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PubMedDate not supplied

Oral and sialochemical findings in patients with autoimmune rheumatic disease.

Forty-two patients with autoimmune rheumatic diseases were evaluated for oral-dental findings and a biopsy of labial minor salivary glands was obtained. Stimulated parotid salivary gland function was assessed and levels of total protein, chloride and albumin in these secretions measured. The patients were stratified into three groups according to the severity of labial gland histopathology (normal histology, 1+ and 2+). Individuals with chronic inflammatory disease of the minor salivary glands had no decrease in stimulated parotid salivary flow but were found to have a greater incidence of oral soft tissue changes commonly associated with salivary dysfunction. However, there were no statistically significant differences in total protein or chloride levels between the groups and no albumin was detected in any samples. These data suggest that stimulated parotid function may be a poor indicator of the extent of salivary involvement in individuals with autoimmune-mediated salivary gland disease.

Arthritis, Rheumatoid↗
PubMed2007

Sclerosing polycystic adenosis of minor salivary glands: report of three cases and review of the literature.

Sclerosing polycystic adenosis (SPCA) of the salivary gland is a rarely encountered lesion of uncertain pathogenesis that shares histologic features with sclerosing adenosis and fibrocystic disease of the mammary gland. To date, fewer than 40 cases of SPCA have been reported in the literature; all but one have arisen in the major salivary glands. We report 3 cases of SPCA involving minor salivary glands and discuss the characteristic histopathologic features of SPCA , which include a combination of fibrosis, tubuloacinar proliferation, and cystic change with retention of a somewhat lobular architecture. We also provide a review of contemporary relevant literature. Given that SPCA has been mistaken for malignant salivary gland neoplasia, a familiarity with the entity is critical. Three new cases of SPCA involving minor glands are added to 1 existing case in the literature to raise awareness of the lesion and to reduce the likelihood of misdiagnosis.

Aged↗
PubMedDate not supplied

Prevalence of orodental findings in HIV-infected Romanian children.

BACKGROUND: Romania, the pediatric AIDS capital of the world, has tremendous unmet dental care needs for children and adolescents with HIV infection. The purpose of this study was to assess the prevalence of orodental conditions in symptomatic HIV-positive children from Constanta, Romania. METHODS: The children underwent dental examinations and treatment at Constanta Municipal Hospital by a volunteer team of dental healthcare professionals from the United States. Oral lesions and dental caries were recorded during an 8-day period prior to initiating comprehensive dental care. RESULTS: The study population consisted of 173 children (88 males; 85 females) with a mean age of 8.8 years (range 6 to 12 years). The primary HIV risk factor was contaminated needle reuse and/or blood products (88%). The most common oral and perioral lesions included: candidiasis (29%), ulcers (15%), salivary gland disease (9%), necrotizing ulcerative gingivitis/periodontitis (5%), linear gingival erythema (4%), labial molluscum contagiosum (3%), oral warts (2%), hairy leukoplakia (2%), and herpes zoster (1%). One or more oral/perioral lesions occurred in 55% of the children. Severe dental caries was noted in the majority of children (dfs/dft 16.9/3.7 and DMFS/DMFT 8.1/3.1). Over-retention of primary teeth (25%) and delayed eruption (42%) were common. Postoperative complications included delayed clotting (common) and thrombocytopenia-induced bleeding disorders (4%). CONCLUSIONS: The oral healthcare needs of Romanian HIV-infected children are considerable, with the majority living with persistent, symptomatic oral disease.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Comparative study of MR sialography and digital subtraction sialography for benign salivary gland disorders.

BACKGROUND AND PURPOSE: MR sialography has become an alternative imaging technique for ductal salivary gland diseases. We compared the diagnostic accuracies of MR sialography and digital subtraction sialography in patients with successful completion of both examinations and benign salivary gland disorders. METHODS: In a prospective study, we attempted to examine salivary glands in 80 patients with clinically suspected diagnoses of sialadenitis and/or sialolithiasis. Each patient underwent digital subtraction sialography and MR sialography. MR sialography was obtained with a T2-weighted single-shot turbo spin-echo sequence (TR/TE 2800/1100 msec, acquisition time 7 seconds), with use of a quadrature head coil. Final diagnoses were confirmed by clinical follow-up and results of biopsy (n = 9) or surgery (n = 19). RESULTS: Failure rate was 5% (four of 80) for MR sialography and 14% (11 of 80) for digital subtraction sialography. Eighty-one salivary glands (48 parotid, 33 submandibular) in 65 patients were successfully visualized with both modalities. MR sialography depicted the main ductal system and first- and second-order branches, whereas digital subtraction sialography was able to depict third-order branches. Sensitivity and specificity to diagnose chronic sialadenitis were 70% and 98% with MR and 96% and 100% with digital subtraction sialography. MR sialography enabled diagnosis of sialolithiasis with a sensitivity of 80% and a specificity of 98% versus 90% and 98% for each with digital subtraction sialography. CONCLUSION: MR sialography with a heavily T2-weighted sequence is highly successful in the noninvasive visualization of the ductal system of major salivary glands. It is useful for diagnosing sialolithiasis and sialadenitis. Digital subtraction sialography, an invasive technique, had a substantial procedural failure rate, particularly for the submandibular duct. However, because of its higher spatial resolution, successfully completed digital subtraction sialography achieved superior diagnostic information compared with that of MR sialography.

Adolescent↗
PubMed1988

Superficial mucoceles: pitfall in clinical and microscopic diagnosis.

Extravasation mucoceles can be so superficial that they are seen as subepithelial blisters. These may rupture and cause superficial painful ulcers, which usually heal quickly. Occasionally such lesions may be seen in association with other mucosal disorders, particularly lichen planus, and a biopsy is undertaken to establish the diagnosis. In addition, the reporting pathologist may make an erroneous diagnosis of a subepithelial vesiculating disorder such as mucous membrane pemphigoid, especially when the clinical history is vague. Eight cases are described that illustrate some of the pitfalls in clinical and microscopical diagnosis of superficial mucoceles.

Adult↗
PubMed1988

Biopsy-documented tuberculous pleural effusion in a patient with biopsy-proven coexisting sarcoidosis.

One year after treatment with corticosteroids for sarcoidosis, a patient presented with biopsy-documented tuberculous pleural effusion while characteristic histopathological findings of sarcoidosis coexisted in many tissues of peripheral organs. Tuberculous pleurisy developed in the presence of disseminated persistent sarcoidosis. Although the interaction of the pathophysiological mechanisms between these two entities is not clear, it is possible that the existence of one does not allow the clinical expression of the other.

Adult↗
PubMed1979

[Differential diagnosis of salivary gland swellings (excluding neoplasms)--the ORL view (author's transl)].

Important investigatory methods for the diagnosis of non-neoplastic salivary gland disease are discussed. The difficulties found with these different methods are emphasized, and biopsy is recommended as the most reliable means for diagnosis. Some salivary gland disorders are caused by hypotensive drugs. Chronic recurrent parotitis is presented as an example of the difficulties in differential diagnosis and treatment.

Biopsy↗