Adenomatoid hyperplasia of oral minor salivary glands

Clinical Implications of Goblet Cells in Dacryoadenosis and Normal Human Lacrimal Glands

PURPOSE

The purpose of this study was to investigate an enlarged dacryoadenotic lacrimal gland and normal lacrimal glands for the presence of goblet cells (mucocytes).

DESIGN

Retrospective clinicopathologic series.

METHODS

An enlarged lacrimal gland (dacryoadenosis) without obvious histopathologic alterations was extensively evaluated histochemically, immunohistochemically, and ultrastructurally to detect the presence of goblet cells and to compare the findings with those in five normal lacrimal glands.

RESULTS

Granular, zymogen-rich pyramidal acinar cells in normal glands predominated over a previously not reported subpopulation of nongranular, pale-staining cells in both dacryoadenotic and normal lacrimal glands. These cells histochemically stained positively with mucicarmine and Alcian blue. Immunohistochemical and electron microscopic evaluations established that there was a displacement or replacement of cytoplasmic gross cystic disease fluid protein-15 and CK 7-positive tonofilaments in the pale acinar cells by myriad mucus granules. The goblet cells constituted approximately 2% of the normal acinar cells and 5% of dacryoadenotic acinar cells. A depletion of myoepithelial cells and ectopic intra-acinar ductular cells were also observed in dacryoadenosis.

CONCLUSION

Dacryoadenosis is caused by an increase in the number of acini without individual acinar cell hyperplasia. A normal cytologic feature of the lacrimal gland is the presence of acinar goblet cells that had been long overlooked; they are increased in number in dacryoadenosis. Intra-acinar ductular cells and the scattered loss of myoepithelial cells are other abnormalities in dacryoadenosis. The presence of lacrimal gland goblet cells may have physiologic implications for the precorneal tear film and its derangements as well as for the histogenesis of mucus-producing carcinomas.

Imaging of Inflammatory Disorders of Salivary Glands

Sialadenitis is among the most common conditions that affect the salivary glands. Inflammation of the salivary glands occurs as the end result of a variety of pathologic conditions, including infectious, autoimmune, and idiopathic causes. Clinically, inflammation of the salivary gland causes pain and localized swelling. The presentation may be acute or chronic, and can be recurrent. Because there is significant overlap of underlying disease mechanisms and clinical presentations, radiologic evaluation often plays a significant role in evaluation. This article is a brief review of sialadenitis, including disease mechanisms, causes, and the practical imaging of the salivary glands.

An unusual case of pulmonary hamartoma with predominant bronchial mucous glands in the peripheral lung

Pulmonary hamartoma (PH) is the most common benign lung tumor, comprising various amounts of mescenchymal components with entrapped epithelial components. We describe an unusual case of PH in the left lower lung lobe of a 60-year-old female. The tumor was 9 × 9 mm in size, light brown, weakly glistening, and microscopically found to be composed of well-developed epithelial and mesenchymal components without atypia. Both components were intermingled but without apparent transition. Epithelial components were occupied by predominant bronchial mucous glands. Serous glands, entrapped bronchioles, and clefts lined by respiratory epithelium were also apparent. Mesenchymal components including cartilage and fat were scattered, and swirling smooth muscle fascicles were interlaced with epithelial components. Collision tumor or other biphasic tumors were unlikely, and hyperplastic change in bronchial glands as in the rare conditions of intraoral minor salivary glands and epithelial entrapments by PH may explain these interesting histological findings. It is important to be aware of the possibility that a large number of bronchial mucous glands may be noted in the peripheral lung, and not to mistake this for other malignancies.

Adenomatoid hyperplasia of the minor salivary glands on the buccal mucosa: A rare case report

INTRODUCTION

Adenomatoid hyperplasia of the minor salivary glands is a hyperplastic oral lesion which may be seen on minor salivary gland bearing areas on all oral mucosa, especially on soft and hard palate. This study reports a rare case of buccal adenomatoid hyperplasia of the minor salivary glands and discusses the clinical significance.

PRESENTATION OF CASE

48 year old male patient presented with a complaint of a swelling on his left cheek. Clinical examination revealed a bluish mass on the buccal mucosa. A provisional diagnosis of salivary gland neoplasm was made and the lesion was excised under local anesthesia. The histological diagnosis was adenomatoid hyperplasia of the minor salivary glands.

DISCUSSION

Buccal localization of the adenomatoid hyperplasia of the minor salivary glands is quite uncommon in the literature. There are two cases in the English literature for our knowledge. In the clinical examination, the nodular and protuberated appearance of the lesion resembles buccal minor salivary gland tumors and vascular lesions. Histological analysis is fundamental to achieve correct diagnosis.

CONCLUSION

The differential diagnosis of buccal nodular, exophytic and colored mucosal lesions should include adenomatoid hyperplasia of the minor salivary glands.

Adenomatoid hyperplasia of lower lip

Adenomatoid hyperplasia (AH) is an uncommon, non-neoplastic swelling on the palate caused due to hyperplasia of the mucinous acini. The lesion clinically presents as a sessile tumor-like nodule resembling pleomorphic adenoma. Histopathologic findings include lobules of enlarged mucinous acini which are filled with secretory granules. The nuclei are squeezed to the basal portions, associated with focal inflammation and ductal dilatation, and a history of trauma is often elicited. Here, we report a rare case of AH of the lower lip in a 20-year-old male patient, which mimics a mucous retention cyst or mucocele.

Non-neoplastic salivary gland lesions: a 15-year study

The spectrum of salivary gland lesions is wide and the relative incidence of neoplastic versus non-neoplastic lesions is variable in different studies. A series of non-neoplastic salivary gland lesions is reviewed to analyze their spectrum and their relative frequency. This is a retrospective study of salivary gland excisions and biopsies received in our department from January 1994 to December 2008. Routine hematoxylin and eosin-stained sections of all the salivary gland excisions and biopsies received were analyzed. Of the 393 salivary gland excisions and biopsies received, 216 cases were reported as non-neoplastic (55%) and formed our study group; 177 (45%) were neoplastic. Non-neoplastic lesions were more frequent in major salivary glands (65.7%) and submandibular gland was the most commonly involved (66.2%). Lip was the most frequent site (81.7%) for minor salivary gland lesions. Inflammation was the predominant pathological finding (49.5%), of which non-specific chronic sialadenitis constituted the majority (86.9%). Sialolithiasis was present in 22 cases (20.6%); all of these cases were of non-specific chronic sialadenitis. Cysts were second in frequency (36.6%), of which mucocele was the most common (54.5%). There were 5.6% cases of benign lympho-epithelial lesions, while normal salivary gland tissue was seen in 6.5% cases. Non-neoplastic salivary gland diseases are more common than neoplastic diseases and have a wide disease spectrum.

Idiopathic hyperplasia of the sublingual glands in totally or partially edentulous individuals

OBJECTIVE

To determine the possible etiologic factors associated with the development of idiopathic hyperplasia of the sublingual gland (IHSG).

STUDY DESIGN

Fifty partially or totally edentulous patients were divided into 2 groups, each with 25 subjects, matched by sex. Group 1 was made up of patients with IHSG, whereas group 2 consisted of patients without IHSG. Patients of both groups were investigated with respect to the use of prostheses, systemic medication, systemic diseases, smoking habits, alcohol consumption, and xerostomia. In addition, patients of group 1 were examined by occlusal radiography, and in 6 of them, a biopsy of the sublingual gland swelling was taken for histopathologic investigation. The Fisher exact test was used, with significance set for P < or = .05.

RESULTS

The comparative analysis revealed no statistical difference between the 2 groups concerning all factors investigated (P > .05). Radiographic examination did not detect any presence of salivary calculi; the histopathologic findings revealed either chronic sialadenitis (4 cases) or normal glandular tissue (2 cases).

CONCLUSION

Our clinical and histopathologic analyses confirm that IHSG is a harmless condition for which no surgical treatment is required. The etiologic investigation did not find any local or systemic factors significantly associated with the development of IHSG. The absence of posterior teeth remains as the only known predisposing factor to be strongly linked to this condition.

Adenomatoid serous hyperplasia of sublingual gland: a case report

We present an example of adenomatoid serous lobular hyperplasia of the sublingual gland. Pathologic examination revealed the lesion was composed of multiple aggregates of normal-appearing serous and mucous acini that varied in size. The ratio of serous gland to mucous glands was 7 to 1. We cannot identify the cause of this condition, however, calcium channel blocking agents prescribed for the treatment of this patient's essential hypertension cannot be ruled out as a pathogenetic factor in the development of the lesion.

Adenomatoid hyperplasia of palatal minor salivary glands

Adenomatoid hyperplasia of palatal minor mucous glands is rare but significant because the clinical appearance mimics malignant disease. The typical history of a painless, indolent palatal swelling, together with the histological picture of benign glandular hyperplasia and hypertrophy, are illustrated in this report.