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PubMed1989

Histology of the major salivary glands.

Major salivary glands are characterized by the presence of numerous excretory units that consist of acini and a peculiar duct system. Under normal conditions, sebaceous glands are annexed to the duct system in the parotid and the submaxillary glands. The excretion of the saliva is assisted by the myoepithelial cells, which play an important role in the morphology of several kinds of salivary gland tumors. Interstitial lymphocytes give rise to the formation of lymph nodes in the parotid gland. Heterotopic salivary tissue is found in many locations throughout the head and neck. Age-induced variations and reactive changes include oncocyte proliferation, fatty infiltration, squamous and mucous metaplasia, hyperplasia, atrophy, and regeneration. An analysis of the normal salivary gland structure permits a morphogenetic approach to an understanding of the variability in histologic types of salivary gland tumors.

Aging↗
PubMed1997

The aminergic and peptidergic innervation of insect salivary glands

Insect salivary glands are glands associated with nutrient intake whose secretions are generally involved in the digestion and lubrication of food. They are under the control of neuroactive substances and may be innervated from several sources including the suboesophageal ganglion, the stomatogastric nervous system and the unpaired median nerves. Both amines and peptides have been suggested to play roles in the control of insect salivation, as indicated by their association with terminals on salivary glands, their effects in salivary gland bioassays and their ability to alter second messenger levels and ion channel conformations. Serotonin and dopamine appear to be the most prominent amines associated with insect salivary glands. Either one or both of these amines are found associated with the salivary glands of the locust, stick insect, cockroach, cricket, dragonfly, mosquito, adult moth and kissing bug. Their roles, although not fully elucidated, appear to be in the control of salivary secretion. Several peptides, including members of the FMRFamide-related family of peptides, are also found associated with insect salivary glands. Sources of peptidergic innervation are as varied as those for aminergic innervation, but information regarding the physiological role of these peptides is lacking. The relevance of the different levels of complexity of salivary gland innervation, which range from the absence of innervation in some species (blowfly) to the presence of several distinct sources in others (locust, cockroach), is not well understood. This review serves to consolidate what is known of the phenotype of salivary neurones in relation to the control of salivation.

Journal Article↗
PubMed1997

The congenital basal cell adenoma of salivary glands. Contribution to the differential diagnosis of congenital salivary gland tumours.

Congenital epithelial tumours of the salivary glands are very rare. The Salivary Gland Registry maintained in the Department of Pathology. University of Hamburg, contains only three cases among a total of 6,646 salivary gland tumours from the years 1965-1994. The three cases were classified as congenital basal cell adenoma, two of the parotid gland and one of the submandibular gland. Histologically, the three adenomas were similar in structure to the adult counterpart of basal cell adenoma with solid, trabecular or tubular (duct-like) patterns. In some cystic spaces of the duct-like structures PAS- and Astra blue-positive substances were secreted. On immunocytochemistry, the luminal duct-like cells showed membranous expression of cytokeratins 3, 5, 6, 7, 13 and 19. In the isomorphic basaloid cells of the solid and trabecular cell nests few cells expressed cytokeratin. On the outside of the solid cell nests there were smaller elongated myoepithelial-like cells, which expressed cytokeratin 14 and vimentin. Cytokeratins 1, 2, 4 and 18 were not expressed. The pattern of expression reflects the different stages of maturity of the tumour cells and is related to the development of the salivary glands until the end of the 3rd embryonal month with an arrest of further cell differentiation. No acinic cells, invasive growth, recurrence or metastases were observed. The differential diagnosis includes other congenital salivary gland tumours, such as hybrid basal cell adenoma-adenoid cystic carcinoma, sialoblastoma or embryoma, carcinoma, hamartoma and teratoma.

Adenoma↗
PubMed1982

Chemotherapy for salivary gland cancer.

Salivary gland cancers are usually treated with surgery and irradiation; however, some of the aggressive salivary gland cancers recur or metastasize and are not amendable to treatment with further surgery or irradiation. Little is known about chemotherapy for these palliative situations because of the relatively scarcity of these cancers. The data in the literature has provided little clinical information because all salivary gland cancers are usually lumped together and/or multiple different drug combination are used. In an effort to arrive at a rational basis for recommending specific drug regimens for specific histologic types of salivary gland cancers, a two-part study was undertaken to determine which chemotherapy drugs seem to be effective or ineffective. One part was a literature review, and the second part was a survey of numerous institutions' experiences, including our own. A total of 85 cases of salivary gland cancers treated with chemotherapy were felt to be evaluable for this study. The overall response rate (complete and partial) was 42%. Although disease responded whether it was local, regional, or distant disease, there was a higher response rate in local-regional disease compared to distant metastases. Salivary gland cancers are definitely sensitive to chemotherapy drugs. This study reveals which drugs seem to be effective and provides some rational basis for future chemotherapy trials for salivary gland cancers.

Adenocarcinoma↗
PubMed1990

Synchronous benign epithelial tumors arising in the palatal minor salivary gland. First report of an unusual minor salivary gland lesion.

A review of the literature shows that unilateral benign salivary gland tumors of different histologic types in a single gland are so rare as to be curiosities, and all of such reported tumors have arisen in the parotid gland. The present paper reports a case of synchronous benign epithelial tumors of different histologic type arising in the palatal minor salivary gland of a 57-year-old woman who had first noted palatal swelling about 20 years previously. Pathologically, the lesion was composed of two distinct tumors, pleomorphic adenoma and lumenless trabecular adenoma, which were sharply demarcated from each other by a thin layer of fibrous connective tissue. Foci of tumor cells with cellular atypia were seen in some areas of the pleomorphic adenoma. The present case is thought to represent a previously undescribed component within the spectrum of minor salivary gland tumors.

Adenoma↗
PubMed2002

[Amplification and overexpression of HER-2/neu in parotid gland salivary duct carcinoma. Immunohistochemical study and fluorescence in situ hybridization].

Salivary duct carcinoma (SDC) is highly malignant salivary gland tumour with aggressive clinical behaviour, characterised by its histological resemblance to invasive ductal carcinoma of the breast. Amplification of gene HER-2/neu and overexpression of its gene product have been shown to have both prognostic and treatment implications in breast cancer. The reports concerning the expression of c-erbB2/HER-2/neu in salivary gland tumours are few and controversial. Thus, eleven cases of SDC were evaluated for HER-2/neu status using immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH). To the best of our knowledge, this is the first molecular genetic analysis of SDCs using FISH. HER-2/neu overexpression, identified as strong membrane staining, was observed in all but one case of SDC in majority of neoplastic cells while only four tumours, of nine cases analysed, revealed HER-2/neu gene amplification by means of FISH analysis. SDCs were associated with poor clinical outcome, 6 patients (55%) died of disseminated carcinoma within 4 to 44 months after therapy. There was no difference in outcome of patients with IHC positive-nonamplified and IHC positive-amplified tumours.

Adult↗
PubMed1996

Cell proliferation in salivary gland tumors.

Salivary gland tumors often pose considerable difficulty in differential diagnostic and prognostic assessment based on histomorphologic grounds alone. Histomorphology may poorly correlate with clinical outcome and the tumors within the same type in classification schedule exhibit different clinical courses. Prognostic relevance of various cell proliferation markers has been investigated in many types of human cancer, recently including salivary gland tumors. Evaluation of DNA content by flow cytometry and by cytophotometry, AgNOR technique, and immunohistochemical detection of antigens in cycling cells such as the Ki67 antigen and proliferating cell nuclear antigen (PCNA) have been applied to a variety of benign and malignant salivary gland tumors in only few studies so far. Cell proliferation, assessed with the MIB1 antibody, that recognizes the Ki67 antigen in proliferating cells, represents a significant prognostic factor for acinic cell carcinomas and mucoepidermoid carcinomas of salivary gland origin. Moreover, much lower proliferative activity as assessed with the MIB1 antibody helps to distinguish difficult cases of polymorphous low grade adenocarcinomas from adenoid cystic carcinomas and may contribute to differentiation of solid myoepithelial cell-rich pleomorphic adenomas from various malignant tumors. Thus, assessment of cell proliferation in salivary gland tumors using the MIB1 antibody and PCNA in paraffin-embedded tissue should be incorporated into routine immunohistologic evaluation of histologically difficult cases of salivary gland tumors.

Cell Division↗
PubMed1998

Homologous carcinomas of the breasts, skin, and salivary glands. A histologic and immunohistochemical comparison of ductal mammary carcinoma, ductal sweat gland carcinoma, and salivary duct carcinoma.

Morphologic mimicry among human malignant neoplasms is a well-known phenomenon in surgical pathology; both undifferentiated and "committed" neoplasms may exhibit this trait. One particularly common group of histologic simulants includes ductal carcinomas of the breasts, the cutaneous appendages, and the salivary glands. One hundred three tumors in this structural cluster were analyzed microscopically and immunohistologically to codify points of potential pathologic similarity and difference. All the lesions were typified by irregularly permeative clusters and cords of atypical polygonal cells with variable luminal differentiation. A proportion of primary neoplasms in each site demonstrated in situ ductal components; in the absence of the latter elements, however, it was not possible to make topography-related morphologic distinctions among them. Immunostains for gross cystic disease fluid protein-15 (GCDFP-15), carcinoembryonic antigen, S100 protein, c-erbB-2 oncoprotein, estrogen receptor protein, and progesterone receptor protein also showed largely overlapping phenotypes in each of the three tumor categories, with selected exceptions. These differences were elucidated through paired chi 2 analysis and included a statistically significant infrequency of GCDFP-15 in eccrine sweat gland carcinomas, a paucity of carcinoembryonic antigen in breast cancers, and an absence of estrogen receptor protein in salivary duct carcinomas. Such findings may be useful in predefined differential diagnostic settings involving the distinction between primary and metastatic ductal cancers of the breasts, skin, and salivary glands. Nevertheless, because of the striking homologies between such tumors at structural and protein-synthetic levels of comparison, it is mandatory that all available clinicopathologic information be used in this context.

Adenocarcinoma↗
PubMed1992

Salivary gland 99mTc-scintigraphy: a grading scale and correlation with major salivary gland flow rates.

Sequential salivary gland scintigraphy with 99mTc-technetium pertechnetate (Tc-99) is a safe, minimally invasive test for study of major salivary glands. However, its relationship to salivary function has not been investigated in detail. We have investigated the relationship between major salivary gland flow rates and Tc-99 scans and developed a new rating scale using scans of a control group with normal salivary function. Salivary flow rates and Tc-99 scans were obtained from healthy, non-medicated subjects (n = 33) and from xerostomic patients (n = 22). There were significant differences between the groups for salivary flow rates and Tc-99 ratings. Significant correlations were found between salivary flow rates and Tc-99 ratings in the control and xerostomic groups. The Tc-99 rating scale proved reliable in assessing salivary dysfunction, and showed a high inter-examiner correlation. These results demonstrate the usefulness of salivary gland scintigraphy in assessing major salivary gland flow rates and the utility of a new rating scale.

Adult↗
PubMed1986

[Mesenchymal (non-epithelial) salivary gland tumors. Analysis of 167 tumor cases of the salivary gland register].

The total material of the Salivary Gland Register (1965-1985) contained 167 mesenchymal tumours with an intra- or paraglandular localisation. This corresponds to 1.5% of all cases of the Salivary Gland Register or to 5% of all salivary gland tumours. Periglandular tumours without relation to the salivary gland tissue, metastatic tumours or malignant lymphomas were not considered in this study. With respect to the localisation, the age and sex distribution and the histopathological classification the following results were obtained: 90% of all mesenchymal tumours were localised in the parotid gland and 10% in the submandibular gland. In lipomas, the percentage of the parotid gland was even 95%; in lymphangiomas, however, it was only 80%. Angiomas occur preferably in the first and second decades and represent in this age period nearly 90% of all mesenchymal tumours. The age peak of lipomas lies in the fifth to sixth decades, whereas neurogenic tumours are distributed relatively equal over the fourth to seventh decades. A sex disposition was seen in lipomas (85% in males), neurinomas (65% in females) and neurofibromas (75% in males). 90% were benign mesenchymal tumours, 10% sarcomas. Within the benign tumours 47.5% were angiomas, 22.5% lipomas, 16% neurogenic tumours and 4% rare benign tumours. In angiomas (79 cases) haemangiomas (50 cases), lymphangiomas (17 cases), mixed haemangiomas and lymphangiomas (9 cases) and haemangiopericytomas (3 cases) could be seen, in neurogenic tumours (27 cases) neurinomas (12 cases), neurofibromas (12 cases) and neurofibromatoses (3 cases), in sarcomas (17 cases) malignant fibrous histiocytomas (5 cases), malignant schwannomas (5 cases), embryonal rhabdomyosarcomas (4 cases) and other rare sarcomas (one case each myxoid liposarcoma, leiomyosarcoma, malignant haemangioendothelioma).(ABSTRACT TRUNCATED AT 250 WORDS)

Hemangioma↗
PubMed1997

Signs and symptoms in patients with salivary gland hypofunction.

Salivary gland hypofunction can have a devastating effect on oral health and may be an indicator of systemic disease such as Sjögren's syndrome. This prospective study investigates the oral and non-oral signs and symptoms in 120 patients with objective evidence of salivary gland hypofunction (ie, an unstimulated whole salivary flow of < 0.2 ml/min). Patients were questioned about symptoms associated with decreased oral function; non-oral symptoms were also noted. The underlying cause of salivary gland hypofunction was established on the basis of clinical and laboratory findings and further investigations. Eighty-five per cent of patients reported symptoms of decreased oral function in addition to oral dryness. Non-oral signs and symptoms were reported by 106 patients. Fifty-three per cent of patients were diagnosed as having Sjögren's syndrome. The prevalence of the following non-oral signs and symptoms were significantly higher in patients with Sjögren's syndrome, than in those without; a history of dry/irritated eyes, salivary gland swelling, dry skin and reduced lacrimal flow. Salivary gland hypofunction is associated with a wide range of oral and non-oral signs and symptoms. Several of these are of potential value as triggers for the clinician to identify patients with Sjögren's syndrome, and should serve to prompt referral for specialist investigation.

Adult↗
PubMed2004

PCNA, Ki-67 and p53 expressions in submandibular salivary gland tumours.

Salivary gland tumours are uncommon with a broad heterogeneity. The most common benign tumour is the pleomorphic adenoma, whereas mucoepidermoid carcinoma and adenoid cystic carcinoma predominate among the malignancies. Most salivary gland tumours occur in the parotid, and consequently clinical and biological data are normally derived from this site. This work describes the expressions of PCNA, Ki-67 and p53 in 15 pleomorphic adenomas, 15 mucoepidermoid carcinomas and 15 adenoid cystic carcinomas of the submandibular gland. Our results showed that all pleomorphic adenomas were negative for p53 and Ki-67 with 66.6% being positive for PCNA. Conversely, p53 was positive in 53% of the mucoepidermoid carcinomas and in 20% of the adenoid cystic carcinomas. Ki-67 was expressed in 47.7% of the mucoepidermoid carcinomas and 40% of the adenoid cystic carcinomas. All malignant tumours were positive for PCNA. These results indicate that the proliferative rate analysed with PCNA and Ki-67 and the expression of p53 in pleomorphic adenoma and adenoid cystic carcinoma of the submandibular gland were similar to those described in the parotid and minor salivary glands. However, mucoepidermoid carcinomas showed higher expression of these markers than those of other salivary glands. This work is the first describing the expression of these immunohistochemical markers exclusively in submandibular salivary gland tumours.

Adenoma, Pleomorphic↗
PubMed2000

Cervical tumor by ectopic salivary gland.

Heterotopic salivary tissue is a rare lesion, although most authors agree that anomalous embryologic development of salivary tissue is the main cause. One case of cervical tumor by ectopic salivary gland is reported, and existent literature is reviewed. A 26-year-old woman was operated on for a cystic tumor in the midline of the neck diagnosed as thyroglossal cyst in the hyoid region. After Sistrunk operation, the recurrence was immediate. A second operation was performed, and a solid tumor located between muscles of the tongue was resected. A long tract opening in recurrent cervical cystic tumor was also removed. No recurrence was evident at 1 year after surgery. Pathological examination of the excised mass revealed an ectopic salivary gland with serous and mucinous acini located between muscles of the tongue. This is a rare case report of a cervical fistula by ectopic salivary gland surrounded by muscles of the tongue draining into a cystic tumor in the hyoid midline lesion. Recurrence of thyroglossal cyst after a correct surgical resection must be suspected as an ectopic salivary tissue. Also when a cystic neck tumor is present, an ectopic salivary gland must be suspected.

Adult↗
PubMed2002

Gene transfer mediated by different viral vectors following direct cannulation of mouse submandibular salivary glands.

The salivary gland has been suggested as an accessible organ for gene transfer to express recombinant proteins locally in the saliva, as well as for secretion to the blood circulation. The aim of this study was to evaluate the efficiency of gene transfer to salivary glands using different viral vectors: adenovirus, vaccinia, herpes simplex type 1 (HSV), and two retroviral vectors (murine leukemia virus (MuLV) and lentivirus). We show, by in situ staining and beta-galactosidase reporter activity assay, that the adenoviral and vaccinia vectors were able to deliver the reporter gene efficiently to acinar and duct cells. The HSV vector was less efficient and infected only the acinar cells. The lentiviral vector infected acinar and duct cells, but at a relatively low efficiency. The MuLV vector did not infect the salivary gland unless cell proliferation was induced. Host immune responses to viral infection, inflammation, apoptosis and lymphocyte infiltration, in the transduced glands, were assessed. The DNA viral vectors induced local lymphocyte infiltration and apoptosis. In contrast, the retroviral vectors did not induce an immune response. Our results describe the outcome of salivary gland infection with each of the five different viral vectors and indicate their advantages and limitations for transferring genes to the salivary glands.

Adenoviridae↗
PubMed1984

Ultrastructural localization of fibronectin in duct cells of human minor salivary glands and its immunochemical detection in minor salivary gland secretion.

Fibronectin (Fn) was localized in duct cells by means of a light and electron microscopic immunohistochemical technique. The subcellular localization demonstrated that Fn is synthesized in these cells and thus not exclusively produced by cells with a mesodermal background. Fn concentration, as measured by radioimmunoassay, was higher in saliva from the minor salivary glands than in unstimulated whole saliva, whereas Fn was undetectable in stimulated parotid saliva. Fn is thus a conspicuous component in unstimulated resting saliva. Fn may be an important factor, negative or positive, for the integrity of the oral hard and soft tissues because it has the capability to bind and agglutinate microorganisms.

Fibronectins↗