 patients had adenoid cystic carcinoma and 10 had poorly differentiated adenocarcinoma. Characteristically these tumors presented as predominantly submucosal masses in the supraglottic or subglottic regions. Surgery was the primary treatment modality used in most cases. The average 2 and 5 year survival rates for patients with this disease were 70.6 percent and 42.8 percent, respectively. Although the 5 year survival rates were comparable between the adenocarcinoma and cystic carcinoma groups, adenocarcinoma was a more rapidly lethal disease than adenoid cystic carcinoma. Salvage after recurrence was seldom possible, although local and regional control could usually be achieved. Distant metastases remain the principal cause of treatment failure.

Actuarial Analysis↗

PubMed1992

Natural history of HIV-associated salivary gland disease.

To describe the natural history of HIV-associated salivary gland disease, which is characterized by enlarged major salivary glands and/or xerostomia in HIV-infected persons, we assessed 22 patients at an initial and follow-up examinations (median span of examinations, 15 months). Sixteen patients (73%) had bilateral parotid gland enlargement, 17 had symptoms of dry mouth, and 11 had both conditions. Parotid gland enlargement remained unchanged in 10 patients, it progressed in 2, and it regressed in 4 during treatment with zidovudine or steroids. Those patients with parotid gland enlargement had a significantly lower mean stimulated parotid flow rate (0.27 ml/min/per gland) than a control group of HIV+ persons without salivary gland disease (0.48 ml/min/per gland) (p less than 0.05), whereas the mean unstimulated whole salivary flow rates did not did not differ significantly between the two groups. The mean salivary flow rate of the study group did not change during the observation period. When HIV-associated salivary gland disease was diagnosed, 5 patients (23%) had AIDS, and at follow-up 10 (46%) had AIDS. Seven of these had Kaposi's sarcoma. The mean peripheral blood CD4 cell count was 280 and 225 per mm3 at the initial and follow-up examinations, respectively. The corresponding CD8 counts were 1138 and 900. The pathogenesis of HIV-associated salivary gland disease may include hyperplasia of intra-parotid lymphoid tissue. Because HIV-associated salivary gland disease can clinically resemble Sjögren's syndrome, the differential diagnosis of bilateral parotid enlargement should include HIV infection.

Acquired Immunodeficiency Syndrome↗

PubMed1985

A cell line from pleomorphic adenoma of the rat salivary gland.

Pleomorphic adenoma of rat salivary gland is extremely rare, and culture of cells obtained from rat salivary gland tumors has not been reported. We have established a long-term cell line from a pleomorphic adenoma of a Sprague-Dawley rat submaxillary gland. The pleomorphic adenoma was composed of oval or spindle-shaped cells occasionally forming a small duct. Alcian blue-positive intercellular matrices, consisting mainly of glycosaminoglycans, were abundant. The cultured cells showed characteristics similar to those of the original tumor. This cell line should be useful for biological and biochemical studies of glycosaminoglycan-synthesis of pleomorphic adenoma cells.

Adenoma, Pleomorphic↗

PubMed1995

Anion exchanger immunoreactivity in human salivary glands in health and Sjögren's syndrome.

Salivary gland ducts play a relevant role in saliva secretion through transport processes. Na(+)-independent chloride-bicarbonate anion exchangers (AE) may be involved in these processes by generating ion fluxes into the salivary secretion. In Sjögren's syndrome, a disorder with gland dysfunction, there might be an impaired expression of AE proteins. Here we study AE immunoreactivities in human salivary glands, both in health and in Sjögren's syndrome. Immunohistochemistry was carried out on salivary glands from normal subjects and patients with Sjögren's syndrome, using two monoclonal antibodies against AE1 and AE2. Normal salivary glands showed AE2 immunoreactivity, which was restricted to the epithelium of the ducts, with no staining at the acini. A strong positivity was seen in the basolateral portion of the striated ducts, while interlobular duct cells showed a discrete positivity at their apical pole. In salivary glands from most of the patients with Sjögren's syndrome, AE2 immunoreactivity was absent in the ducts as well as in the acini. In both normal and diseased salivary glands, AE1 immunoreactivity was only located at the erythrocyte membrane. The recently reported AE0 was discarded because no AE0 message was found in salivary glands by reverse transcription polymerase chain reaction. In conclusion, AE2 immunoreactivity is observed in the ducts of normal salivary glands, particularly in the striated ducts. AE2 immunoreactivity is virtually absent in salivary glands from patients with Sjögren's syndrome, which may reflect either a loss of AE2 after inflammatory atrophy, or a primary defect occurring in the disease.

Adult↗