Chronic Sclerosing Sialadenitis of the Submandibular Gland and its Histopathological Spectrum in the IgG4-Related Disease: a Series of 17 Cases

PURPOSE

This study aimed to characterize the histopathological immunohistochemical features of chronic sclerosing sialadenitis, emphasizing the IgG4-related disease.

METHODS

Seventeen cases of chronic sclerosing sialoadenitis were examined for histopathological aspects, (inflammation, fibrosis, glandular parenchyma, and lymphoid follicles) and immunohistochemistry (BCL2, CD3, CD20, CD34, CD163, p63, cyclin D1, mast cell, SMA, S100A4, IgG, and IgG4) which were scored. IgG4-related disease features were investigated. Demographic and clinical data were also collected.

RESULTS

Males predominated (10:7), with an average lesion size of 3.9 cm. Common histopathological findings included reduced acinar parenchyma, lymphoid follicle formation, and ductular proliferation. CD3-positive T lymphocytes and CD34- and SMA-positive stromal fibroblasts were abundant. Nine cases (53%) showed sialoliths and three cases met the criteria for IgG4-related disease.

CONCLUSION

CSS of the submandibular gland represents a reactive pattern rather than IgG4-RD as only 3 cases seemed to be related to IgG4-RD. The immunohistochemical profile revealed an abundant population of CD3-positive T lymphocytes, as opposed to regulatory proteins such as cyclin D1, demonstrating that populations of CD34- and SMA-positive stromal fibroblasts contribute to the fibrosis characteristic of CSS. In addition, our results provide a comprehensive insight into the study of CSS and its relationship with IgG4-RD.

E-CADERIN, N-CADERIN, SLUG, SNAIL, and TWIST contribute to epithelial-mesenchymal transition in salivary gland tumors

BACKGROUND

Transcription factors are important in the epithelial-mesenchymal transition process and are possibly related to the development of a more invasive tumor phenotype. Thus, the objective of this study was to analyze the expression and identify the localization of cellular markers related to the epithelial-mesenchymal transition process in salivary gland tumors.

STUDY DESIGN

The expression and localization of E-CADERIN, N-CADERIN, SLUG, SNAIL, and TWIST were evaluated, using immunohistochemistry, in 48 salivary gland tumors, being 17 pleomorphic adenomas (PA), 14 adenoid cystic carcinomas (ACC), and 17 mucoepidermoid carcinomas (MEC). these proteins were compared to clinical and histopathologic parameters. normal gland tissues were included for immunohistochemical comparisons.

RESULTS

ACC and MEC cases showed higher expression of SNAIL compared to PA. MEC showed high expression of SLUG and TWIST. Low expression of N-CADHERIN, SNAIL, and TWIST in ACC was frequent in T3 and T4. High expression of TWIST in MEC was more frequent at age ≥ 40 years A positive correlation was only observed between N-cadherin/SNAIL in ACC, between SNAIL/TWIST in MEC, and between SLUG/TWIST in PA.

CONCLUSION

This study provided insight into EMT-related proteins (E-cadherin, N-cadherin, SNAIL, SLUG, and TWIST) and their contribution to the maintenance of morphogenesis and the development of the salivary gland tumors and showed a positive correlation among N-CADHERIN/SNAIL in ACC and SNAIL/TWIST in MEC.

Características de Casos de Câncer Bucal no Estado da Bahia, 1999-2012: um Estudo de Base Hospitalar

Introdução: O câncer bucal representa um grave problema de saúde pública no Brasil e no mundo. As informações dos casos diagnosticados por câncer, assim como os indicadores de mortalidade por essa doença, traduzem o perfil da população acometida por ela, além de auxiliar na formulação de políticas públicas para a prevenção e controle dessa enfermidade e para a melhoria da assistência oncológica. Objetivo: Descrever o perfil clínico e epidemiológico de indivíduos com câncer bucal atendidos em hospitais de referência do Estado da Bahia. Método: Estudo descritivo, retrospectivo, dos casos de câncer bucal provenientes do Sistema de Informatização de Registros Hospitalares de Câncer. Foi realizada análise descritiva das variáveis sociodemográficas, clínicas e relacionadas ao uso de tabaco e álcool. Resultados: Foram incluídos 3.309 casos, com predomínio de homens (70,16%), idade superior a 54 anos (61,43%), pardos (84,15%), com nível de escolaridade baixo (78,68%) e provenientes do interior do Estado (73,20%). O estadiamento IV foi o mais frequente (55,23%), o tipo histológico foi carcinoma de células escamosas (83,61%) e a localização primária do tumor na língua (31,10%). Ao final do primeiro tratamento, apenas 9,31% encontravam-se sem evidência de doença/em remissão completa, enquanto 32,47% foram a óbito. A maioria dos indivíduos apresentava história de consumo de álcool e uso de tabaco. Conclusão: Na Bahia, o câncer bucal tem sido diagnosticado tardiamente e tem acometido mais homens, acima dos 54 anos, de cor parda, com baixa escolaridade, resultando em um percentual importante de óbitos.