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Diagnosis of salivary gland disease using ultrasound and sialography: a comparison.

Thirty-one patients with a suspected inflammatory or neoplastic lesion of a major salivary gland were investigated with ultrasound, and in 27 of them sialography was carried out in addition. The results of the diagnostic procedures were compared. Lesions of the gland parenchyma and intra and extra-glandular duct ectasia were demonstrated by ultrasound. Salivary stones were demonstrated by this method and ultrasound allowed assessment of periglandular structures. Sialography is indispensable for detailed assessment of the salivary ducts. The present report shows that ultrasound is superior to sialography in the assessment of salivary gland disease. The investigation is non-invasive, cheap, and requires neither contrast nor radiation and can be repeated at will for follow-up.

Adenolymphoma↗

Salivary gland disease in HIV/AIDS and primary Sjögren's syndrome: analysis of collagen I distribution and histopathology in American and African patients.

BACKGROUND: Salivary gland disease (SGD) in HIV/AIDS is clinically and histopathologically very similar to Sjögren's Syndrome (SS), although the mechanism of tissue damage is unknown. The aim of this study is to determine the prevalence of SGD in primary SS and in HIV/AIDS in USA and in West African patients, and to seek distinguishing histopathologic features that may help to elucidate underlying mechanisms. METHODS: Histologic sections of minor salivary glands from 164 HIV-positive and -negative patients from Cameroon and the US, and from 17 US patients with primary SS, were evaluated following salivary gland biopsy for inflammatory changes. To confirm the presence of fibrosis, collagen I, which is the most abundant collagen type, was assessed immunohistochemically in H&E-stained sections. RESULTS: Forty-eight per cent of patients with HIV from Cameroon had severe SGD, while it was only in 6% of patients from the US. Patients with HIV in the US had less fibrosis and collagen I deposits than Cameroonians. Seventy-six per cent of US HIV-positive patients had received anti-retroviral therapy, while none of the African patients had. SS and AIDS patients had a tendency for lymphocytes to locate in a perivascular rather than in a periductal distribution. CONCLUSIONS: The prevalence of SGD and the presence of fibrosis and collagen I in Cameroonians with HIV is significantly higher than in HIV-positive American patients, and is similar to US patients with primary SS. The impact of patient selection, anti-retroviral therapy, and pathogenic mechanisms on salivary gland pathology is discussed.

Acquired Immunodeficiency Syndrome↗

Ultrasonographic evaluation of salivary gland diseases.

Ultrasonography is an imaging modality in which the high frequency sound waves are sent into the tissues and the acoustic impedence of the tissues are received, amplified and imaged. The echoes of the tissues vary according to their densities. Ultrasonography is applied in the field of medicine, in the evaluation of soft tissues, to record their movements and to assess their vascularity. In the oro-facial region, ultrasonography is employed in the evaluation of salivary glands, cervical lymph nodes, in soft tissues and post-operative swellings. Ten interesting cases of salivary gland diseases are presented here, each case showing a characteristic sonographic feature and providing a useful diagnostic clue in the identification of the disease.

Adolescent↗

Salivary gland disease in dogs and cats: 245 cases (1985-1988).

Diagnostic pathology records spanning 41 months (July 1985 through November 1988) were searched for diagnoses of salivary gland disease in dogs and cats. Review of 87,392 records from that period revealed 245 cases (0.3%) in which salivary gland tissue had been evaluated. During that period, salivary gland tissue was submitted to the laboratory almost twice as often from dogs (160 cases) as from cats (85 cases). On the basis of histologic examination, 89% of salivary gland submissions from small animal practices were allotted to 1 of 5 major categories: malignant neoplasms (30%; 74/245), sialadenitis (26%; 64/245), normal salivary gland (16%; 40/245), sialocele (9%; 21/245), and salivary gland infarction (8%; 20/245). The remaining 11% of submissions included various degenerative or fibrotic lesions, ductal ectasia, sialolithiasis, edema, benign neoplasia, and secondary salivary involvement with systemic or cervical lymphosarcoma or with fibrosarcoma in the head and neck.

Animals↗

Salivary gland disease in human immunodeficiency virus-positive women from the WIHS study. Women's Interagency HIV Study.

OBJECTIVE: To determine the prevalence of enlargement, tenderness, and absence of saliva on palpation as indicators of salivary gland disease in women who are human immunodeficiency virus (HIV)-positive. STUDY DESIGN: The study subjects are participants in the Women's Interagency HIV Study (WIHS), a multicenter study examining HIV-seropositive women and at-risk HIV-seronegative women. A total of 576 HIV-positive women and 152 HIV-negative women were examined at their baseline oral visit for clinical markers of salivary gland disease. Viral load levels, CD4 counts, and CD8 counts were obtained as part of the related core study. RESULTS: HIV-positive women had higher rates of salivary gland enlargement (4.3%), tenderness (6.9%), and absence of saliva on palpation (26.6%) compared with HIV-negative women, who had rates of 1.3%, 4.6%, and 13.2%, respectively. Absence of saliva was significantly different (P =. 001) between the 2 groups. When 2 of the 3 clinical findings were combined, comparisons between the HIV-positive women and HIV-negative women became significant at the P <.05 level for every combination, except for enlargement/tenderness for the submandibular/sublingual gland. For the HIV-positive women, the viral load was significantly related to enlargement (P =.019) and enlargement/absence of saliva on palpation (P =.037) for the parotids and enlargement (P =.046), absence of saliva (P =.043), and enlargement/absence of saliva (P =.022) for the submandibular/sublingual glands. Significant linear trends were found for increasing viral load and enlargement (P =.013) and enlargement/tenderness (P =.024) for the submandibular/sublingual glands. Significance was present for submandibular/sublingual absence of saliva and tenderness/absence of saliva for CD4 and CD8 medians. CONCLUSIONS: Serostatus is related to salivary gland disease as assessed by glandular enlargement, tenderness, and absence of saliva on palpation. Furthermore, our findings indicate that a multidimensional approach to gland assessment may provide a more complete and perhaps more adequate description of glandular involvement with HIV infection.

Adolescent↗

[Usefulness of imaging in the diagnosis of salivary gland diseases].

UNLABELLED: The aim of this study was to evaluate the value of modern imaging modalities in the diagnosis and management of different salivary gland diseases. MATERIAL AND METHODS: Material comprised of 135 patients (79 women and 56 men) at the age 14-70 (mean aged 35, 7). Ultrasonography (US) was basic examination in every case. Results of US examinations were compared with sialography, CT and MR imaging. Final diagnosis was established on the basis of histopathologic examination. RESULTS: The big usefulness of new visualization techniques, especially modem ultrasonography in detecting neoplastic and inflammatory processes of salivary glands was stated. CONCLUSION: US is the first, precious imaging modality to evaluate a small lesions (in diameter above 5 mm) of the parotid and submandibular gland. CT and MR is better to evaluate large tumors and should be performed whenever a malignancy is strongly suspected or has been assessed.

Adolescent↗

The role of MRI in facial swelling due to presumed salivary gland disease.

50 consecutive patients presenting with facial swelling thought clinically to be due to salivary gland disease underwent MRI. Examinations were interpreted by one radiologist without access to previous investigations. Records were reviewed to determine the reliability and role of MRI in patient management, and the contribution of other prior or subsequent investigations. MRI findings were verified against operative findings, percutaneous biopsy or clinical follow-up (periods ranging from 8-58 months). A mass was found in 27 patients; in 11 of these patients, disease was extrinsic to the salivary gland. MRI diagnosis of tumour was correct in all patients and MRI was a reliable investigation for planning surgical resection. No mass was found in 23 patients, 8 of whom had normal appearances. Evidence of salivary duct dilatation was seen in 12 patients and fatty infiltration was seen in 3. MRI findings appeared correct in all patients. Prior investigation was undertaken in 29 patients, including orthopantomography, ultrasound and sialography; none provided additional information. Sialography was carried out in three patients after MRI and concurred with MRI in all cases. MRI was an adequate basis for management in all patients and therefore appears to be an effective first line investigation of facial swelling. It is reasonable for patients to undergo preliminary investigation for dental sepsis, this being the most common cause of facial swelling. Further study is required to determine whether MRI can completely replace invasive sialography.

Adenoma, Pleomorphic↗

An association between salivary gland disease and serological abnormalities in Sjögren's syndrome.

In the labial salivary glands (LSGs) of 16 primary and 18 secondary Sjögren's syndrome (SS) patients, infiltrating lymphocytes were histologically and immunohistochemically examined; also, the serum levels of rheumatoid factor, antinuclear antibodies, anti-DNA antibodies, anti-SS-A and anti-SS-B antibodies, and immunoglobulins (including IgG, IgM and IgA) were all assayed. An immunohistochemical analysis of the lymphocyte subsets in LSGs revealed that severe lymphocytic infiltration was frequently accompanied by marked B cell accumulation both in primary and secondary SS patients. Furthermore, local B cell accumulation was also closely associated with elevated levels of anti-SS-A and anti-SS-B antibodies and IgG, and this association was statistically significant in the group with primary SS but not in the group with secondary SS. Thus, local lymphocytic infiltration, especially B cell accumulation, in the salivary glands is suggested to be involved in serological abnormalities in primary SS, while complicated autoimmune diseases other than SS may also be involved in serological abnormalities in secondary SS.

Adolescent↗

Benign salivary gland disease.

The majority of benign clinical problems that present affect the major salivary glands--parotid and submandibular. However, there are numerous minor salivary glands located in the mucosa of the head and neck which have the same predilection to the same diseases that affect the major glands but to a lesser frequency.

Adult↗

Ultrasound in salivary gland disease.

This text reviews the normal ultrasound (US) anatomy of the salivary glands along with tumoral, lithiasic, and inflammatory pathologies. For salivary gland tumors, US does have limitations (failure to visualize the entire parotid gland, relations with the nerve plexus, in-depth spread of large tumors, false-negative errors of malignancy for small encapsulated tumors). However, US is a simple technique allowing correct identification of the benign nature of a lesion in over 80% of the cases. For lesions under 3 cm in diameter, US is generally the only imaging technique used; for larger lesions, CT or MR is required. Sialolithiasis and inflammatory diseases are being documented by US more and more and the indications for sialography have strongly decreased.

Adenolymphoma↗

Diagnostic imaging in salivary gland disease.

A review of the current status of salivary gland imaging is presented. The potentials and limitations of sialography, scintigraphy, ultrasonography, computed tomography, and magnetic resonance imaging are discussed so that a rational approach to their use can be adopted.

Diagnostic Imaging↗