Clear cell carcinoma of minor salivary glands

Two cases of carcinoma of the minor salivary glands are presented in which most cells had clear cytoplasm. Both patients had clinical histories in excess of 10 years and, in the one case with adequate follow-up, no recurrence had occurred after a further 11 years. Both tumours were locally invasive. The clear cells contained small amounts of glycogen, but no intracytoplasmic mucin. Immunohistochemical and ultrastructural studies showed epithelial features, with no evidence of myoepithelial differentiation. These tumours were very similar to the small number of previously reported cases, which were all considered to be low-grade carcinomas. Amongst the differential diagnoses, the most important is metastatic clear cell carcinoma of the kidney and this can only be confidently excluded clinically or by the use of imaging techniques. In summary, we consider intraoral clear cell carcinoma to be a distinct tumour of low malignant potential.     

Electron microscopic immunogold localization of statherin in human minor salivary glands

In this study, which supplements a recent article on the localization of statherin in human major salivary glands, we investigated the intracellular distribution of this peptide in minor salivary glands by immunogold cytochemistry at the electron microscopy level. In the lingual serous glands of von Ebner, gold particles were found in serous granules of all secreting cells, indicating that statherin is released through granule exocytosis. In buccal and labial glands, mostly composed of mucous tubuli, statherin reactivity was detected in the serous element, which represents only a small population of the glandular parenchyma. In these serous cells, however, statherin labeling was absent in secretory granules and restricted to small cytoplasmic vesicles near or partially fused with granules. Vesicle labeling could be related to the occurrence of an alternative secretory pathway for statherin in buccal and labial glands.     

Multifocal canalicular adenoma of the minor labial salivary glands

Canalicular adenoma (CA) is an uncommon benign neoplasia of salivary glands which is clinically difficult to recognise. Despite having an excellent prognosis, the histological diagnosis and clinical management of this entity can be troublesome. While the main differential diagnosis to consider is basal cell adenoma (BCA), similar histological patterns and multifocality have been observed in adenoid cystic carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA), both locally-aggressive malignancies which require radically different treatment to CA. An emphasis has been placed on the value of immunohistochemistry in avoiding diagnostic and surgical errors. CA is positive for AE1/AE3, CD117 and S-100 protein, and negative for p63, α-SMA, Ki 67 and vimentin. Here we discuss the case of a 61-year-old female with CA in her right upper lip, showing multifocal growth histologically. The differential diagnosis with other adenomas is discussed in addition to the role of immunohistochemical studies that can confirm the clinical and surgical findings.     

Histochemical study of Magellanic penguin (Spheniscus magellanicus) minor salivary glands during postnatal growth

The histological and histochemical features of the minor salivary glands during postnatal development have been generally associated with the type of food ingested. However, recent studies support the fact that these salivary glands develop independently of the diet; in fact, minor salivary glands have similar morphological and histochemical characteristics in adult individuals of species with different diet regimens. Thus, the aim of this study was to characterize the developmental morphology of the penguin minor salivary glands and to contrast them with minor salivary glands of other species. The tongue, palatine, and mouth cavity (bottom) minor salivary glands of newborn, 1‐ to 20‐day‐old, and adult magellanic penguins were studied with hematoxylin–eosin, periodic acid–Schiff, alcian blue, toluidine blue, and lectin histochemistry. Minor salivary glands were present at all ages, although they were only moderately developed in animals less than 15 days old. After this age, glands were abundant in all age groups; in addition, cells from the glandular epithelium were functionally mature and secreted mucins. Nevertheless, in newborn to 15‐day‐old penguins, mucins were located only at the apical cytoplasm of mucous cells. In all ages, mucous cells displayed periodic acid–Schiff‐positive, alcianophilic, and metachromatic reactions; among mucous cells, other orthochromatic cells appeared interspersed. From 15 days on, histochemical reactions became more intense until adulthood, and the cytoplasm of secretory cells was filled with glycoproteins and sulfomucins. Moreover, lectins bound to different oligosaccharides in mucous cells, depending on the stage of maturation of the glands. In conclusion, penguin minor salivary glands are already present at birth, and show progressive and quantitative increases in mucous secretionduring postnatal development. These changes are necessary not only for nutrient ingestion, but also for nonimmune protection of the buccal cavity. Anat Rec 254:298–306, 1999. © 1999 Wiley‐Liss, Inc.     

Plasma cell populations in labial salivary glands from patients with and without Sjögren's syndrome

Plasma cells expressing IgG, IgA and IgM were quantified in labial salivary glands from patients with Sjögren's syndrome (n = 25) and compared with glands from patients with a variety of systemic diseases (n = 32) and normal individuals (n = 15). Based on qualitative and quantitative analysis, glands from the systemic disease group were divided into normal histology (n = 24) and non-specific inflammation (n = 8) groups. There were no significant differences in cell densities or Ig class proportions between histologically normal glands from patients and those from normal volunteers. Total immunocyte densities were significantly increased in sialadenitis ( P ≤0.025) and Sjögren's syndrome ( P ≤0.001) compared with normal histology glands. In both the sialadenitis and Sjögren's syndrome groups there were significant increases in IgG and IgM cell densities (IgG, P ≤0.006; IgM, P ≤0.001) and proportions (IgG, P ≤0.05; IgM, P ≤0.001). There were no significant differences in immunocyte densities or proportions between the sialadenitis and Sjögren's syndrome groups except for a lower percentage proportion of IgA cells in the latter ( P ≤0.038). In all groups the total and individual Ig-class cell densities showed significant positive correlations with extent of leucocyte infiltration ( P ≤0.01) and negative correlations between IgA and IgG and/or IgM cell proportions. Analysis of the plasma cell data alone and in combination with quantifiable histological parameters failed to yield specific or sensitive diagnostic information. The results suggest that changes in glandular plasma cell populations in Sjögren's syndrome are non-specific.     

Oncocytic hyperplasia in the human minor salivary glands: A post-mortem study

Oncocytic hyperplasia in the human labial salivary glands was sought in a series of 217 post-mortem subjects. Oncocytic change occured in 183 subjects and hyperplasia was found in 19 of those (the overall incidence being 8.8%), ranging in age from the third deacde to the ninth. The sex distribution showed a significantly greater rate in males (16 of 139 males, 11.5%; 3 of 78 females, 3.8%). Oncocytic hyperplasia occurred in the duct system, and not in the acinar regions; it was frequently seen in the interlobular and intralobular ducts. Oncocytic hyperplasia was classified into four types; focal hyperplasia of the duct wall resulting in partial thickening of the duct wall; marked hyperplasia resulting in thickening of the duct wall, extending over half of the circumference; marked hyperplasia extending to the whole duct wall and intralobular adeno-tubular hyperplasia with or without cystic dilatation. About half of the subjects with oncocytic hyperplasia showed a few hyperplastic foci in one gland. The changes increased in severity in older subjects.     

Phenotypes in canalicular adenoma of human minor salivary glands reflect the interplay of altered secretory product, absent neuro-effector relationships and the diversity of the microenvironment

AIMS: Uncertainty about the factors influencing phenotypes in salivary canalicular adenoma prompted the present investigation. METHODS AND RESULTS: Specimens of canalicular adenoma from 15 patients were examined with the use of histology, histochemistry for protein, mucosubstances and pigments, nerve staining and immunocytochemistry for cytoskeleton components. The tumours consisted largely of simple cells lining tubules that were occasionally cystic or branching and budding, and were set in loose, vascular and often haemorrhagic stroma. Other phenotypes recognized were mucous cells, apocrine-like cells, pigmented cells, microliths and stromal macrophages, detected in 26.6%, 20%, 33.3%, 20% and 53. 3% of the patients, respectively. Simple cells showed moderate levels of -SH groups and strong immunoreactivity for 'simple' epithelial phenotype cytokeratin. The simple cells lining cystic tubules showed additional immunoreactivity for 'stratified' epithelial phenotype cytokeratin, possibly an adaptation to mechanical pressure. Lumina showed variable levels of neutral and carboxylated glycoproteins, and chondroitin sulphate. Stroma showed high levels of chondroitin sulphate and hyaluronic acid. Mucous cells showed high levels of -SS- groups and nonsulphated glycoproteins. Apocrine-like cells contained lipofuscin. Pigmented cells contained haemosiderin, possibly a consequence of localized iron overload. Microliths contained mucosubstances. Macrophages often contained lipofuscin. No nerves were found in relation to the tumours. CONCLUSIONS: The results suggest that, contrary to popular belief, phenotypes in canalicular adenoma do not reflect histogenetic concepts but rather may derive from the interplay between an altered secretory product, consisting of glycosaminoglycan and an immature form of glycoprotein, the lack of neuro-effector relationships and the different microenvironments throughout the tumour.     

Detection of Epstein-Barr virus antigens and DNA in major and minor salivary glands using immunocytochemistry and polymerase chain reaction: possible relationship with Sjogren's syndrome.

This study has investigated the presence of Epstein-Barr virus (EBV) in parotid (n = 12), submandibular (n = 15), and minor salivary glands (n = 25) using immunohistochemical methods for detection of EBV-encoded antigens and the polymerase chain reaction (PCR) for detection of viral DNA. Major salivary glands were from patients without connective tissue disease. Labial glands were from patients with primary Sjogren's syndrome (n = 10), rheumatoid arthritis (n = 8), or from normal individuals (n = 7). None of the glands exhibited specific reactivity for lytic (EA-D, EA-R, VCA) or latent (EBNA-2, LMP) viral antigens. Antibodies to EA-D, when used at 20-50 times their optimal concentration, gave lumenal staining of ducts and acini of all the specimens tested (n = 14), irrespective of the presence (n = 8) or absence (n = 6) of EBV-DNA by PCR. Ductal immunoreactivity for the EBV/C3d (CR2, CD21) receptor was found in 40 per cent of specimens. PCR detected EBV-DNA in 64 per cent submandibular, 46 per cent parotid, and 80 per cent of minor glands. There were no significant differences in the detection of EBV-DNA between specimen/patient groups. Only type A EBV was detected by strain typing PCR. These results indicate that EBV (type A), undetected immunocytochemically, is commonly present at low copy numbers within salivary glands irrespective of a clinical diagnosis of Sjogren's syndrome.     

原发性干燥综合征的涎腺超声表现

干燥综合征是一种发病率仅次于类风湿关节炎的自身免疫病,多累及涎腺和泪腺,以中年女性多见。其病因尚不清楚,诊断标准不一,诊断方法各有千秋。本文将超声在原发性干燥综合征中的作用加以综述,为临床提供一种更好的诊断方法。     

Existence and distribution of melanocytes and HMB-45-positive cells in the human minor salivary glands

The existence and distribution of melanocytes in the human minor salivary glands were investigated in a series of autopsy and biopsy materials. The cells with the following characteristics were regarded as melanocytes; spindle-shaped or dendritic cells with fine granular pigments: (i) stained brownish-black by hematoxylin-eosin stain, and black by Masson-Fontana's silver impregnation method; and (ii) disappeared after treatment with peroxide and potassium permanganate solution. In addition, the expression of antigen identified by anti-HMB-45 antibody in serial sections with melanocytes was examined. Melanocytes were found in eight (1.8%) of 445 cases, and there was no relationship between the existence of melanocytes and significant diseases of the subjects. Various numbers of melanocytes were distributed in fibrous tissue around the interlobular ducts, intralobular ducts and acini, but were not in direct contact with the epithelia. Neither melanocytes nor melanin granules were found in the salivary gland epithelia. HMB-45-positive cells without intracytoplasmic fine granules were found solitarily or in small groups in periductal and periacinar fibrous tissues with or without slight infiltration of small mononuclear cells.     

Diagnostic difficulties in lesions of the minor salivary glands

A wide range of lesions arise from the intra-oral salivary glands, and often present a diagnostic challenge to specialists and generalists alike. Of the salivary neoplasms, pleomorphic adenoma is the most common, but its morphological diversity may bring several other entities to mind, notably polymorphous adenocarcinoma, particularly in a small incisional biopsy. Polymorphous adenocarcinoma in turn shares features with adenoid cystic carcinoma. Immunohistochemistry and molecular cytogenetic studies can assist diagnosis in the face of overlapping morphology. The other salivary neoplasms most likely to be encountered in the oral cavity are canalicular adenoma, mucoepidermoid carcinoma, secretory carcinoma and acinic cell carcinoma. Of the non-neoplastic conditions, necrotising sialometaplasia is most likely to be misdiagnosed as neoplastic on both clinical and histological grounds. However, careful consideration of the clinicopathological features of an adequate tissue specimen will enable correct diagnosis.     

Apoptosis and apoptotic-related factors in mucoepidermoid carcinoma of the oral minor salivary glands

The oncoproteins Bcl-2 and Bax, the tumor suppressor gene product p53, TUNEL (TdT [terminal deoxynucleotidyl transferase] dUTP nick end-labeling) and the cell-cycle antigen Ki-67 were studied in 71 cases of mucoepidermoid carcinoma originating in the oral minor salivary glands. Grade I tumors had higher expression of Bcl-2 than Grade II and III tumors (chi2 test, 0.01相似文献   

Development of human minor salivary glands: expression of mucins according to stage of morphogenesis

The formation of salivary glands entails the proliferation of epithelial cells from the stomatodeum into the underlying ectomesenchyme, culminating in a complex network of ducts and acinar bulbs. The extent to which mucins regulate this process is unknown, but they appear to mediate luminal space formation and maturation. Our aim was to examine mucin expression patterns during the morphogenesis of human salivary glands. Mucin expression - MUC1, 2, 3, 4, 5AC, 5B, 6, and 16 - was analyzed in specimens of developing human salivary glands, obtained from fetuses at 4-24 weeks' gestation, and fully developed salivary glands by immunohistochemistry. Expression patterns were analyzed qualitatively according to the development stage of the salivary glands. Mucins 1, 3, 4, 5B, and 16 were expressed during salivary gland development - being stronger in all ductal segments by the final phases of branching morphogenesis and in mature glands. Acinar cells were negative for most mucins, including MUC1 in mature salivary glands. Mucins 2, 5AC, and 6 were not expressed. Mucins MUC1, 3, 4, 5B, and 16 are expressed in developing human salivary glands and in mature glands, suggesting important roles in the maturation and maintenance of the ductal network.     

Basaloid carcinomas of salivary glands

Three cases of carcinoma of major salivary glands with basaloid morphology are presented. One case was a clear example of a basal cell adenocarcinoma, an uncommon and infrequently recognized, low-grade tumour of major salivary glands. The remaining two cases showed a higher cytological grade of malignancy but shared some features of basal cell adenocarcinoma. Common features included the architectural pattern and myoepithelial cell differentiation, as demonstrated by smooth muscle-specific actin positivity, in cells associated with the deposition of extracellular basal lamina-like material. The relationship between these cases and adenoid cystic carcinoma is discussed.     

Identification of oncocytic lesions of salivary glands by anti-mitochondrial immunohistochemistry

 

Aims:

To evaluate the immunohistochemistry using an anti-mitochondria antibody in the investigation of various oncocytic lesions of the salivary glands.  

Methods and results:

Ten cases of adenolymphoma (Warthin's tumour) and one case each of benign oncocytoma and oncocytic carcinoma of the salivary glands were examined. Normal salivary glands were also tested. They were investigated immunohistochemically using mouse monoclonal antibody against human mitochondria. In normal salivary glands, epithelial cells of the striated ducts showed a thick linear immunoreactivity, which corresponded well to the intracytoplasmic distribution pattern of mitochondria. In addition, a small number of swollen epithelial cells showing an intense, finely granular immunoreactivity in the cytoplasm were scattered in the ductal system and acini ('oncocytic metaplasia'). Almost all neoplastic cells involved in adenolymphoma, benign oncocytoma, and oncocytic carcinoma showed an intense, finely granular immunoreactivity in the cytoplasm.  

Conclusions:

Immunohistochemistry using the anti-mitochondria antibody proved to be a highly sensitive and specific method for light microscopic identification of mitochondria and superior to routine H & E or PTAH stain especially in the detection of isolated oncocytic cells.     

干燥综合征并原发性胆汁性肝硬化致多种心律失常

 报道1例出现多种心律失常的干燥综合征并原发性胆汁性肝硬化患者,以提高对此类患者的诊治水平。     

Autoimmune hepatitis in primary Sjogren's syndrome: pathological study of the livers and labial salivary glands in 17 patients with primary Sjogren's syndrome

Although primary Sjogren's syndrome (pSS) is an autoimmune exocrinopathy, the involvement of liver has been reported. Because no study focusing on autoimmune hepatitis (AIH) in pSS has been published, the purpose of the present study was to perform a clinical and histological examination of the liver, focusing on AIH, in 17 pSS patients. The patients had liver enzyme abnormalities without hepatitis virus infection. In all cases, biopsied livers were examined, and in 10 cases biopsied labial salivary glands were also examined histologically. Based on the authors' diagnostic criteria for AIH in pSS, the liver diseases consisted of AIH (eight cases, 47%), primary biliary cirrhosis (PBC; six cases, 35%), non-specified chronic hepatitis (two cases, 12%) and acute hepatitis (one case, 6%). Lymphoplasmacytic infiltrate, with predominancy of CD3(+) T cells, was noted in both the liver and salivary glands in the patients with AIH. The patients with AIH with severe interface hepatitis had a good response to immunosuppressive therapy. The comparison of liver histology between the PBC with pSS group and the PBC without pSS group showed that the incidence of lymphoid non-suppurative cholangitis was higher in PBC with pSS. In conclusion, the present study offers new information on the relatively common occurrence, diagnostic criteria and treatment effects of AIH in pSS.