Light and ultrastructural features of lymphoepithelial lesions of the salivary glands in Mikulicz's disease

This investigation deals with the histogenesis of the so-called 'epimyoepithelial islands' in Mikulicz's disease of the major salivary glands and is based on light and electron microscopic study in six patients. The 'epimyoepithelial islands' represent collapsed acini prior to their complete involution and disappearance, the intraductal cellular proliferation, stratification and differentiation into luminal and peripheral myoepithelial cells with partial and complete obliteration of their lumina and finally, cord-like proliferation and formation of nests of residual pluripotential cells showing squamous metaplasia and occasional myoepithelial cell differentiation. A pink, homogeneous and hyaline material on light microscopic examination is multilayered and extracellular and is in close association with the basal lamina when viewed with electron microscope.     

Coping with dental treatment: The potential impact of situational demands

Coping strategies and anxiety responding of dental patients were studied in order to test the generalizability of previous findings based on volunteer blood donors. State and trait coping measures were administered once, and a process coping scale was administered at three points throughout treatment. Self-report, behavioral observation, and psychophysiological measures of anxiety were sampled for the same periods as process coping. Findings included the replication of a negative relationship between avoidant coping and patient anxiety ratings. Fluctuations in coping were evident across periods, and impact of situational demands and constraints was introduced as an explanation for these variations. A method for direct assessment of coping consistency was introduced. On the basis of the replicable associations with anxiety measures, the ability to detect changes in coping within a situation, and the ability to provide direct evidence of coping consistency, the use of process methodology for coping assessment is encouraged.This research was conducted while the first author was supported by funding from the Medical Research Council of Canada.Portions of this research were presented at the annual convention of the Society of Behavioral Medicine, Philadelphia, 1984.     

Secretion of salivary immunoglobulin a in relation to age,saliva flow,mood states,secretion of albumin,cortisol, and catecholamines in saliva

Salivary immunoglobulin A (IgA) is one characteristic humoral factor of the local immune system in the upper respiratory tract. Epidemiological studies emphasize the importance of secretory IgA in the protection from infections of the upper respiratory tract. However, due to high interindividual variability of secretion of salivary IgA, it remains difficult to define normal ranges. This series of studies focused on identification of factors influencing basal secretion of salivary IgA. The results indicate a significant relationship between age and salivary IgA concentration. Children below 7 years have lower salivary IgA concentration than children above 7 years or adults. Furthermore, a significant inverse relationship between saliva flow and salivary IgA concentration was found. Gender, mood states, salivary albumin, salivary catecholamines, and salivary cortisol were not associated with salivary IgA. It can be concluded that for defining normal ranges of salivary IgA, age and saliva flow have to be considered.     

Adenoid cystic carcinoma of minor salivary glands. Analysis of 86 cases

Summary 819 salivary gland tumors in surgical pathology files over a 25-year period were reviewed. Among 117 adenoid cystic carcinomas, 86 were located in minor salivary glands and were selected for a clinico-pathological analysis. Complementary histoenzymological investigations and electron microscopic study were performed on specimens from 7 and 13 patients respectively.Adenoid cystic carcinoma occured in older patients (mean age of 54 years) than the other salivary neoplasms. The sex ratio was 1/1. The tumor was located more often in the palate and, to a lesser degree in the buccal floor, tongue or gums.Histologically, epithelial nests contained characteristic cyst-like spaces (cylinders) and 3 varieties of such cylinders were described (mucoid, mucohyalin and hyalin). According to the predominant pattern, 3 types of tumors were shown: basaloïd, cribriform and trabecular. A comparison between histological results and clinical behaviour, available in 67 patients, demonstrated positive correlations. The basaloïd form had always a poor prognosis (numerous early recurrences and metastases, frequent lethal evolution). The cribriform type had an intermediate prognosis, better than basaloïd type and less good than trabecular group (100% of patients still alive at 8 years).Histoenzymological studies revealed high level of acid phosphatase, alkaline phosphatase and leucine aminopeptidase activities round cylindromatous cavities. On the other hand, high oxidative enzyme activities were evenly distributed in all cell types.Ultrastructural findings emphasized the immature characters of epithelial tumor cells. These cells contained numerous ribosomes, but few other organelles. Some more differentiated glandular or epidermoid cells were scattered in neoplastic islands. Rare myoepithelial cells lay in periphery of lobules. Cylinder-like spaces were filled with replicated basal lamellae, mucopolysaccharidic granules and fibrillar structures (microfibrils and periodic collagen fibrils).In the light of these results the histogenesis of this neoplasm was discussed. Like the pleomorphic adenoma, adenoid cystic carcinoma was thought to arise from intercalated ducts. Unable to acquire any high degree of differentiation, this blastomatous tumor had a cellular component almost similar to that shown in intermediate stage of salivary gland embryogenesis.The authors wish to thank M.A. Leost and M. Tacnet for their technical assistance     

Ontogenesis of the secretory immune system and innate defence factors in human parotid glands

Immunoglobulin-producing cells and epithelial expression of secretory component (SC), amylase, lysozyme (Ly) and lactoferrin (Lf) were studied by immunohistochemistry to obtain information about the development of mucosal immunity. Tissue specimens were obtained from 20 fetal and 40 postnatal parotid glands. (1) Fetal specimens. Occasional IgM- and IgA- but no IgD-, IgG- or IgE- producing cells were seen (ratios, IgM:IgA:IgD:IgG:IgE approximately 4:1:0:0:0). The IgAl subclass dominated (median 90%, range 50-95%) and these cells were mostly J-chain-positive (median 97%, range 94-98%). Only few IgA2-producing cells were seen (median 10%, range 5-50%) and they were also mostly J-chain-positive (median 99%, range 98-100%). Amylase, Ly and Lf were most prominent in early fetal life, while only small amounts of SC were present. (2) Postnatal specimens. Secretory component increased markedly along with a growing number of IgA- and IgD-producing cells (IgA:IgM:IgD:IgG:IgE approximately 4:2:1:1:0). The IgAl subclass remained predominant (median 65%, range 50-90%) although the proportion of IgA2-positive cells tended to be raised (median 35%, range 10-50%). Most IgAl (median 97%, range 67-100%) and IgA2 (median 94%, range 75-100%) cells were J-chain-positive. These features probably reflected local activation of the immune system in response to environmental factors. The amount of amylase, Ly and Lf decreased shortly after delivery, perhaps because the cellular stores were emptied by postnatal increase in secretory activity.     

Electron Microscopic Study of Adenoid Cystic Carcinoma

This ultrastructural study is based on nine cases of adenoid cystic carcinoma arising from the salivary glands. Electron microscopically, the tumors consisted of five cell types: relatively differentiated intercalated duct cells, secretory cells, undifferentiated cells, cells of a squamous nature, and myoepithelial cells. Special attention was paid to the characteristic extracellular substances noted by light microscopic examination of these tumors. The hyaline material of the pseudocysts contained not only mucopolysaccharide granules but also fingerprintlike structures formed by replicated basement membrane. Some of these structures had a dense core, probably composed of mucopolysaccharide granules. Cell islands surrounded by elasticlike material also were found. The true lumina were usually filled with membranovesicular structures originating from fragments of the lining cells, mainly those with squamous differentiation. These membranovesicular structures included electron-dense rods, filamentous whorls, and structures displaying periodicity.     

53例涎腺腺样囊性癌MMP—2和MMP—9表达与神经浸润和淋巴结转移的关系

目的研究涎腺腺样囊性癌MMP-2和MMP-9表达情况,评估其与涎腺腺样囊性癌神经浸润和淋巴 结转移的关系。方法选取53例涎腺腺样囊性癌,以抗MMP-2和MMP-9单克隆抗体用Envision法进行免疫 组织化学染色和半定量分析。结果MMP-2和MMP-9在涎腺腺样囊性癌中的表达率分别为67.92％和 79.25％;有神经浸润的腺样囊性癌其MMP-2和MMP-9的表达水平远高于无浸润者(P＜0.05,P＜0.05);随 着MMP-2和MMP-9的表达水平增高,淋巴结转移率也增高(P＜0.05,P＜0.05)。结论提示MMP-2和 MMP-9的高表达与涎腺腺样囊性癌易侵犯神经的特性及发生淋巴结转移密切相关。     

Diagnostic and prognostic biomarkers in salivary gland tumours

Salivary glands are a heterogeneous group of neoplasms and are diagnostically challenging with overlapping microscopic features between tumours as well as intra-tumour morphological diversity. Correct diagnosis is essential to ensure appropriate management and follow-up. Morphological and cytological analysis of haematoxylin and eosin stained tissue sections is supplemented by a large number of immunohistochemical and special stains as well as molecular rearrangements. A broad literature search was performed to provide an overview of all biomarkers used for diagnosis and prognosis prediction of salivary gland tumours. The wide range of biomarkers reported in the literature can be overwhelming but used in the correct context can aid diagnosis and predict the behaviour of these challenging tumours. They can also help identify recently described new entities.     

Concordance of second opinion diagnosis in salivary gland cytopathology: experience from a single academic institution

Interpretation of fine needle aspiration (FNA) material from salivary gland lesions has high interobserver variability due to the heterogenous and overlapping cytological features of various lesions. For this reason, second opinion consultation may play an important role in guiding appropriate clinical management for challenging cases. We aimed to report our experience with salivary gland cytology consultation cases at our academic center. Consecutive salivary gland FNA cases received from outside institutions for second opinion consultation between 2013 and 2022 were reviewed. Cases were divided into true consults (diagnostic assistance sought) or confirming consults (reviewed by in-house cytopathologists for patients being transferred to our institution for treatment). All diagnoses were re-classified using the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). Discordance between reclassified consult diagnostic categories and preliminary diagnostic categories was recorded. Consultation resulted in a change in the diagnostic category in 15% of confirming and 18% of true consult cases. The overall distribution of diagnostic categories provided by outside pathologists was similar to consult diagnoses. Only 4 (5.4%) confirming and 3 (5.5%) true consult cases had major diagnostic discrepancies, which may impact the clinical treatment. Moderate interobserver variability is often expected with salivary gland FNA. However, in our consultation practice, we found a relatively high degree of concordance between submitting and consult diagnoses utilizing the MSRSGC.     

涎腺淋巴上皮瘤样癌

对 5例涎腺淋巴上皮瘤样癌进行临床病理和免疫组织化学染色观察。其是一种具有特殊组织学表现的低分化或未分化癌 ,浸润的淋巴细胞以T细胞为主。肿瘤预后与肿块大小、发生部位、浸润程度及有否淋巴结转移有关。诊断应与良性淋巴上皮病变、转移或浸润性低分化鳞癌及恶性淋巴瘤进行鉴别。