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The salivary glands produce saliva, which helps in mediating the oral colonization of microbes, the repair of mucosa, the remineralization of teeth, lubrication and gustation. However, certain medications, therapeutic radiation and certain autoimmune diseases can cause a reduction in the salivary flow. The aim of this report was to review and highlight the indications and techniques of salivary gland engineering to counter hyposalivation. This report concludes that in the literature, numerous strategies have been suggested and discussed pertaining to the engineering of salivary gland, however, challenges remain in terms of its production and accurate function. Dedicated efforts are required from researchers all over the world to obtain the maximum benefits from salivary gland engineering techniques.

The pathophysiology of eustachian tube dysfunction (ETD) remains poorly characterized, and it may result in significant patient morbidity. A recent study has identified a collection of previously unidentified salivary glands in the nasopharynx that overlay the torus tubarius. While salivary gland tissue has been described in the nasopharynx, the newly discovered salivary gland tissue has been denoted tubarial glands (TGs) and theorized to be a distinct organ. The TGs have been suggested to aid in lubrication of the oropharynx and nasopharynx. However, the exact clinical significance of TGs is unknown. Given the proximity of the TG to the eustachian tube, it is possible that the TGs may be related to the development of ETD. Future studies of the TGs and related pathophysiology may improve approaches to developing future ETD treatments.

We report the case of a 6-year-old patient with suspected recurrence of a plunging ranula in clinical and ultrasonographic examination. Surgical resection of the left submandibular and sublingual glands had already been performed. Since persistent glandular tissue could not be excluded with certainty via MRI, we expanded diagnostics by performing a PET/MRI using a head and neck imaging protocol and the radiotracer 18F-PSMA-1007, which is physiologically expressed by salivary gland tissue. The 18F-PSMA-PET/MRI provided evidence of a cystically transformed, diminishing seroma in the left retro-/submandibular region. No 18F-PSMA expressing glandular tissue could be detected in the area of resection, excluding a relapse of a plunging ranula. As a consequence, we opted for a conservative treatment without further surgical intervention. We conclude that a simultaneous 18F-PSMA-PET/MRI is a comprehensive imaging modality, which can help to rule out persistent salivary tissue and recurring plunging ranula. It is a useful tool to facilitate the decision making of surgical interventions.

Purpose: The purpose of this work was to evaluate the expression of GRP78 as a prognostic indicator of aggressiveness in salivary gland tumors and to relate its expression with the biological behavior of the salivary gland tumors. Material and Method: 80 cases of salivary gland tissues were collected as paraffin embedded blocks: 30 benign cases (15 pleomorphic adenoma and 15 Warthin’s tumors) and 45 malignant cases (15 carcinoma ex pleomorphic adenomas, 15 mucoepidermoid carcinomas in addition to 15 adenoid cystic carcinoma). Additionally, 5 normal salivary gland tissues. Using GRP78 antibody, an immunohistochemical investigation was done for all specimens. Results: The mean area percent of immunoexpression was greatest in malignant variants of salivary gland tumors, followed by benign variants of salivary gland tumors and the least value recorded in normal salivary gland tissue. Conclusion: According to the current study, GRP78 is considered as a useful marker for diagnosis of malignancy of salivary gland.

Background: In biological system, cells are considered as dynamic and complex structures likewise cellulardisintegration is also a complex process which occurs in a sequence. Therefore, these autolytic cellularchanges have been investigated by forensic pathologist in an attempt to find markers that may assist indetermining the time of death. In this study we attempt to analyse the efficacy of oral soft tissues specificallysalivary gland in concluding the time since death.Methodology: After obtaining approval from the human ethical committee, informed consent from therelative of the corpse and the investigating police officer, demographic information, as well as post mortemnumber was recorded. Submandibular Salivary Gland was collected for histopathological analysis duringroutine autopsy procedure. The specimens were fixed immediately in 10% formalin, processed, sectionedand stained with haematoxylin and eosin. The stained sections were evaluated under light microscope forhistopathological changes.Conclusion. The histopathological changes in the autopsied salivary gland tissue can be used as an adjuvantto estimate the post-mortem interval.

Accessory parotid gland (APG) is a small salivary gland tissue ranging from 0.5 to 1 cm diameter in size, located almost 7 mm anterior to the main parotid gland. APG is a common anatomical variant, but accessory parotid gland tumors are very rare, accounting for only 1%–7.7% of all parotid gland tumors. We present a case of adenoid cystic carcinoma involving accessory parotid gland, a very rare condition with only, to the best of our knowledge, other 7 cases described in literature. Surgical excision was performed and eventful postoperative recovery, without severe surgical complications and no signs of recurrence at 12 months of follow-up was obtained, with a good cosmetic result. An extensive review of the literature has been performed and the results are presented in order to establish a correct diagnostic-therapeutic protocol for these oncologic patients.

Oncocytic sialolipoma is a very rare tumor of which only three cases have been reported. This entity is considered to be a variant of sialolipoma which harbours oncocytic nodules within a well-circumscribed lipomatous mass. We report a parotid mass in 73-year-old female that was difficult to diagnose in imaging and on biopsy. Ultrasonography and MRI demonstrated a mass with features thought to be consistent with lipoma. Twice needle core biopsies were performed. Both were indefinite for diagnosis. The first report favoured a lipoma and the second report suggested the lesion represented oncocytic hyperplasia or an oncocytoma. The microscopic examination of the excised surgical specimen demonstrated typical features of oncocytic sialolipoma, characterized by a predominately lipomatous component, sparse normal-appearing salivary gland tissue and multiple oncocytic nodules. This is the second case of oncocytic sialolipoma reported to occur in the parotid gland.

Heterotopic Salivary Gland Tissue (HSGT) of the larynx is an extremely rare pathology, with only 8 cases reported in English literature. We are reporting 2 cases of HSGT in the larynx which we encountered in our practice. The first one is a unique presentation of a 45 year old female with HSGT in bilateral false vocal cords. While the second case is 50-year-old male patient with HSGT in the left false vocal cord and subglottic region. With these 2 cases, we would be discussing about the clinical presentation of this rare anomaly and add to the literature.

Lipomas are the most common soft tissue lesions occurring in the salivary glands but have a very low incidence. Lipomas commonly occur in the parotid gland, and lipomas in the submandibular gland (SMG) are rare. Until recently, ordinary lipomas of the parotid gland and some variants of lipomas of the SMG have been reported. However, few reports of ordinary lipomas occurring within the SMG exist in the literature. We report an extremely rare case of ordinary lipoma within the right SMG of a 65-year-old man. The tumor measured a 2.0 × 1.8 × 2.7 cm, was a well-capsulated homogenous yellow mass, which was composed of mature adipose tissue. A partially mixed area with salivary gland tissue was observed. There has not been much research on lipomatous tumors from the SMG because of their rareness. Most lipomatous tumors in the parotid gland are known as ordinary lipomas, but more research is needed to determine whether they can be applied to the SMG. Thus, this report will be instrumental in the understanding of lipomatous tumors of the SMG.

Background Ecto-5’-nucleotidase (CD73) plays an important role in the development of several types of cancer; however, its prognostic significance in salivary gland tumors remains unknown. The current study was conducted to investigate the expression of CD73 in such tumors. Material and Methods In this retrospective study, immunohistochemical expression of CD73 was evaluated in 25 pleomorphic adenomas, 20 mucoepidermoid carcinomas and 20 adenoid cystic carcinomas using the Envision technique. Labeling indices of CD73 expression were calculated and compared between lesions. Results Immunohistochemical analysis demonstrated that the CD73 expression was significantly higher in salivary gland tumors than in normal salivary gland tissue (p0.05). Conclusions The findings suggest that CD73 can be an independent and useful biomarker for predicting the clinical behavior of salivary gland tumors. Key words:Ecto-5’-nucleotidase, immunohistochemistry, salivary gland tumors.

Conclusion The diagnosis of immunoglobulin G4-related disease (IgG4-RD) should be based on the morphology of tissue biopsy, and this study recommends a submandibular gland (SMG) biopsy for accurate diagnosis and to exclude malignant disease. Objective To clarify which type of biopsy specimen (SMG or labial salivary gland [LSG]) should be taken from patients with IgG4-RD. Methods This study included 33 patients with IgG4-RD (21 women; 12 men) who were subjected to both SMG and LSG biopsies at Sapporo Medical University between 2011-2015. Tissues obtained from the SMG and LSG specimens were evaluated. Results All SMG specimens satisfied the diagnostic criteria for IgG4-RD, whereas 19 (57.6%) LSG specimens satisfied the diagnostic criteria for IgG4-RD. Histological evaluation showed fibrosis in all the SMG specimens and in eight LSG specimens (24.2%). Obliterative phlebitis was seen in nine SMG specimens (27.3%), but it was absent in all the LSG specimens.

Mucoceles is the most common benign minor salivary gland lesion commonly affecting children and adolescents, being more prevalent on lower labial mucosa with periodic rupture history and local trauma. A complete excision is recommended for mucoceles, including associated salivary gland tissue and marginal glands. Conventional surgical intervention as well as laser excision is indicated.

Radiation-induced hyposalivation is still a major problem after radiotherapy for head and neck cancer. Current and promising new thoughts to reduce or salvage radiation damage to salivary gland tissue are explored. The main cause underlying radiation-induced hyposalivation is a lack of functional saliva-producing acinar cells resulting from radiation-induced stem cell sterilization. Current methods to prevent that damage are radiation techniques to reduce radiation-injury to salivary gland tissue, surgical techniques to relocate salivary glands to a region receiving a lower cumulative radiation dose, and techniques to make salivary gland cells more resistant to radiation injury. These preventive techniques cannot be applied in all cases, also reduce tumor sensitivity, or do not result in a sufficient amelioration of the dryness-related complaints. Therefore, alternative methods on techniques to salvage salivary glands that are damaged by radiation are explored with promising results, such as stem cell therapies and gene transfer techniques to allow the radiation-injured salivary gland tissue to secrete water.

Objectives/hypothesis Dehydrated vocal folds are inefficient sound generators. Although systemic dehydration of the body is believed to induce vocal fold dehydration, this causative relationship has not been demonstrated in vivo. Here we investigate the feasibility of using in vivo proton density (PD)-weighted magnetic resonance imaging (MRI) to demonstrate hydration changes in vocal fold tissue following systemic dehydration in rats. Study design Animal study. Methods Sprague-Dawley rats (n = 10) were imaged at baseline and following a 10% reduction in body weight secondary to withholding water. In vivo, high-field (7 T), PD-weighted MRI was used to successfully resolve vocal fold and salivary gland tissue structures. Results Normalized signal intensities within the vocal fold decreased postdehydration by an average of 11.38% ± 3.95% (mean ± standard error of the mean [SEM], P = .0098) as compared to predehydration levels. The salivary glands experienced a similar decrease in normalized signal intensity by an average of 10.74% ± 4.14% (mean ± SEM, P = .0195) following dehydration. The correlation coefficient (percent change from dehydration) between vocal folds and salivary glands was 0.7145 (P = .0202). Conclusions Ten percent systemic dehydration induced vocal fold dehydration as assessed by PD-weighted MRI. Changes in the hydration state of vocal fold tissue were highly correlated with that of the salivary glands in dehydrated rats in vivo. These preliminary findings demonstrate the feasibility of using PD-weighted MRI to quantify hydration states of the vocal folds and lay the foundation for further studies that explore more routine and realistic magnitudes of systemic dehydration and rehydration. Level of evidence NA. Laryngoscope, 128:E222-E227, 2018.

Pleomorphic adenoma directly arising in the neck is thought to originate from heterotopic salivary gland tissue. In this article, we present the case of a 55-year-old female patient with a histologically proven pleomorphic adenoma located at the left mandibular angle, anteriorly to the sternocleidomastoid muscle and posteroinferiorly to the submandibular gland. As the patient also had an ipsilateral thyroid nodule with coarse calcifications, clinical and radiological features suggested a possible level II metastatic lymph node. However, ultrasound-guided fine needle aspiration cytology and postsurgery histopathological examination revealed a pleomorphic adenoma arising from heterotopic salivary gland tissue unrelated to a benign thyroid nodule. In this article, we provide a review of the existing literature on heterotopic salivary gland tissue and related neoplasms and discuss their imaging presentation.

Irradiation of salivary glands remains the main dose-limiting side effect of therapeutic PSMA-inhibitors, especially when using alpha emitters. Thus, further advances in radiopharmaceutical design and therapy strategies are needed to reduce salivary gland uptake, thereby allowing the administration of higher doses and potentially resulting in improved response rates and better tumor control. As the uptake mechanism remains unknown, this work investigates the salivary gland uptake of [177Lu]Lu-PSMA-617 by autoradiography studies on pig salivary gland tissue and on PSMA-overexpressing LNCaP cell membrane pellets. Displacement studies were performed with non-labeled PSMA-617 and 2-PMPA, respectively. The uptake of [177Lu]Lu-PSMA-617 in glandular areas was determined to be partly PSMA-specific, with a high non-specific uptake fraction. The study emphasizes that [177Lu]Lu-PSMA-617 accumulation in pig salivary glands can be attributed to a combination of both specific and non-specific uptake mechanisms. The observation is of high impact for future design of novel radiopharmaceuticals addressing the dose-limiting salivary gland irradiation of current alpha endoradiotherapy in prostate cancer.

Acinic Cell Carcinoma (AcCC) is a slow growing, malignant tumour of salivary glands, predominantly found in parotid gland and rarely in submandibular gland or minor salivary glands. Rarely, the tumour can arise in Heterotopic Salivary Gland Tissue (HSGT) and can present bilaterally. Synchronous contralateral tumour or tumour arising in HSGT is easily missed clinically. Fine Needle Aspiration Cytology (FNAC) is an important preoperative diagnostic investigation in cases of AcCC. Sometimes its diagnosis on cytology is very difficult and it is easily misdiagnosed as benign, affecting the long term prognosis. Here, we present two unusual cases of AcCC. One developed in HSGT and the other was synchronous bilateral. Though the histological features of AcCC appear to be characteristic but clinical suspicion and cytological features have been described as equally important for preoperative diagnosis. Present cases highlight the importance of a cytopathologist who plays an important role in its preliminary diagnosis.

We have read with great interest the letter to the editor by van Roon et al 1 commenting on our paper ‘Towards personalised treatment in primary Sjogren's syndrome: baseline parotid histopathology predicts responsiveness to rituximab treatment’.2 The authors argue that there is a need for standardisation of the histopathological characteristics of salivary gland tissue of patients with primary Sjogren's syndrome (pSS), in general, and of the presence of germinal centres (GCs), in particular. We fully agree with van Roon et al 1 and other authors about the need for consensus guidelines to standardise the histopathological evaluation of salivary gland biopsies in patients with pSS.3 A standardised scoring system may facilitate prognostication and stratification of patients with pSS and is needed for a valid evaluation of various clinical trials.3 In particular, histological definition of GCs in salivary gland tissue is warranted, since these structures can be difficult to detect in diagnostic H&E-stained tissue sections. Detection of GCs in the periductal lymphoid infiltrates of the salivary glands is clinically relevant, because the presence of these structures is associated with more severe disease.4 Importantly, the presence of GCs in minor salivary gland biopsies has been postulated to be a predictor of patients who are at risk of lymphoma development.5 …

Manganese-enhanced MRI has previously been used for visualization of brain architecture and functional mapping of neural pathways. The present work investigated the potential of manganese-enhanced MRI for noninvasive imaging of salivary glands in living subjects. Marked shortening of T1 was observed in salivary glands of naive mice (n = 5) 24–48 h after systemic administration of MnCl2 (0.4 mmol/kg, intraperitoneally). Three-dimensional MR microscopy confirmed selective contrast enhancement of salivary gland tissues post–MnCl2 injection. Ectopic and orthotopic head and neck tumor xenografts also showed an increase in R1 at 24 h following MnCl2 injection (0.2 mmol/kg, intraperitoneally). However, tumor enhancement was minimal compared to salivary gland tissue. Salivary gland R1 values were lower in mice bearing orthotopic head and neck tumors compared to naive mice. These results demonstrate, for the first time, the usefulness of manganese-enhanced MRI in the visualization of salivary glands and head and neck tumors in vivo. Magn Reson Med, 2010. © 2010 Wiley-Liss, Inc.

Sebaceous differentiation in normal salivary gland tissue is known to occur, but primary sebaceous neoplasms of the salivary gland are extremely rare. To the best of our knowledge, very few studies have described thin-section computed tomography (CT) and magnetic resonance (MR) imaging results in patients with sebaceous lymphadenomas. We describe a 75-year-old man with a sebaceous lymphadenoma of the right salivary gland. Thin-section CT images revealed a well-defined, inhomogeneous, low-density mass with scattered fat density areas, whereas dynamic MR images revealed a mass with fat intensity areas with an early enhanced and delayed washout pattern and an enhanced capsule.

Salivary gland neoplasms comprise phenotypically and biologically diverse lesions of uncertain histogenesis. Objectives: The present study was carried out to assess the immunohistochemical expression of HER-2/neu protein and of silver binding nucleolar organizer regions in normal salivary tissue. Materials and methods: Twenty paraffin blocks of salivary tumors containing surrounding normal salivary tissue were used in the study. One section was processed to investigate HER-2/neu protein expression and another section was stained to assess the mean Ag NOR counts in normal salivary tissue. Results: Only two cases of the studied normal salivary tissue showed HER-2/neu expression (10%), which was expressed only in ductal cells with 4.2 ± 2.1 mean number of reactive cells per five high power fields (HPFs). Statistically significant (P = 0.01) higher mean Ag NOR counts in ductal (2 ± 0.83) than in acinar cells (1.2 ± 0.01) of normal salivary tissue were found. Conclusion: It was concluded from the data of the present study that ductal cells of normal salivary tissue are a proliferative pool and an oncogenic target which plays an important role in the histogenesis of salivary gland tumors. Keywords: Histogenesis, HER-2/neu expression, AgNORs, Salivary gland neoplasms

Introduction: Salivary gland neoplasms are not uncommon lesions that are seen in the head and neck region. The role of cell cycle regulators as well as that of oncogenes remains unexplored in the pathogenesis of these neoplasms. Aim: Present study was conducted to evaluate the expression of p27 in the three common salivary gland neoplasms. Materials and Methods: A total of 34 cases (19 pleomorphic adenoma, 8 mucoepidermoid carcinoma and 7 adenoid cystic carcinoma) were included. The sections were subjected to p27 staining and rated for the expression. Results: Of the total 52.6% of pleomorphic adenoma cases, 25% of mucoepidermoid carcinoma cases and only 14.2% of adenoid cystic carcinoma cases showed strong expression suggesting variable p27 expression in both malignant neoplasms. Normal salivary gland tissue was stained as a positive control for the evaluation. Conclusion: The results of the study suggest an important role for p27 in pathogenesis of mucoepidermoid carcinoma as well as adenoid cystic carcinoma while its role in pathogenesis of pleomorphic adenoma remains questionable keeping in view the strong expression of p27 in the same.

Stafne bone cavities (SBCs) are mandibular radiolucent lesions with challenging differential diagnoses. Many radiologic methods have been proposed to visualize the presence of salivary gland tissues inside the cavities. This report describes a case of bilateral angular mandibular radiolucent cavities located below the mandibular nerve canal. Magnetic resonance (MR) imaging showed continuity between the submandibular glands and the tissue herniated into the cavities. The ductal system of the 2 submandibular glands was evaluated using MR sialography. MR sialography depicted opacification of the glandular ductal system distinct from the contents of the cavities up to its primary branches, confirming the diagnosis of SBC. MR sialography visualized the submandibular gland ducts and the presence of salivary gland tissue inside the mandibular cavities with precise topographic information. This technique does not involve cannulation or injection of contrast agents and does not expose a patient to radiation. MR sialography is a valuable addition to the common imaging procedures used in the investigation of SBCs.

The accessory parotid gland is a small unit of salivary gland tissue separated from the main parotid gland and lying on the masseter muscle. The accessory parotid gland is not rare, but accessory parotid gland tumors are rare. Accessory parotid gland tumors are associated with a higher rate of malignant tumors than are the main parotid glands, because the accessory parotid gland is made up of a fairly equal percentage of mucinous and serous acinar units in contrast to the predominant serous composition of the main parotid gland, as is the submandibular gland. Herein, we describe the diagnosis and treatment of accessory parotid gland tumors.

Intra-oral lipoma is a well-known entity, but lipomatous tumors including salivary gland tissue containing clustered or peripherally located ducts and acinar cells are uncommon. They are a newly recognized entity of salivary gland lipoma, designated sialolipoma. We describe a case of sialolipoma arising in the floor of the mouth presenting with apparently normal salivary gland tissue, as demonstrated by both histologic and immunohistochemical findings, in a 67-year-old female. Complete surgical removal of the tumor with preservation of the sublingual gland was implemented after a careful examination confirming that the lesion did not originate from the sublingual gland.

In order to evaluate the correlation between functional impairment and changes in the expression pattern of immunohistochemical antibodies in the early phase of radiation-induced dysfunction of salivary glands, eight rabbits were scintigraphically examined prior to and 24 h after irradiation with 15 Gy. The parotid glands were studied using HE-staining, Ki-67, alpha-smooth muscle actin (ASMA) and tenascin-C antibodies at every scintigraphic examination. The results demonstrated a significant alteration in the 99mTc-pertechnetate uptake in all irradiated glands. HE-staining showed no relevant impairment of salivary gland tissue in this early phase. Immunohistochemically, we observed a marked re-distribution of ASMA and tenascin-C as well as a reduction of the proliferating rate of acinar cells. This immunohistochemical change correlated with the functional impairment manifested scintigraphically. This study proves the possibility to assess disorders of salivary gland function with immunohistological antibodies as early as 24 h after irradiation and yields the prerequisites to prove the effects of radioprotective agents on salivary gland tissues.

While head and neck surgeons are accustomed to recognizing malignancies in their practices, developmental lesions are much less often encountered, and as such are not as likely to be included amongst other (more aggressive) differential diagnostic considerations. One such developmental lesion is the choristoma, defined as an architecturally normal arrangement of mature tissues found in a location not normally host to such tissues. Choristomas composed of recognizable salivary gland tissue may be found in a variety of locations including the middle ear. Middle ear salivary choristomas are distinctly unusual lesions and typically manifest as unilateral conductive hearing loss; while both adult and pediatric patients have been diagnosed with middle ear choristomas, most patients have been in the first two decades of life. As these are benign, nonprogressive lesions, treatment has been directed toward complete surgical excision whenever feasible, and biopsy for diagnosis with subsequent observation in the case of those lesions which are difficult to remove without endangering the facial nerve. There have been rare instances in which choristomas have been linked to the subsequent development of neoplasms, but in the main choristomas are regarded as self-limited developmental heterotopias.

This paper reports a rare case of sebaceous adenoma on the right mandibular retromolar mucosa in a 73-year-old Japanese man, with a review of the English literature of sebaceous adenomas of salivary gland origin. A painless and yellowish polypoid lesion in the retromolar mucosa was histologically a relatively well-circumscribed neoplastic mass composed of well-differentiated sebaceous cells with cystic and duct-like structures, and was considered to be a true sebaceous gland neoplasm arising from the minor salivary gland tissue.

The heterotopic salivary gland or salivary choristoma is defined as a tumor - like growth of otherwise normal salivary gland found in an abnormal location. In general, salivary gland tissue is not observed in the gingiva, with only isolated case reports having been found. The occurrence of the case in the midline, especially in the anterior two - thirds of the hard palate, has not been documented so far (PubMed search engine). It is apparent that these reported cases constitute a unique clinico -pathologic entity. Clinically, they appear as soft tissue tumors and are composed of lobules of salivary gland tissue.

Background Mucoepidermoid carcinoma (MEC) is a malignant neoplasm that originates most commonly in the major and minor salivary glands. The aim of this study is to determine the relationship between mucin-1 (MUC1) expression and patient outcome based on a large number of cases. Patients and methods Surgical specimens from 357 patients with primary salivary gland MEC and 10 patients with normal salivary gland tissue were examined by immunohistochemistry. The relationship between MUC1 expression and the clinicopathological data and patient survival was analyzed. Results Results showed that MUC1 expression level was higher in MEC tissues than in paired normal tissues ( P = 0.001), and the expression level of MUC1 was significantly associated with gender ( P = 0.02), location ( P = 0.001), grade ( P = 0.001), stage ( P = 0.0018) and lymph node metastasis ( P = 0.001). In addition, increased expression of MUC1 was confirmed as a strong predictor of poor survival in salivary gland MEC (HR 2.175 [95% CI 1.263, 3.745]; P = 0.0051). Conclusion The findings indicate that an increased expression of MUC1 may be of great value in assessing the development and prognosis of salivary gland MEC, and could be used as a new molecule target to improve outcomes for these patients in the future.

Papillary-cystic variant of acinic cell carcinoma is a rare tumour confined to salivary gland tissue. Here, we report the first case ever to manifest in a tumour affecting the lacrimal gland, a completely different tissue type, and review the current published literature on this type of tumour.

The canalicular adenoma is an uncommon, benign salivary gland tumor that most frequently occurs in the upper lip. Rarely, it manifests itself clinically and histologically as a multifocal lesion, a feature not generally seen with other intraoral salivary gland tumors. Here we report a case of canalicular adenoma that manifested itself with 13 clinically discrete tumor masses involving the upper lip and anterior buccal mucosa. In addition to the clinical nodules, there were microscopic foci of tumor cells in the adjacent normal-appearing salivary gland tissue surrounding the tumors. This article also reviews previously reported multifocal canalicular adenomas and discusses their features, emphasizing differences in the reported growth patterns of this unusual tumor.

We ligated the duct of the rat submandibular gland and to prepare a model of submandibular gland atrophy. Two weeks after ductal ligation, the effects of bFGF on the regeneration of salivary gland tissue were investigated.1) Two-week ductal ligation caused severe atrophy of acini, and the glandular weight decreased up to 26%.2) Isoproterenol and bFGF administration significantly increased the number of PCNApositive cells.3) The proliferative effect of bFGF in vivo was peak at a dose of 1 ng/gland.4) Although isoproterenol stimulated cell proliferation, especially in the ductal region, bFGF promoted the proliferation of various kinds of cells, including acini.5) Two weeks after bFGF administration, the glandular weight increased and the tissue recovered, especially in the acinic region, as compared with the control group. Our results indicate that bFGF may accelerate the regeneration of atrophic salivary gland tissue.

Fifty-three antibodies submitted to the ISOBM TD-3 Workshop on the prostate specific antigen (PSA) were evaluated for their reactivity in frozen and formalin fixed tissue from benign hyperplastic prostate and salivary gland tissue. Only 13/53 antibodies showed clear reactivity in both frozen and paraffin sections, while some antibodies appeared to react only in formalin-fixed paraffin sections. Many antibodies showed extensive nonspecific reactivity in tissue sections. These results highlight the fact that the number of monoclonal antibodies suitable for immunohistochemical detection of PSA is still relatively limited.

Heterotopic salivary gland tissue (HSGT) represents an uncommon lesion, usually presenting as a discharging sinus in the base of the neck. Diagnostic criteria and embryogenesis of this entity still remain unclear. For the purpose of clarifying both subjects, all lateral cervical anomalies undergoing surgery during a 12-year period were examined. Histological study showed salivary tissue in 10 out of 119 patients. However, only 5 of them accomplished HSGT criteria. This study presents the second largest series to date of undisputed HSGT in the lower neck. Both accessory glands and branchial cleft anomalies should be distinguished from this lesion. Neoplastic transformation in HSGT, although extremely rare, should also be considered.

Sialolipoma is a new variant of salivary gland lipoma, which was first proposed by Nagao et al. (Histopathology 2001; 38: 30) in 2001. We report this rare case of sialolipoma in the hard palate. A 60-year-old Japanese woman was referred to our department complaining of a painless swelling on the right side of the hard palate. Intra-oral examination revealed a soft, elastic, dome-shaped mass with 1 cm in diameter located in the posterior part of the hard palate. Magnetic resonance imaging examination revealed high intensity on T1-weighted image and isointensity on T2-weighted image. Incisional biopsy revealed that the tumor was encapsulated by fibrous tissue, consisted of adipose tissue, and also contained normal salivary gland tissue peripherally. First diagnosed as an ordinary lipoma of the hard palate, the tumor was excised. According to the recent criteria of histologic findings of sialolipoma, we rediagnosed the tumor as sialolipoma of the hard palate. J Oral Pathol Med (2006) 35: 376–8

Necrotising sialometaplasia is a benign self-limiting inflammatory process which occurs in the salivary gland tissue. The condition is a diagnostic challenge mimicking malignancy both clinically and histopathologically. Commonly, it presents in the hard palate. Here, we report an unusual case in a 56-year-old man which presented in the floor of the mouth.

A pilot study was performed to examine the presence of nerve fibres in minor salivary gland tissue samples obtained by two procedures: punch and linear incisional techniques. The study was undertaken on a convenience sample of five cryopreserved corpses (mean age 74 ± 3.5 years; three males and two females). Biopsies were performed on the buccal side of the lower lip, between the mid-line and the corner of the mouth. Each corpse had one side of the lower lip biopsied by punch and the contralateral side using a linear incision. All punch samples (100%) displayed severed nerve fibres, whereas no nerve fibres (0%) could be identified in the samples obtained by means of the linear incision technique. While the linear incision approach permitted retrieval of at least five glands, punch biopsies did not provide enough material for the diagnosis of Sjogren's syndrome. Within the limitations of the study, our results strongly discourage the punch technique for minor salivary gland lip biopsy and provide information on the superiority of the linear incisional biopsy in terms of neural damage. These results may also promote the undertaking of clinical trials on patients in whom Sjogren's syndrome is suspected, comparing the morbidity associated with the linear incisional technique vs. minimally invasive biopsies.

This article describes a case of renal cell carcinoma that metastasized to the right Wharton's duct of a 73-year-old man. Metastases of renal cell carcinoma to the oral tissues are rare. Involvement of salivary gland tissue appears to be exceedingly rare, and a metastatic focus localized only in the Wharton's duct never has been reported in the literature.

Myoepithelioma (ME) is a rare benign neoplasm of salivary gland, which commonly originates from parotid gland. Limited number of cases originating from the minor salivary gland tissue have been reported. MEs have characteristic histopathologic and immunohistochemical features, helping in its definitive diagnosis. Here, we present a case of plasmacytoid ME of the palate with review of literature. To the best of our knowledge, only 19 such cases have been reported in literature till date.

Lymphoepithelial cysts of the parotid gland are frequently associated with cervical lymphadenopathy. These unique cysts have recently been recognized as another manifestation of HIV disease. Proliferation of lymphocytes and salivary gland tissue contained within intraparotid lymph nodes is observed. The lymphoepithelial cyst is the end product. Ultrasound imaging serves as an excellent technique to demonstrate the existence of these cysts.

The occurrence and composition of intranodal salivary gland tissue (ISGT) in the head and neck region were investigated. ISGT was mainly composed of mature acini, intercalated ducts and intralobular ducts but immature acini (20.8%) and immature small ducts (18.8%) were also observed. The latter resembled salivary gland tissue in an early developmental stage. Various histological changes of ISGT were observed including cyst formation (16.7%), oncocytic metaplasia (8.3%), oncocytic adenomatous hyperplasia (8.3%) and ductal proliferation (20.8%). Thus ISGT may contain immature components with a potential for differentiation and proliferation.

A case report of ectopic salivary gland tissue at the base of the neck is presented. Heterotopic salivary gland tissue (HSGT) is found infrequently in the neck. This lesion, present since birth, typically presents as a discharging sinus in the base of the neck. Benign and malignant neoplasms may arise in such HSGT. The origin of HSGT is thought to be heteroplasia of the epithelium of the precervical sinus of His.

Lingual mandibular salivary gland defects in the posterior part of the mandible are not uncommon. Analogous defects in the anterior region, however, are rare, and the four new cases presented in this report bring the total number of reported cases up to 24. The purpose of the present study was to review and analyze the clinical, radiographic, and histologic features of the previously reported cases together with those of the present study. The majority of these defects were located in the cuspid and/or premolar area and were diagnosed in men in their fifth and sixth decades of life. Almost all defects contained normal salivary gland tissue. The differential diagnosis, treatment, and pathogenesis of these defects are discussed.

Sialolipoma is a rare tumour of the salivary gland that is composed of mature adipocytes and normal salivary gland tissue. We report an unusual case of a sialolipoma of the submandibular gland in a 77-year-old woman. The location of this tumour has not to our knowledge been previously described. The tumour was excised and has not recurred during 22 months postoperatively.

Heterotopic salivary gland tissue is the presence of salivary tissue outside of the salivary glands. It is an uncommon condition but it can be the source of the full spectrum of salivary gland diseases. We present a rare case of pleomorphic adenoma developing from heterotopic salivary gland tissue in an upper neck lymph node not related to the major salivary glands. This article reviews the difficulty of the differential diagnosis with other cervical masses, embryogenesis, clinical manifestations and treatment of this condition.La presencia de tejido salival fuera de las glándulas salivales se denomina heterotopía salival. Es poco frecuente, pero puede ser asiento de todo el espectro de patologías de las glándulas salivales. Se presenta un caso poco común de un adenoma pleomorfo en la región superior del cuello, desarrollado sobre una inclusión de tejido salival en un linfonodo, de manera independiente a las glándulas salivales. Se revisa la dificultad del diagnóstico diferencial dentro de las masas cervicales, su embriogénesis, manifestación clínica y tratamiento.

Palate sialolipomas are rare. Less than 10 cases located in the hard palate are reported to our knowledge. We report a case of hard palate sialolipoma, peculiar by the intratumor vascular patterns. A 67-year-old man presented with a 1.5 cm lesion of the oral hard palate. The lesion was surgically resected. On microscopy, the lesion, partly encapsulated, consisted of a proliferation of mature adipocytes containing normal minor salivary gland tissue and branching intratumoral vessels of varied size with irregularly thickened wall and papillary projections or tufts. The microscopic features of the tumor we report suggest that vascular malformation-like patterns may occur in sialolipomas of the hard palate. This morphological vascular peculiarity should be acknowledged since it may represent source of hemorrhage.