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Bruett CT, Freedman PD, Reich RF. Dysgenetic Polycystic Disease of the Salivary Glands: A Case Report of This Rare Entity Occurring for the First Time in the Minor Salivary Glands of the Tongue, and a Review of the Literature. Head Neck Pathol 2024; 18:4. [PMID: 38334835 PMCID: PMC10857984 DOI: 10.1007/s12105-023-01607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/01/2023] [Indexed: 02/10/2024]
Abstract
Dysgenetic polycystic disease, also known just as polycystic disease, is a very rare developmental abnormality affecting the salivary gland duct system. This entity has been reported in only 21 patients previously, although a careful review suggests only 16 patients have histological evidence of the disease. In previously reported cases, this lesion most commonly presents as either an incidental finding or as a swelling affecting the parotid glands bilaterally, or rarely the submandibular glands bilaterally. This case report details the first time dysgenetic polycystic disease is found affecting the minor salivary glands of the tongue in a 55-year-old male. Histochemical and immunohistochemical stains are presented and include positivity for AE1/AE3 and p63, and negativity for progesterone receptor, androgen receptor, mammaglobin, S100 and BRAF V600E. PAS-D and Congo Red highlight special microamyloid spheroliths structures intraluminally.
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Affiliation(s)
- Carter T Bruett
- New York Presbyterian/Queens, Flushing, Queens, New York, USA.
- , 56-31 141st Street, Flushing, NY, USA.
| | - Paul D Freedman
- New York Presbyterian/Queens, Flushing, Queens, New York, USA
| | - Renee F Reich
- New York Presbyterian/Queens, Flushing, Queens, New York, USA
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2
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Hernandez-Prera JC, Saeed-Vafa D, Heidarian A, Gewandter K, Otto K, Wenig BM. Sclerosing Polycystic Adenoma: Conclusive Clinical and Molecular Evidence of Its Neoplastic Nature. Head Neck Pathol 2021; 16:416-426. [PMID: 34410594 PMCID: PMC9187789 DOI: 10.1007/s12105-021-01374-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/14/2021] [Indexed: 02/06/2023]
Abstract
Sclerosing polycystic adenosis, initially considered a non-neoplastic salivary gland lesion and classified as such in the 2017 WHO Classification of Head and Neck Tumors, has been the subject of controversy regarding its possible neoplastic nature. The reporting of recurrent PI3K pathway alteration represents evidence to support these lesions as being neoplastic and more appropriately referred to as sclerosing polycystic adenoma (SPA). Herein, we provide additional evidence that supports the classification of SPA as a true neoplasm. Eight cases of SPA were identified in our database and consultation files. All cases were subjected to PTEN immunohistochemistry (IHC) and next-generation sequencing (NGS). In addition, one patient underwent genetic counseling and germline testing. The cases included 5 men and 3 women with a mean age of 41 years (range 11-78) and all tumors arose in the parotid gland. One patient had multiple recurrences over a period of 2 years. Morphologically the tumors were circumscribed and characterized by an admixture of acini, ducts and cysts embedded in a fibrotic/sclerotic stroma. The cells lining the ducts and cysts showed variable granular, vacuolated, foamy and apocrine cytoplasmic features, as well as acinar cells contained intracytoplasmic brightly eosinophilic granules. The apocrine intraductal proliferations showed mild to moderate atypia in 6 cases. One case showed overt malignant morphology that ranged from intraductal carcinoma to invasive salivary duct carcinoma. Seven cases tested for PTEN IHC showed loss of nuclear expression in the acinar and ductal cells with retained PTEN expression in the myoepithelial cell and stroma. NGS detected PIK3CA or PIK3R1 genetic alterations in 7 cases, including a novel TFG-PIK3CA fusion. Coexisting PTEN mutations were seen in 4 cases, including in a patient with clinical stigmata of Cowden syndrome and confirmed by germline genetic testing. Our findings herein documented including recurrence of tumor, malignant transformation, high prevalence of PI3K pathway oncogenic alterations and the possible heretofore undescribed association with Cowden syndrome add support to classifying SPA as true neoplasms justifying their designation as adenoma, rather than adenosis.
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Affiliation(s)
- Juan C Hernandez-Prera
- Department of Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
| | - Daryoush Saeed-Vafa
- Department of Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Amin Heidarian
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Kristen Otto
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Bruce M Wenig
- Department of Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
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3
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Le Roux MK, Graillon N, Hadj-Saïd M, Scemama U, Lutz JC, Chossegros C. Stensen duct dilation: Case series of minimally invasive treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:e114-e117. [PMID: 30878397 DOI: 10.1016/j.oooo.2019.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 10/27/2022]
Abstract
Stensen's duct dilation is a rare condition characterized by a global or partial idiopathic dilation of the Stensen duct. Affected individuals usually show either aesthetically compromised features, such as a tubular-shaped swelling in the cheek, or with mildly painful inflammatory episodes. Three women between ages 61 and 67 years were diagnosed with Stensen duct dilation after sialo-magnetic resonance imaging (MRI). They were treated with botulinum toxin A (BTX-A). Our preliminary results suggest that BTX-A was efficient as a suspensive treatment. BTX-A should remain a first-line treatment of the early silent symptoms of Stensen duct dilation, such as swelling and aesthetic issues. The use of BTX-A avoids more serious procedures and further complications.
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Affiliation(s)
- Marc-Kevin Le Roux
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France.
| | - Nicolas Graillon
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
| | - Mehdi Hadj-Saïd
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
| | - Ugo Scemama
- Aix Marseille University, SPMC EA 3279, Marseille, France; Department of Radiology, Hôpital Nord, Aix-Marseille University, chemin des Bourrely, Marseille, France
| | - Jean-Christophe Lutz
- Stomatology and Maxillo-Facial Surgery Department, Strasbourg University Hospital, Strasbourg cedex, France
| | - Cyrille Chossegros
- Oral and Maxillofacial Surgery Department, University Hospital Center Conception, Marseille, France; Aix Marseille University, SPMC EA 3279, Marseille, France
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4
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Abstract
Salivary gland tumors and tumor-like lesions in the pediatric population are uncommon. They comprise a heterogeneous group of infectious/inflammatory and neoplastic conditions. Pediatric salivary neoplasms include benign tumors of mesenchymal or epithelial origin as well as malignancies of epithelial (carcinomas), mesenchymal (sarcoma) or hematolymphoid (lymphoma) derivation. Infectious/inflammatory conditions and hematolymphoid malignancies may represent either genuine parenchymal pathology or conditions involving intraglandular lymph nodes of the parotid glands (intraglandular lymphadenopathy and intraglandular nodal lymphomas). Pediatric sialadenitis may be of diverse etiologies including viral (mumps, CMV, HIV, etc.), bacterial, autoimmune (juvenile Sjögren syndrome) or idiopathic (chronic recurrent juvenile sialectatic sialadenitis). Angiomatous lesions (juvenile capillary hemangioma, lymphangioma and vascular malformation) and pleomorphic adenomas represent the most common pediatric benign mesenchymal and benign epithelial tumors, respectively. The vast majority of salivary gland carcinomas in children and adolescents represent low-grade mucoepidermoid carcinomas followed by acinic cell and adenoid cystic carcinomas (together >80% of carcinomas). Other malignant neoplasms include (rhabdomyo-) sarcomas, malignant lymphomas and very rarely sialoblastomas. This long differential diagnosis list of etiologically and biologically highly heterogeneous entities, their shared clinical presentation as "salivary gland enlargement" and the significant differences in their therapeutic strategies and prognosis underline the need for careful assessment to identify the correct diagnosis. Diagnosis is mainly based on a set of typical clinical and imaging features, serological/microbiological findings and, in selected cases, histomorphological characteristics in biopsy specimens.
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5
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Pantanowitz L, Thompson LDR, Rossi ED. Diagnostic Approach to Fine Needle Aspirations of Cystic Lesions of the Salivary Gland. Head Neck Pathol 2018; 12. [PMID: 29524082 PMCID: PMC6232202 DOI: 10.1007/s12105-018-0904-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Fine needle aspiration (FNA) has diagnostic and therapeutic value in the management of salivary gland cysts. Rendering an accurate diagnosis from an aspirated salivary gland cyst is challenging because of the broad differential diagnosis, possibility of sampling error, frequent hypocellularity of specimens, morphologic heterogeneity, and overlapping cytomorphology of many cystic entities. To date, there have been no comprehensive review articles providing a practical diagnostic approach to FNA of cystic lesions of salivary glands. This article reviews the cytopathology of salivary gland cysts employing 2017 World Health Organization terminology, addresses the accuracy of FNA, and presents The Milan System approach for reporting in cystic salivary gland cases. The utility of separating FNA specimens from salivary gland cysts, based upon the presence of mucin and admixed lymphocytes in cyst fluid is demonstrated. A reliable approach to interpreting FNA specimens from patients with cystic salivary gland lesions is essential to accurately determine which of these patients may require subsequent surgery.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, USA.
- Department of Pathology, UPMC Shadyside UPMC Cancer Pavilion, Suite 20, 5150 Centre Ave, Pittsburgh, PA, 15232, USA.
| | - Lester D R Thompson
- Pathology Department, Woodland Hills Medical Center, Woodland Hills, CA, USA
| | - Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Catholic University of Sacred Heart, Rome, Italy
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6
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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. Int J Oral Maxillofac Surg 2018; 47:223-227. [DOI: 10.1016/j.ijom.2017.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 11/19/2022]
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7
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Chahed H, Meherzi S, Mediouni A, Ben Amor M. Intraparotid ductal ectasia: rare cause of parotid swelling. BMJ Case Rep 2017; 2017:bcr-2017-220243. [PMID: 28754751 DOI: 10.1136/bcr-2017-220243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 41-year-old patient was hospitalised for a chronic right parotid mass. A cervical ultrasound revealed a cystic mass of the parotid. Cervical MRI found a ductal ectasia of the parotid and submandibular glands associated with a retention cyst of the right parotid. He had a right total parotidectomy. Histopathological examination of the lesion revealed a multilocular cystic mass with a diffuse glandular ectasia of salivary ducts. The patient had an uneventful postoperative course without any recurrence of symptoms.
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Affiliation(s)
- Houda Chahed
- Department of ENT, Hopital la Rabta, Tunis, Tunisia
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8
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Dysgenetic Polycystic Disease of Minor Salivary Gland: A Rare Case Report and Review of the Literature. Case Rep Pathol 2017; 2017:5279025. [PMID: 28203473 PMCID: PMC5288519 DOI: 10.1155/2017/5279025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 01/09/2017] [Indexed: 11/17/2022] Open
Abstract
Polycystic (dysgenetic) disease of the salivary glands is a rare entity that has only recently been described in the literature. The disease is more commonly seen in females and majority of the cases have presented as bilateral parotid gland swellings. This case presenting in a 21-year-old male is the first of this unusual entity involving solely the minor salivary gland on the lower lip. This case report highlights the importance for the clinician to be aware of this differential diagnosis, when treating an innocuous lesion like a mucocele.
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9
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Koudounarakis E, Willems S, Karakullukcu B. Dysgenetic polycystic disease of the minor and submandibular salivary glands. Head Neck 2016; 38:E2437-E2439. [PMID: 26855244 DOI: 10.1002/hed.24401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/29/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Dysgenetic polycystic salivary gland disease is a rare pathology. No case of minor salivary gland involvement has been reported in the literature. METHODS A female patient presented with bilateral tumors of the parotid glands, bilateral submandibular gland enlargement, and multiple cystic lesions of the oral mucosa. MRI of the neck was performed along with fine-needle aspiration (FNA) of the parotid tumors and excisional biopsy of an oral lesion. RESULTS Imaging and FNA findings of the parotid glands were suggestive of bilateral Warthin tumors. Excisional biopsy of the oral lesion revealed a minor salivary gland with histopathological features of dysgenetic polycystic salivary gland disease. Submandibular gland enlargement was also attributed to this rare entity based on the imaging characteristics. CONCLUSION This is the first report of dysgenetic polycystic salivary gland disease of the minor salivary glands, combined with involvement of the submandibular glands and bilateral Warthin tumors of the parotid gland. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2437-E2439, 2016.
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Affiliation(s)
- Eleftherios Koudounarakis
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Stefan Willems
- Department of Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Baris Karakullukcu
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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10
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Cottom H, O'Neill N, Kumar A, Hunter KD. Progressive bilateral enlargement and pain affecting the parotid salivary glands: an unusual histologic finding. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:664-9. [PMID: 26324748 DOI: 10.1016/j.oooo.2015.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 05/25/2015] [Accepted: 07/03/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Hannah Cottom
- Speciality Trainee (Oral Pathology), Department of Histopathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - Niall O'Neill
- Senior House Officer (Oral Medicine and Oral Pathology), Charles Clifford Dental Hospital, Sheffield, UK
| | - Anand Kumar
- Speciality Trainee (OMFS) Department of Oral and Maxillofacial Surgery, Charles Clifford Dental Hospital, Sheffield, UK
| | - Keith D Hunter
- Reader in Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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11
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Iro H, Zenk J. Salivary gland diseases in children. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2014; 13:Doc06. [PMID: 25587366 PMCID: PMC4273167 DOI: 10.3205/cto000109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Salivary gland diseases in children are rare, apart from viral-induced diseases. Nevertheless, it is essential for the otolaryngologist to recognize these uncommon findings in children and adolescents and to diagnose and initiate the proper treatment. The present work provides an overview of the entire spectrum of congenital and acquired diseases of the salivary glands in childhood and adolescence. The current literature was reviewed and the results discussed and summarized. Besides congenital diseases of the salivary glands in children, the main etiologies of viral and bacterial infections, autoimmune diseases and tumors of the salivary glands were considered. In addition to the known facts, new developments in diagnostics, imaging and therapy, including sialendoscopy in obstructive diseases and chronic recurrent juvenile sialadenitis were taken into account. In addition, systemic causes of salivary gland swelling and the treatment of sialorrhoea were discussed. Although salivary gland diseases in children are usually included in the pathology of the adult, they differ in their incidence and sometimes in their symptoms. Clinical diagnostics and especially the surgical treatment are influenced by a stringent indications and a less invasive strategy. Due to the rarity of tumors of the salivary glands in children, it is recommended to treat them in a specialized center with greater surgical experience. Altogether the knowledge of the differential diagnoses in salivary gland diseases in children is important for otolaryngologists, to indicate the proper therapeutic approach.
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Affiliation(s)
- Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, University of Erlangen-Nuremberg, Germany
| | - Johannes Zenk
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, University of Erlangen-Nuremberg, Germany
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12
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Yoruk O, Kılıc K, Kantarcı M. "Mustache sign" due to Stensen duct dilation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e514-6. [PMID: 24209996 DOI: 10.1016/j.oooo.2013.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/31/2013] [Accepted: 08/05/2013] [Indexed: 11/15/2022]
Abstract
An 80-year-old woman presented with a 5-year history of painless swellings of the left and right cheeks. The degree of swelling did not change with mastication. On palpation, the cheeks were soft, well defined, and movable. Compression and massage of the swollen areas caused increased salivary discharge from the orifices of the Stensen ducts. Three-dimensional computed tomography showed well-bordered, 15- to 20-mm wide, bilateral, tube-like dilatations of the ducts. The ductal origin of the swellings was explained to the patient, but she refused invasive procedures, thus no sialogram or surgical procedure was performed. We describe the clinical and radiographic features of a case of bilateral, congenital Stensen duct dilatation with bilateral swelling of the cheeks.
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Affiliation(s)
- O Yoruk
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey.
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13
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Miyashita M, Taguchi A, Ochiai T, Kawahara I, Hasegawa H, Kagami H. An aberrant parotid gland duct with a cutaneous orifice, accompanied by sialolithiasis. J Oral Maxillofac Surg 2012; 71:77-82. [PMID: 22901859 DOI: 10.1016/j.joms.2012.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 04/02/2012] [Accepted: 04/05/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Midori Miyashita
- Department of Oral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Japan
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14
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Wang Y, Yu GY, Huang MX, Mao C, Zhang L. Diagnosis and treatment of congenital dilatation of Stensen's duct. Laryngoscope 2011; 121:1682-6. [DOI: 10.1002/lary.21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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15
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Polycystic Parotid Disease in a Male Child: Report of a Case and Review of the Literature. J Oral Maxillofac Surg 2011; 69:1375-9. [DOI: 10.1016/j.joms.2010.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 03/19/2010] [Accepted: 05/19/2010] [Indexed: 11/19/2022]
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16
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Noonan VL, Kalmar JR, Allen CM, Gallagher GT, Kabani S. Sclerosing polycystic adenosis of minor salivary glands: report of three cases and review of the literature. ACTA ACUST UNITED AC 2007; 104:516-20. [PMID: 17150380 DOI: 10.1016/j.tripleo.2006.08.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2006] [Revised: 08/24/2006] [Accepted: 08/28/2006] [Indexed: 01/11/2023]
Abstract
Sclerosing polycystic adenosis (SPCA) of the salivary gland is a rarely encountered lesion of uncertain pathogenesis that shares histologic features with sclerosing adenosis and fibrocystic disease of the mammary gland. To date, fewer than 40 cases of SPCA have been reported in the literature; all but one have arisen in the major salivary glands. We report 3 cases of SPCA involving minor salivary glands and discuss the characteristic histopathologic features of SPCA , which include a combination of fibrosis, tubuloacinar proliferation, and cystic change with retention of a somewhat lobular architecture. We also provide a review of contemporary relevant literature. Given that SPCA has been mistaken for malignant salivary gland neoplasia, a familiarity with the entity is critical. Three new cases of SPCA involving minor glands are added to 1 existing case in the literature to raise awareness of the lesion and to reduce the likelihood of misdiagnosis.
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Affiliation(s)
- Vikki L Noonan
- Department of Oral and Maxillofacial Pathology, Boston University School of Dental Medicine, Boston, Massachusetts
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17
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Eveson JW, Speight PM. Non-neoplastic lesions of the salivary glands: New entities and diagnostic problems. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.cdip.2005.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Layfield LJ, Gopez EV. Cystic lesions of the salivary glands: cytologic features in fine-needle aspiration biopsies. Diagn Cytopathol 2002; 27:197-204. [PMID: 12357495 DOI: 10.1002/dc.10168] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A variety of neoplastic and nonneoplastic lesions of the salivary glands have a predominantly cystic architecture. Fine-needle aspirates of these lesions yield watery or mucoid material, frequently of low cellularity. Such aspirates may be obtained from mucus retention cysts, lymphoepithelial cysts, cystadenomas, Warthin's tumors, cystic pleomorphic adenomas, low-grade mucoepidermoid carcinomas, cystadenocarcinomas, and examples of polycystic disease of the parotid gland. The cellular component within the fluid obtained from these lesions may be exceedingly scant or absent, making cytologic diagnosis difficult and, at times, impossible. We studied a series of 56 cystic lesions of the salivary glands, including 38 Warthin's tumors, 6 benign cysts, 2 lymphoepithelial cysts, 5 low-grade mucoepidermoid carcinomas, 1 cystic pleomorphic adenoma, 2 cystadenomas, and 2 cystadenocarcinomas. Careful attention to the cellular elements present often allowed definitive cytologic diagnosis, with an overall accuracy rate of 84%. The presence of atypical squamous metaplasia in oncocytic lesions was a significant cause of false-positive diagnoses of carcinoma (4 cases, 7%). Aspirates of low-grade mucoepidermoid carcinoma may contain no epithelial cells and result in false-negative diagnoses (1 case, 2%).
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Affiliation(s)
- Lester J Layfield
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA
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19
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Layfield LJ, Gopez EV. Histologic and fine-needle aspiration cytologic features of polycystic disease of the parotid glands: case report and review of the literature. Diagn Cytopathol 2002; 26:324-8. [PMID: 11992377 DOI: 10.1002/dc.10108] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Polycystic disease of the parotid glands is a rare disorder, with only eight examples to our knowledge being reported in the literature. The disease presents as a painless enlargement of one or both parotid glands and does not appear to be associated with other disease processes within the head and neck, or with polycystic disease of the kidney, pancreas, or congenital fibrosis of the liver. The histology has been well described. The overall glandular architecture is preserved but the lobules are markedly distended by cysts whose lining appears to be intercalated duct in differentiation. Characteristic eosinophilic laminated spheroliths lie in many of the cystic spaces. Aspirate smears are characterized by a relatively clean background in which are distributed histiocytes, red blood cells, and small clusters of ductal epithelial cells. Polycystic disease of the parotid glands must be differentiated cytologically from mucous retention reaction, mucoceles, benign lymphoepithelial cysts, and cystic neoplasms, including Warthin's tumor, low-grade mucoepidermoid carcinoma, cystadenoma, and papillary cystadenocarcinoma.
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Affiliation(s)
- Lester J Layfield
- Department of Pathology, Division of Anatomic Pathology, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132, USA
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20
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Mandel L, Surattanont F. Bilateral parotid swelling: a review. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 93:221-37. [PMID: 11925529 DOI: 10.1067/moe.2002.121163] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Louis Mandel
- Salivary Gland Center, Columbia University School of Dental and Oral Surgery, New York-Presbyterian Hospital, Columbia Campus, New York, NY 10032, USA
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21
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Abstract
From personal observations, I review the genetic disorders of salivary gland development and function, including the lacrimo-auriculodentodigital (LADD) syndrome, autosomal dominant hypoplasia/agenesis of salivary and/or lacrimal glands, chronic recurrent sialadenitis, polycystic-dysgenetic disease of the parotids and salivary calculi.
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Affiliation(s)
- H R Wiedemann
- Department of Pediatrics, Christian-Albrechts-Universität, Kiel, Germany
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22
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Ficarra G, Sapp JP, Christensen RE, Polyakov V. Dysgenetic polycystic disease of the parotid gland: report of case. J Oral Maxillofac Surg 1996; 54:1246-9. [PMID: 8859246 DOI: 10.1016/s0278-2391(96)90362-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- G Ficarra
- Institute of Odontology and Stomatology, University of Florence, Italy
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23
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Abstract
Polycystic disease of salivary glands is a rare condition which hitherto has been reported only in the parotid glands. We report a case in which an accessory salivary gland had evidence of polycystic disease.
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Affiliation(s)
- D J McFerran
- Royal Ear Hospital, Middlesex Hospital Outpatient Department, London
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24
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Smyth AG, Ward-Booth RP, High AS. Polycystic disease of the parotid glands: two familial cases. Br J Oral Maxillofac Surg 1993; 31:38-40. [PMID: 7679283 DOI: 10.1016/0266-4356(93)90096-f] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Polycystic (dysgenetic) disease of the parotid glands is a rare disorder with only three fully documented reports in the literature containing a total of six cases. This developmental disorder of the distal ductal system appears limited to the parotid glands of female patients and is usually bilateral. We present two further cases with a confirmed familial background to add to the literature. This is the first documented report of familial polycystic disease of the parotid glands. The pathogenesis, mode of inheritance, clinical features, histological appearance and management of this interesting condition are discussed.
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Affiliation(s)
- A G Smyth
- Sunderland District General Hospital
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25
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Barr LC, Cox PJ, Maskell GF, Thomas JM. Benign parotid cysts associated with human immunodeficiency virus infection. Br J Surg 1993; 80:39. [PMID: 8204111 DOI: 10.1002/bjs.1800800113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- L C Barr
- Department of Surgery, Royal Marsden Hospital, London, UK
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26
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Abstract
A case report of a 14-year-old girl, presumed to have PPD, is presented. Those manifestations of this patient's disease that can be added to the classic picture of PPD include a decreased salivary flow rate and a sialochemistry that reflects a mild chronic parotitis. In addition, cysts and sialoliths were demonstrated grossly rather than microscopically.
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Affiliation(s)
- L Mandel
- Salivary Gland Center, Columbia University School of Dental and Oral Surgery, New York, NY 10032
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27
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Abstract
Sialocysts of salivary glands are outnumbered greatly by pseudocystic lesions, exemplified by mucoceles. In the major salivary glands, sialocysts are preponderantly lesions of the parotid glands, where they are classified as 1) salivary duct cysts, 2) lymphoepithelial cysts, or 3) dysgenetic or congenital cysts. All arise from salivary ducts and have no relation with the branchial apparatus.
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Affiliation(s)
- J G Batsakis
- University of Texas M.D. Anderson Cancer Center, Houston 77030
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28
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Dobson CM, Ellis HA. Polycystic disease of the parotid glands: case report of a rare entity and review of the literature. Histopathology 1987; 11:953-61. [PMID: 3311958 DOI: 10.1111/j.1365-2559.1987.tb01901.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We report a case of polycystic disease of the parotid glands. This is a rare disorder and we know of only two previous documented cases in the literature. The disease presents with painless enlargement of one or both parotid glands and is not associated with any clinical abnormality of salivation or with any apparent anomaly of the other salivary glands. Histologically, the overall glandular architecture is preserved but the lobules are all markedly distended by epithelial-lined cysts, which appear to be derived from the intercalated ducts. Characteristic congophilic laminated spheroliths are present within the cystic spaces. The condition must be differentiated from cystic neoplasms, particularly papillary cystic adenocarcinoma, and from various non-neoplastic disorders including sialectasia, retention cysts and lymphoepithelial cysts.
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Affiliation(s)
- C M Dobson
- University Department of Pathology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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29
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Morris MR, Moore DW, Shearer GL. Bilateral multiple benign lymphoepithelial cysts of the parotid gland. Otolaryngol Head Neck Surg 1987; 97:87-90. [PMID: 3112693 DOI: 10.1177/019459988709700118] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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30
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Gigi O, Geiger B, Eshhar Z, Moll R, Schmid E, Winter S, Schiller DL, Franke WW. Detection of a cytokeratin determinant common to diverse epithelial cells by a broadly cross-reacting monoclonal antibody. EMBO J 1982; 1:1429-37. [PMID: 6202509 PMCID: PMC553228 DOI: 10.1002/j.1460-2075.1982.tb01334.x] [Citation(s) in RCA: 157] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
A monoclonal antibody derived from a mouse immunized with bovine epidermal prekeratin has been characterized by its binding to cytoskeletal polypeptides separated by one- or two-dimensional gel electrophoresis and by immunofluorescence microscopy. This antibody (KG 8.13) binds to a determinant present in a large number of human cytokeratin polypeptides, notably some polypeptides (Nos. 1, 5, 6, 7, and 8) of the 'basic cytokeratin subfamily' defined by peptide mapping, as well as a few acidic cytokeratins such as the epidermis-specific cytokeratins Nos. 10 and 11 and the more widespread cytokeratin No. 18. This antibody reacts specifically with a wide variety of epithelial tissues and cultured epithelial cells, in agreement with previous findings that at least one polypeptide of the basic cytokeratin subfamily is present in all normal and neoplastic epithelial cells so far examined. The antibody also reacts with corresponding cytokeratin polypeptides in a broad range of species including man, cow, chick, and amphibia but shows only limited reactivity with only a few rodent cytokeratins. The value of this broad-range monoclonal antibody, which apparently recognizes a stable cytokeratin determinant ubiquitous in human epithelia, for the immunohistochemical identification of epithelia and carcinomas is discussed.
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