RESUMO
SUMMARY: The salivary glands in pathological conditions produce countless different clinical presentations, and due to their complex neuroanatomy, their pain symptoms vary widely. However, in the literature to date, few studies characterize salivary gland pain. The aim of this study was to conduct a literature review concerning the clinical characteristics of pain in various salivary gland pathologies. A literature review was done through a systematic search of scientific articles in the Web of Science (WoS), MEDLINE, Scopus, and Elton B. Stephens Company (EBSCO) databases. The free terms "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", and "pain" were used along with the Boolean operators OR and AND. The search yielded a total of 1896 articles, of which 60 fulfilled the inclusion criteria and were ultimately included in this review. It is described that pain is a nonspecific symptom of a glandular pathology and is characterized mainly by the location of the pain, which is correlated with the anatomical location of the affected salivary gland. Among the painful salivary gland pathologies, we found inflammatory disorders, including infections, obstructions, disorders secondary to hyposalivation; systemic autoimmune diseases; neoplasms, and neuropathic pain disorders. The diagnosis and management of salivary gland pain require knowledge of the causes and mechanisms of the pain, and it is to recognize the signs and symptoms of salivary gland disorders to be able to diagnose and treat them.
Las glándulas salivales en condiciones patológicas producen un sinfín de presentaciones clínicas diferentes, y debido a su compleja neuroanatomía generan variaciones en su sintomatología dolorosa. Sin embargo, en la literatura hasta ahora son escasos los estudios que caracterizan el dolor de glándulas salivales. El objetivo de este estudio fue realizar una revisión de la literatura respecto a las características clínicas del dolor en diversas patologías de glándulas salivales. Se realizó una revisión de la literatura, a través de la búsqueda sistemática de artículos científicos en las bases de datos Web of Science (WoS), MEDLINE, Scopus y Elton B. Stephens Company (EBSCO). A través de los términos libres: "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", "pain", junto con los operadores booleanos OR y AND. La búsqueda arrojó un total de 1896 artículos, de los cuales 60 cumplieron los criterios de inclusión y fueron finalmente incluidos en esta revisión. Se describe que el dolor es un síntoma poco específico para la patología glandular y está caracterizado principalmente por la localización del dolor, el cual se correlaciona con la ubicación anatómica de la glándula salival afectada. Dentro de las patologías dolorosas de glándulas salivales encontramos los trastornos inflamatorios, incluidas infecciones, obstrucciones, trastornos secundarios a hiposalivación; enfermedades sistémicas autoinmunes; neoplasias y trastornos de dolor neuropático. El diagnóstico y manejo del dolor de glándulas salivales requiere del conocimiento de las causas y mecanismos del dolor, siendo necesario reconocer los signos y síntomas de los trastornos de glándulas salivales para ser capaces de diagnosticarlos y tratarlos.
Assuntos
Humanos , Doenças das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Dor FacialRESUMO
Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.
Assuntos
Doenças da Boca , Mucocele , Doenças das Glândulas Salivares , Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Mucocele/epidemiologia , Mucocele/patologia , Doenças das Glândulas Salivares/patologia , Doenças das Glândulas Salivares/cirurgia , Estudos Retrospectivos , Estudos Transversais , Doenças da Boca/epidemiologia , Doenças da Boca/patologiaRESUMO
Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/patologia , Doenças das Glândulas Salivares/terapia , Doenças das Glândulas Salivares/epidemiologia , Parotidite/epidemiologia , Sialadenite/epidemiologia , Espectroscopia de Ressonância Magnética , Cálculos das Glândulas Salivares/epidemiologia , Tomografia Computadorizada por Raios X , Prontuários Médicos , Incidência , Prevalência , Estudos Retrospectivos , Estudos Longitudinais , Ultrassonografia , Biópsia por Agulha Fina , AlemanhaRESUMO
OBJECTIVE: This systematic review evaluated the efficacy of immunobiologics for the management of oral disease in Sjögren's syndrome (SS). MATERIALS AND METHODS: MEDLINE® , Embase, Scopus, and the Cochrane Library were searched for evidence on the use of immunobiologics for management of glandular disease in SS. Primary outcomes were xerostomia and salivary gland dysfunction, assessed via visual analogue scales, disease-specific scales for SS, measurement of salivary flow, ultrasound data, and quality of life measures. RESULTS: Seventeen studies (11 randomized controlled trials and 6 observational studies) met inclusion criteria. Rituximab showed efficacy in improving salivary gland function but not xerostomia. Abatacept showed promise in improving both xerostomia and salivary flow. Belimumab exhibited long-term improvement of salivary flow and subjective measures. The novel agent CFZ533 improved both disease activity and patient-reported indexes. CONCLUSIONS: There is strong evidence pointing to the efficacy of rituximab in the management of oral disease in SS. Future controlled trials may elucidate the efficacy of belimumab and abatacept. The new drug CFZ533 is a promising alternative for the management of SS and its salivary gland involvement. In considering these agents, the promise of efficacy must be balanced against the harmful effects associated with biologic agents.
Assuntos
Antirreumáticos/uso terapêutico , Fatores Biológicos/uso terapêutico , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Rituximab/uso terapêutico , Doenças das Glândulas Salivares/terapia , Glândulas Salivares/fisiopatologia , Síndrome de Sjogren/tratamento farmacológico , Xerostomia/fisiopatologia , Congressos como Assunto , Humanos , Qualidade de Vida , Saliva/química , Saliva/metabolismo , Doenças das Glândulas Salivares/patologia , Síndrome de Sjogren/fisiopatologia , Escala Visual AnalógicaRESUMO
Abstract Obesity has reached pandemic proportions in recent years. Not only adults suffer from the disease, but increasingly children and young people. One of the main causes of overweight and obesity is excessive food intake, in particular heavily processed carbohydrates. Obesity alters multiple organs, including the salivary glands, bringing functional alterations with it. Among researchers, the relation between obesity and tooth decay, periodontal disease and xerostomia is being debated. More and more scientific reports are drawing attention to the changes in the microflora of the oral cavity during obesity. All changes are closely related to the morphological and functional alterations of the salivary glands. This article review presents the current points of view regarding the impact of obesity on the health of the salivary glands, and how changes their functions influence other structures in the oral cavity.
Resumen La obesidad ha alcanzado proporciones pandémicas en los últimos años. No solo los adultos padecen la enfermedad, sino también cada vez más niños y jóvenes. Una de las principales causas del sobrepeso y la obesidad es la ingesta excesiva de alimentos, en particular los carbohidratos altamente procesados. La obesidad altera múltiples órganos, incluidas las glándulas salivales, y trae consigo alteraciones funcionales. Entre los investigadores, se está debatiendo la relación entre la obesidad y la caries dental, la enfermedad periodontal y la xerostomía. Cada vez más informes científicos están llamando la atención sobre los cambios en la microflora de la cavidad oral durante la obesidad. Todos los cambios están estrechamente relacionados con las alteraciones morfológicas y funcionales de las glándulas salivales. Esta revisión del artículo presenta los puntos de vista actuales sobre el impacto de la obesidad en la salud de las glándulas salivales, y cómo los cambios en sus funciones influyen en otras estructuras de la cavidad oral.
Assuntos
Adolescente , Adulto , Criança , Humanos , Glândulas Salivares/patologia , Obesidade/complicações , Doenças Periodontais/etiologia , Doenças Periodontais/epidemiologia , Doenças das Glândulas Salivares/etiologia , Doenças das Glândulas Salivares/patologia , Glândulas Salivares/metabolismo , Xerostomia/etiologia , Xerostomia/epidemiologia , Cárie Dentária/etiologia , Cárie Dentária/epidemiologia , Obesidade Infantil/complicações , Obesidade Infantil/epidemiologia , Obesidade/epidemiologiaRESUMO
Obesity has reached pandemic proportions in recent years. Not only adults suffer from the disease, but increasingly children and young people. One of the main causes of overweight and obesity is excessive food intake, in particular heavily processed carbohydrates. Obesity alters multiple organs, including the salivary glands, bringing functional alterations with it. Among researchers, the relation between obesity and tooth decay, periodontal disease and xerostomia is being debated. More and more scientific reports are drawing attention to the changes in the microflora of the oral cavity during obesity. All changes are closely related to the morphological and functional alterations of the salivary glands. This article review presents the current points of view regarding the impact of obesity on the health of the salivary glands, and how changes their functions influence other structures in the oral cavity.
La obesidad ha alcanzado proporciones pandémicas en los últimos años. No solo los adultos padecen la enfermedad, sino también cada vez más niños y jóvenes. Una de las principales causas del sobrepeso y la obesidad es la ingesta excesiva de alimentos, en particular los carbohidratos altamente procesados. La obesidad altera múltiples órganos, incluidas las glándulas salivales, y trae consigo alteraciones funcionales. Entre los investigadores, se está debatiendo la relación entre la obesidad y la caries dental, la enfermedad periodontal y la xerostomía. Cada vez más informes científicos están llamando la atención sobre los cambios en la microflora de la cavidad oral durante la obesidad. Todos los cambios están estrechamente relacionados con las alteraciones morfológicas y funcionales de las glándulas salivales. Esta revisión del artículo presenta los puntos de vista actuales sobre el impacto de la obesidad en la salud de las glándulas salivales, y cómo los cambios en sus funciones influyen en otras estructuras de la cavidad oral.
Assuntos
Obesidade/complicações , Glândulas Salivares/patologia , Adolescente , Adulto , Criança , Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Humanos , Obesidade/epidemiologia , Obesidade Infantil/complicações , Obesidade Infantil/epidemiologia , Doenças Periodontais/epidemiologia , Doenças Periodontais/etiologia , Doenças das Glândulas Salivares/etiologia , Doenças das Glândulas Salivares/patologia , Glândulas Salivares/metabolismo , Xerostomia/epidemiologia , Xerostomia/etiologiaRESUMO
Aluminum absorption leads to deposits in several tissues. In this study, we have investigated, to our knowledge for the first time, aluminum deposition in the salivary glands in addition to the resultant cellular changes in the parotid and submandibular salivary glands in a model of chronic intoxication with aluminum citrate in rats. Aluminum deposits were observed in the parotid and submandibular glands. Immunohistochemical evaluation of cytokeratin-18 revealed a decreased expression in the parotid gland with no changes in the submandibular gland. A decreased expression of α-smooth muscle actin was observed in the myoepithelial cells of both glands. The expression of metallothionein I and II (MT-I/II), a group of metal-binding proteins, which are useful indicators for detecting physiological responses to metal exposure, was higher in both glands. In conclusion, we have shown that at a certain time and quantity of dosage, aluminum citrate promotes aluminum deposition in the parotid and submandibular glands, leads to an increased expression of MT-I/II in both the glands, damages the cytoskeleton of the myoepithelial cells in both glands, and damages the cytoskeleton of the acinar/ductal cells of the parotid glands, with the submandibular glands showing resistance to the toxicity of the latter.
Assuntos
Ácido Cítrico/toxicidade , Doenças das Glândulas Salivares/induzido quimicamente , Glândulas Salivares/efeitos dos fármacos , Glândulas Salivares/patologia , Animais , Regulação da Expressão Gênica/efeitos dos fármacos , Imuno-Histoquímica , Masculino , Metalotioneína/genética , Metalotioneína/metabolismo , Ratos , Ratos Wistar , Doenças das Glândulas Salivares/metabolismo , Doenças das Glândulas Salivares/patologia , Glândulas Salivares/citologia , Glândulas Salivares/metabolismoRESUMO
OBJECTIVE: To validate the minimal criteria of the histopathologic diagnosis of oral chronic graft-versus-host disease, based on the histopathologic classification of the National Institutes of Health and correlate them with clinical features. METHODS: Forty-one specimens containing both oral mucosa and salivary glands were analyzed in slides stained with hematoxylin-eosin. The histological specimens were blindly examined by two trained pathologists using criteria recommended for the histopathologic diagnosis of chronic graft-versus-host disease proposed by the National Institutes of Health Consensus. The clinical classification of chronic graft-versus-host disease was correlated with analysis of slides. RESULTS: Our data showed that the epithelium was involved in 39/41 specimens, presenting acanthosis (29/70.7%), exocytosis of lymphocytes (29/70.7%), thickening of basal lamina (29/70.7%), and apoptosis (15/36.6%). Connective tissue presented interstitial inflammatory infiltrate (38/92.7%). Minor salivary glands showed periductal fibrosis (38/92.7%), mixed periductal inflammatory infiltrate (32/78%), ductal ectasia (30/73.2%), lymphocytes around and into acinar units (30/73.2%), and interstitial fibrosis (29/70.7%). The most common clinical manifestations were lichenoid aspect (40/97.6%), complaints of sensitivity to oral feeding (38/92.7%), and dry mouth sensation (36/87.8%). CONCLUSION: This study validated the National Institutes of Health Consensus of minimal histologic criteria for diagnosis of oral chronic graft-versus-host disease and has not found an association between the severity of clinical manifestation and the histopathological stage.
Assuntos
Doença Enxerto-Hospedeiro/patologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Doenças das Glândulas Salivares/patologia , Biópsia , Doença Crônica , Consenso , Doença Enxerto-Hospedeiro/classificação , Doença Enxerto-Hospedeiro/complicações , Humanos , Mucosa Bucal/patologia , National Institutes of Health (U.S.) , Estados UnidosRESUMO
Objective To validate the minimal criteria of the histopathologic diagnosis of oral chronic graft-versus-host disease, based on the histopathologic classification of the National Institutes of Health and correlate them with clinical features. Methods Forty-one specimens containing both oral mucosa and salivary glands were analyzed in slides stained with hematoxylin-eosin. The histological specimens were blindly examined by two trained pathologists using criteria recommended for the histopathologic diagnosis of chronic graft-versus-host disease proposed by the National Institutes of Health Consensus. The clinical classification of chronic graft-versus-host disease was correlated with analysis of slides. Results: Our data showed that the epithelium was involved in 39/41 specimens, presenting acanthosis (29/70.7%), exocytosis of lymphocytes (29/70.7%), thickening of basal lamina (29/70.7%), and apoptosis (15/36.6%). Connective tissue presented interstitial inflammatory infiltrate (38/92.7%). Minor salivary glands showed periductal fibrosis (38/92.7%), mixed periductal inflammatory infiltrate (32/78%), ductal ectasia (30/73.2%), lymphocytes around and into acinar units (30/73.2%), and interstitial fibrosis (29/70.7%). The most common clinical manifestations were lichenoid aspect (40/97.6%), complaints of sensitivity to oral feeding (38/92.7%), and dry mouth sensation (36/87.8%). Conclusion This study validated the National Institutes of Health Consensus of minimal histologic criteria for diagnosis of oral chronic graft-versus-host disease and has not found an association between the severity of clinical manifestation and the histopathological stage. .
Objetivo Validar os critérios mínimos de diagnóstico histopatológico da doença do enxerto contra hospedeiro crônica oral, com base em critérios de classificação do National Institutes of Health, e correlacioná-los com as características clínicas. Métodos Quarenta e um espécimes contendo mucosa oral e glândulas salivares foram analisados em lâminas coradas por hematoxilina-eosina. Os espécimes histológicos foram avaliados de forma cega, por dois patologistas calibrados, utilizando os critérios recomendados para diagnóstico histopatológico de doença do enxerto contra hospedeiro crônica propostos pelo Consenso do National Institutes of Health. A classificação clínica da doença do enxerto contra hospedeiro crônica foi correlacionada após a análise das lâminas. Resultados Nossos resultados mostraram que o epitélio estava comprometido em 39/41 espécimes, apresentando acantose (29/70,7%), exocitose de linfócitos (29/70,7%), espessamento da lâmina basal (29/70,7%) e apoptose (15/36,6%). O tecido conjuntivo apresentou infiltrado inflamatório intersticial em 38 (92,7%) casos. Nas glândulas salivares menores, observaram-se fibrose periductal (38/92,7%), infiltrado inflamatório periductal misto (32/78%), ectasia ductal (30/73,2%), linfócitos em torno e migrando para dentro dos ácinos (30/73,2%), e fibrose intersticial (29/70,7%). As manifestações clínicas mais comuns foram mucosa de aspecto liquenoide (40/97,6%), queixa de sensibilidade bucal ao se alimentar (38/92,7%), e sensação de boca seca (36/87,8%). Conclusão Os critérios mínimos para o diagnóstico histopatológico da doença do enxerto contra hospedeiro crônica oral, com base no Consenso do National Institutes of Health, foram ...
Assuntos
Humanos , Doença Enxerto-Hospedeiro/patologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Doenças das Glândulas Salivares/patologia , Biópsia , Doença Crônica , Consenso , Doença Enxerto-Hospedeiro/classificação , Doença Enxerto-Hospedeiro/complicações , Mucosa Bucal/patologia , National Institutes of Health (U.S.) , Estados UnidosRESUMO
Introducción y objetivos: La probabilidad de recurrencia del adenoma pleomorfo y la agresividad de algunas variedades de neoplasias malignas de glándulas salivales requieren de un recurso de fácil aplicación que contribuya a establecer un pronóstico. El objetivo de este trabajo fue analizar biomarcadores en tejido tumoral obtenido por escisión quirúrgica a fin de determinar su implicancia en el pronóstico de tumores malignos y benignos potencialmente recidivantes de glándulas salivales. Materiales y métodos: Este estudio, de tipo descriptivo transversal, fue realizado sobre una selección de treinta y seis pacientes con diagnóstico de tumores benignos y malignos de glándulas salivales con y sin recidiva. Ellos fueron seleccionados en los Servicios de Cirugía de Cabeza y Cuello de los hospitales Córdoba y Privado de la ciudad de Córdoba. El protocolo de trabajo y el consentimiento informado que firmaron los participantes fueron previamente aprobados por los Comités Institucionales de Ética de Investigación en Salud (CIEIS) de los hospitales mencionados. Los pacientes fueron distribuidos en cuatro grupos de estudio según el comportamiento biológico y la presencia o no de recidiva: TBSR (tumor benigno sin recidiva), BCR (tumor benigno con recidiva), TMSR (tumor maligno sin recidiva), TMCR (tumor maligno con recidiva). Se confeccionó una ficha individual y se obtuvieron muestras de tejido tumoral, las cuales fueron fijadas para luego aplicar las técnicas de inmunohistoquímica. Dos observadores independientes realizaron el análisis mediante microscopía óptica. Resultados: MUC1, Ki-67 y p53 presentan un alto porcentaje de marcación (91, 91 y 86%, respectivamente), en tanto que c-erbB-2 sólo se expresó en un 20% de los casos. Este último marcó solamente en un 10% de los tumores benignos y Ki-67 fue el único se expresó que en el 100% de los tumores malignos.
SUMMARY: Introduction and objective: the probability of recurrence of pleomorphic adenoma and the aggressiveness of home malignant salivary gland neoplasms require an easily applicable method to help in establishing a prognosis. The aim of this study was to analyze the expression of biomarkers in tumor tissue obtained by surgical excision in order to determine its implication in predicting malignant and potentially recurrent benign salivary gland tumors. Materials and methods: a descriptive cross study was carry out on thirty-six patients with diagnosis of benign and malignant salivary gland tumors both with and without recurrence. They were selected from the Head and Neck Surgery Departments of the Córdoba and Privado hospitals, in Córdoba, Argentina. The study protocol and the informed consent which were signed by the participants were reviously approved by the Institutional Committee for Ethics in Health Research (CIEIS) of the involved hospitals. Patients were distributed in four study groups according to tumor biological behavior and presence or absence of recurrence: BTwR (benign tumor without recurrence), BTR (benign tumor with (recurrence), MTwR (malignant tumor without recurrence) and MTR (malignant tumor with recurrence). An individual record was produced and tumor tissue samples were obtained and fixed for immunohistochemistry procedures. A light microscopy analysis was performed by two independent observers. Results: MUC1, p53 and Ki-67 have marked in a high percentage (91, 91 and 86%, respectively) whereas c-erbB-2 was expressed only in 20% of cases
Assuntos
Humanos , Masculino , Feminino , Adenocarcinoma/epidemiologia , Doenças das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Biomarcadores Tumorais/isolamento & purificação , Glândulas Salivares , ArgentinaRESUMO
Introducción y objetivos: La probabilidad de recurrencia del adenoma pleomorfo y la agresividad de algunas variedades de neoplasias malignas de glándulas salivales requieren de un recurso de fácil aplicación que contribuya a establecer un pronóstico. El objetivo de este trabajo fue analizar biomarcadores en tejido tumoral obtenido por escisión quirúrgica a fin de determinar su implicancia en el pronóstico de tumores malignos y benignos potencialmente recidivantes de glándulas salivales. Materiales y métodos: Este estudio, de tipo descriptivo transversal, fue realizado sobre una selección de treinta y seis pacientes con diagnóstico de tumores benignos y malignos de glándulas salivales con y sin recidiva. Ellos fueron seleccionados en los Servicios de Cirugía de Cabeza y Cuello de los hospitales Córdoba y Privado de la ciudad de Córdoba. El protocolo de trabajo y el consentimiento informado que firmaron los participantes fueron previamente aprobados por los Comités Institucionales de Etica de Investigación en Salud (CIEIS) de los hospitales mencionados. Los pacientes fueron distribuidos en cuatro grupos de estudio según el comportamiento biológico y la presencia o no de recidiva: TBSR (tumor benigno sin recidiva), BCR (tumor benigno con recidiva), TMSR (tumor maligno sin recidiva), TMCR (tumor maligno con recidiva). Se confeccionó una ficha individual y se obtuvieron muestras de tejido tumoral, las cuales fueron fijadas para luego aplicar las técnicas de inmunohistoquímica. Dos observadores independientes realizaron el análisis mediante microscopía óptica. Resultados: MUC1, Ki-67 y p53 presentan un alto porcentaje de marcación (91, 91 y 86%, respectivamente), en tanto que c-erbB-2 sólo se expresó en un 20% de los casos. Este último marcó solamente en un 10% de los tumores benignos y Ki-67 fue el único se expresó que en el 100% de los tumores malignos.(AU)
SUMMARY: Introduction and objective: the probability of recurrence of pleomorphic adenoma and the aggressiveness of home malignant salivary gland neoplasms require an easily applicable method to help in establishing a prognosis. The aim of this study was to analyze the expression of biomarkers in tumor tissue obtained by surgical excision in order to determine its implication in predicting malignant and potentially recurrent benign salivary gland tumors. Materials and methods: a descriptive cross study was carry out on thirty-six patients with diagnosis of benign and malignant salivary gland tumors both with and without recurrence. They were selected from the Head and Neck Surgery Departments of the Córdoba and Privado hospitals, in Córdoba, Argentina. The study protocol and the informed consent which were signed by the participants were reviously approved by the Institutional Committee for Ethics in Health Research (CIEIS) of the involved hospitals. Patients were distributed in four study groups according to tumor biological behavior and presence or absence of recurrence: BTwR (benign tumor without recurrence), BTR (benign tumor with (recurrence), MTwR (malignant tumor without recurrence) and MTR (malignant tumor with recurrence). An individual record was produced and tumor tissue samples were obtained and fixed for immunohistochemistry procedures. A light microscopy analysis was performed by two independent observers. Results: MUC1, p53 and Ki-67 have marked in a high percentage (91, 91 and 86%, respectively) whereas c-erbB-2 was expressed only in 20% of cases(AU)
Assuntos
Humanos , Masculino , Feminino , Glândulas Salivares , Glândulas Salivares/patologia , Biomarcadores Tumorais/isolamento & purificação , Adenocarcinoma/epidemiologia , Doenças das Glândulas Salivares/patologia , ArgentinaRESUMO
BACKGROUND: Salivary mucocele is an accumulation of saliva in a single or multiloculated cavity lined by connective tissue that is contiguous to a salivary gland-duct complex and is the most common condition affecting the salivary glands in dogs. Occasionally, different types of metaplastic lesions, such as squamous and osseous metaplasia - which are rare lesions in animals - can be observed in association with salivary mucocele. CASE PRESENTATION: A right facial enlargement was suddenly observed in a 4-year-old non-spayed female Shih-Tzu dog. The lesion presented itself as a soft and fluctuant mass located in the right side of the face near to the neck. Histologically, the mass consisted of a cavitary formation without an epithelial lining. Additionally, microscopic examination revealed the presence of osteoid-producing cells which gave rise to areas of bone formation, probably induced by irritation due to the presence sialoliths. Such cells and bone formations were also present in the cavity wall, consequently leading us to classify the condition as a salivary mucocele with osseous metaplasia. CONCLUSIONS: In the present case, the pathogenesis was probably associated with the presence of sialoliths, which can behave as etiological agents for the metaplastic lesion. The occurrence of osteoid metaplasia is a rare peculiar condition in the canine salivar y gland, and due to the rarity and lack of information about this specific disease, no clinical data can yet be associated with the development of salivary mucocele with osseous metaplasia in dogs.
Assuntos
Doenças do Cão/patologia , Mucocele/veterinária , Ossificação Heterotópica/veterinária , Doenças das Glândulas Salivares/veterinária , Animais , Doenças do Cão/cirurgia , Cães , Feminino , Mucocele/patologia , Mucocele/cirurgia , Ossificação Heterotópica/patologia , Ossificação Heterotópica/cirurgia , Doenças das Glândulas Salivares/patologia , Doenças das Glândulas Salivares/cirurgiaRESUMO
Las glándulas de Blandin-Nuhn son un grupo de pequeñas glándulas salivales mucoserosas, ubicadas en el espesor de los haces musculares de la zona anterior de la cara ventral de la lengua. Los mucoceles de las glándulas de Blandin-Nuhn son poco frecuentes. Se revisa la literatura y se presentan dos casos de mucocele de las glándulas de Blandin-Nuhn, ambos casos eran lesiones exofíticas, indoloras, una de ellas asociada a trauma. Los mucoceles de las glándulas salivales linguales anteriores deben ser resecados hasta el plano muscular para evitar la recidiva. Como esta lesión puede ser confundida con otras patologías, se recomienda su estudio histopatológico para evitar diagnósticos errados.
The Blandin-Nuhn glands are a small group of mucous serous salivary glands, located in the thickness of the muscle bundles of the anterior ventral side of the tongue. Mucocele of the glands of Blandin-Nuhn has been reported as unusual. We review the literature and present two cases of mucocele of the glands of Blandin-Nuhn, both cases were exophytic lesions, painless, one associated with trauma. Mucoceles of the salivary glands should be resected up to the muscular plane to avoid recurrence. Because this lesion may be confused with other diseases, it is recommended an histopathological exam to avoid misdiagnosis.
Assuntos
Humanos , Masculino , Adulto , Feminino , Doenças da Língua/patologia , Doenças das Glândulas Salivares/patologia , Glândulas Salivares Menores/patologia , Mucocele/patologia , Diagnóstico Diferencial , Doenças da Língua/diagnóstico , Doenças da Língua/terapia , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/terapia , Mucocele/diagnóstico , Mucocele/terapiaRESUMO
OBJECTIVE: To evaluate the clinicopathologic features of pediatric mucoceles diagnosed in two public institutions in Brazil during an 18-year period. METHOD AND MATERIALS: Clinical data (age, sex, history of trauma, location, and size) of 138 cases of mucoceles in children 0 to 16 years of age were obtained from medical records. The lesions were classified as mucus extravasation phenomenon and mucus retention phenomenon, depending on the presence of epithelial lining in the microscopic analysis. RESULTS: Mucoceles made up 24.5% of the oral pediatric lesions diagnosed in the period of study. Age at diagnosis ranged from 0.4 to 16.0 years, with a mean age of 10.8 years. Of the total of mucoceles, 87 were observed in females and 51 in males. The lower lip was the most commonly affected site, and a history of trauma was related by 87% of the patients. Histologically, 96.4% of mucoceles were diagnosed as mucus extravasation phenomenon. Cases of mucus retention phenomenon were relatively more common in the floor of the mouth, since one in three lesions in this location belonged to this histologic type. Regarding lesions in the lower lip, only 2.65% were diagnosed as mucus retention phenomenon. CONCLUSION: Trauma is the main etiologic factor involved in the development of mucoceles in children. The mucus extravasation phenomenon is the most common histologic type in this age group. Although rare, the retention type seems to be more common in lesions on the floor of the mouth.
Assuntos
Mucocele/patologia , Doenças das Glândulas Salivares/patologia , Adolescente , Criança , Pré-Escolar , Traumatismos Faciais/complicações , Feminino , Humanos , Lactente , Doenças Labiais/patologia , Masculino , Soalho Bucal/patologia , Mucocele/etiologia , Estudos Retrospectivos , Glândulas Salivares Menores/patologiaRESUMO
OBJECTIVE: To analyse and compare the expression of Palate, Lung, and Nasal Epithelium Clone (PLUNC) proteins in salivary glands from patients with and without AIDS (control group) using autopsy material. METHODS: We analysed the expression of PLUNCs using immunohistochemistry in parotid (n = 45), submandibular (n = 47) and sublingual gland (n = 37) samples of AIDS patients [30 with normal histology, 21 with mycobacteriosis, 14 with cytomegalovirus (CMV) infection, 30 with chronic non-specific sialadenitis, and 30 HIV-negative controls. In situ hybridization (ISH) for SPLUNC 2 in the HIV-negative group was performed. RESULTS: SPLUNC 1 expression was detected in the mucous acini of submandibular and sublingual glands, and SPLUNC 2 were seen in the serous cells. LPLUNC 1 expression was only positive in the salivary ducts. There was a higher expression of SPLUNC 2 in AIDS patients with CMV infection and mycobacteriosis when compared with all other groups. The intensity of staining for SPLUNC 2 was greater around the lesions than the peripheral ones. ISH for SPLUNC 2 showed perinuclear positivity in the serous cells in all HIV-negative cases. CONCLUSIONS: SPLUNC 1 and LPLUNC 1 proteins were similarly expressed in the salivary glands of AIDS patients and non-HIV patients. CMV infection and mycobacteriosis increase SPLUNC 2 expression in serous cells in the salivary gland of AIDS patients.
Assuntos
Síndrome da Imunodeficiência Adquirida/patologia , Glicoproteínas/análise , Fosfoproteínas/análise , Glândulas Salivares/patologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Adolescente , Adulto , Idoso , Infecções por Citomegalovirus/patologia , Feminino , Soronegatividade para HIV , Humanos , Imuno-Histoquímica , Hibridização In Situ , Masculino , Pessoa de Meia-Idade , Doenças Parotídeas/patologia , Glândula Parótida/patologia , Ductos Salivares/patologia , Doenças das Glândulas Salivares/patologia , Membrana Serosa/patologia , Sialadenite/patologia , Glândula Sublingual/patologia , Glândula Submandibular/patologia , Doenças da Glândula Submandibular/patologia , Tuberculose Bucal/patologia , Adulto JovemRESUMO
PURPOSE: This study aims to review anatomical, clinical, and pathological concepts as well as to discuss the most adequate therapeutic approach to the mucoceles of the glands of Blandin-Nuhn. DISCUSSION: The glands of Blandin-Nuhn are localized in the ventral part of the tongue, next to the apex in the lingual median plane. Development of a mucocele in this site is rarely seen; besides, as the glands of Blandin-Nuhn are not encapsulated and are directly overlapped to the muscle tissues, their manipulation tends to be different from the other oral mucoceles. CONCLUSION: As Blandin-Nuhn mucoceles are uncommon and their clinical appearance could be similar to other lesions, it is important that health professionals know their clinical and histopathological features to avoid having them misdiagnosed.
Assuntos
Mucocele/patologia , Doenças das Glândulas Salivares/patologia , Glândulas Salivares Menores/patologia , Doenças da Língua/patologia , Diagnóstico Diferencial , Humanos , Mucocele/diagnóstico , Mucocele/cirurgia , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/cirurgia , Glândulas Salivares Menores/cirurgia , Doenças da Língua/diagnóstico , Doenças da Língua/cirurgiaRESUMO
OBJECTIVE: To assess the histopathological, immunohistochemical (IHC), and in situ hybridization (ISH) features found in the submandibular (SM) and sublingual (SL) glands of 105 acquired immunodeficiency syndrome (AIDS) patients at autopsy. STUDY DESIGN: Gender, age, CD4 cell level, and clinical histories were obtained from clinical charts (SM: n = 103; SL: n = 92). Histologic analysis of hematoxylin and eosin, Gomori-Grocott, and Ziehl-Neelsen stained tissues, IHC to detect infectious agents and characterize inflammatory cells in sialadenitis, and ISH for EBER-1/2 were performed. RESULTS: The mean age of the patients and CD4 cell count were 36 years and 76 cells/microL, respectively. Fifty-eight cases (SM: n = 51 [49%]; SL: n = 54 [59%]) were considered to be microscopically normal. The most common infectious conditions were mycobacteriosis (SM: n = 11 [10%]; SL: n = 7 [7%]), followed by cytomegalovirus (CMV) (SM: n = 14 [13%]; SL: n = 2 [2%]), and cryptococcosis (SM: n = 3 [3%]; SL: n = 4 [4%]). Human immunodeficiency virus (HIV) p24 (SM: n = 2 [2%]; SL: n = 1 [1%]) and EBER-1/2 (SM: n = 9 [39%]; SL: n = 4 [20%]) were seen only in macrophages and lymphocytes, respectively. The most prevalent cells seen in chronic nonspecific sialadenitis (SM: n = 25; SL: n = 25) were CD8+ T lymphocytes, whereas CD68+ macrophages were predominant in the mycobacteriosis-associated granulomatous and nonspecific diffuse macrophagic sialadenitis. Concomitant infections occurred in 5 cases (SM: n = 4; SL: n = 1) and non-Hodgkin lymphoma in 1 case. CONCLUSIONS: Infectious diseases and chronic nonspecific sialadenitis were the main alterations found in the SM and SL glands. These alterations were greater in the SM than in the SL glands. CD8+ T lymphocytes and CD68+ macrophages might be relevant to the pathogenesis of the sialadenitis. Clinicians should consider these diseases when assessing the major salivary glands in advanced AIDS patients and follow biosafety procedures to avoid contamination by HIV, CMV, mycobacteriosis, and cryptococcosis.
Assuntos
Síndrome da Imunodeficiência Adquirida/patologia , Doenças das Glândulas Salivares/patologia , Glândula Sublingual/patologia , Glândula Submandibular/patologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Infecções Oportunistas Relacionadas com a AIDS/virologia , Síndrome da Imunodeficiência Adquirida/complicações , Adolescente , Adulto , Idoso , Criança , Criptococose/complicações , Criptococose/patologia , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/complicações , Infecções por Mycobacterium/patologia , Doenças das Glândulas Salivares/classificação , Doenças das Glândulas Salivares/complicações , Doenças das Glândulas Salivares/microbiologia , Doenças das Glândulas Salivares/virologia , Índice de Gravidade de Doença , Glândula Sublingual/microbiologia , Glândula Sublingual/virologia , Glândula Submandibular/microbiologia , Glândula Submandibular/virologia , Adulto JovemRESUMO
The authors examined the clinical and histopathological features of 48 cases of mucocele of the glands of Blandin-Nuhn. Data of all patients with mucocele treated at the Department of Oral and Maxillofacial Surgery totaled 312 cases during the 6-year period of study were analyzed. There was no sex predominance, and most patients were younger than 20 years. All lesions were located on the ventral surface of the tongue, and they were more frequently observed at the tip of the tongue whereas few ones occurred more posteriorly. All lesions presented a polypoid appearance. Histopathologically, the mucoceles were of the extravasation type and trauma might be the most frequent etiological factor. This type of mucocele was the second most frequent one and should not be considered rare.