A case of Schwannoma in the submandibular gland was reported which had been misdiagnosed as pleomorphic adenoma before operation. The tumor was originated from lingual nerve which in turn invaded the Schwann membrane near the submandibular ganglion.
Adenoma, Pleomorphic ; Diagnostic Errors ; Humans ; Neurilemmoma ; diagnosis ; Submandibular Gland ; pathology ; Submandibular Gland Neoplasms ; diagnosis

Sialolithiasis, the most common salivary gland pathology, is caused by calculi in the gland itself and its duct. While patients with small sialoliths can undergo conservative treatment, those with standard-size or larger sialoliths require sialolithotomy. In the present case study, we removed two sialoliths located beneath the mucosa in the posterior and anterior regions of Wharton's duct, respectively. For the posterior calculus, we performed sialolithotomy via an intra-oral approach; thereafter, the small anterior calculus near the duct orifice was removed by hydraulic power. This method has not previously been reported. There were no complications either during the operation or postoperatively, and the salivary function of the gland remained normal.
Calculi* ; Humans ; Methods* ; Mucous Membrane ; Needles* ; Pathology ; Salivary Ducts ; Salivary Gland Calculi ; Salivary Glands ; Submandibular Gland

Adult ; Carcinoma, Squamous Cell ; pathology ; therapy ; Female ; Humans ; Submandibular Gland Neoplasms ; pathology ; therapy

BACKGROUNDAutologous transplantation of the submandibular gland (SMG) into the temporal fossa with microvascular anastomosis has been successfully applied in severe xerophthalmia patients as a permanent tear substitute. However, severe xerophthalmia can be accompanied by salivary gland dysfunction, making such autotransplantation unsuitable. Therefore, SMG allotransplantation might be a solution. The aim of this study was to assess the technical feasibility of submandibular gland allotransplantation.

METHODSTwelve miniature swine were randomized to serve as donors or recipients. One SMG was transplanted between a donor and a recipient. The donor SMG was revascularized by microvascular anastomosis of its vascular pedicle to the recipient lingual artery and external jugular vein. The secretory duct was implanted into the vestibule of the mouth through a subcutaneous tunnel. No immunosuppressive agent was administered. The results were assessed by visual inspection of the secretion, and histopathological examination of the transplanted SMG.

RESULTSTechnically, all surgical procedures were successful. Clear secretion flowed out of the duct as soon as blood supply of the transplanted submandibular gland was reestablished. The secretion of the gland lasted for 5 days. As expected, an acute rejection reaction occurred after surgery because no immunosuppressive agents were used. Secretion from the transplanted SMG ceased within 5 days.

CONCLUSIONSA model of SMG allotransplantation can be established in miniature swine. The technique of submandibular gland allotransplantation is feasible.

Animals ; Microscopy, Electron ; Models, Animal ; Submandibular Gland ; pathology ; transplantation ; ultrastructure ; Swine ; Swine, Miniature ; Transplantation, Homologous

OBJECTIVETo analyze the clinicopathologic features of chronic sclerosing submaxillaritis (CSS).

METHODSThe clinical and pathological characteristics of 9 CSS were analyzed.

RESULTSIn the 9 patients, there were 6 males and 3 females. The age of patients ranged from 51 - 77 years old. All of the tumors were located in the submandibular gland, presenting with painless and firm mass. Histologically, a well-defined mass lesion with extensive lymphocytes and plasma cells infiltration, preservation of lobular architecture, with acinar atrophy. The reactive hyperplasia of lymphoid follicles may be found in CSS. The phlebitis and obliterating phlebitis also formed. Immunohistochemistry showed evidence of diffuse infiltration of plasma cells. The mean number of IgG4-positive plasma cell per high-power field (HPF) was 186, mean value of the IgG4:IgG ratio was 0.71. Three of these 9 cases had manifestations of IgG4-associated systemic disease.

CONCLUSIONSCSS is considered as a part of IgG4-related sclerosing diseases, recognition of which is very essential for a successful treatment. When diagnosis is made, it is necessary to ascertain whether lesion occurs within salivary gland only or in combination with outside IgG4-related sclerosing disease. The establishment of follow-up is also necessary. Some patients show good response to steroid therapy.

Aged ; Female ; Humans ; Immunoglobulin G ; metabolism ; Male ; Middle Aged ; Plasma Cells ; immunology ; Sclerosis ; Sialadenitis ; metabolism ; surgery ; Submandibular Gland ; pathology ; surgery

We describe a rare complication of acute unilateral submandibular gland swelling following the use of laryngeal mask airway (LMA) in two patients with otherwise uneventful perioperative airway management. This is likely to be a consequence of the pressure exerted by the airway cuff on the tissues within the submandibular triangle. As this complication is rarely reported, its true incidence may in fact be higher, suggesting a need for greater attention on LMA cuff pressures and degree of cuff inflation. We discuss the presenting clinical features, pathophysiology and utilisation of ultrasonographic confirmation of sialadenopathy, and review the current anaesthetic literature to raise awareness of this unusual and under-reported complication of LMA. This complication can be mitigated by incorporating routine manometric checks and limiting intracuff pressures to < 60 cmH2O, potentially avoiding LMA insertions in patients with sialolithiasis and avoiding the use of nitrous oxide.
Adult ; Anesthetics ; therapeutic use ; Female ; Humans ; Laryngeal Masks ; adverse effects ; Male ; Pressure ; Submandibular Gland ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo analyze the risk factors for level Ib lymph node enlargement on CT in patients with nasopharyngeal carcinoma (NPC) and provide clinical evidence for defining the indications of prophylactic level Ib irradiation.

METHODSA total of 435 newly diagnosed NPC patients receiving radiotherapy in Nanfang Hospital in the past 2 years were enrolled in this analysis. The correlations were analyzed with Logistic regression between level Ib lymphadenopathy and the clinical risk factors including T stage, N stage, diameter of level II lymph nodes, submandibular gland involvement, nasal cavity involvement, oropharyngeal involvement, and involvement of 4 or more lymphatic drainage regions.

RESULTSUnivariate analysis showed that level Ib lymphadenopathy were positively correlated with N stage (P=0.023), submandibular gland involvement (P=0.045), and level II lymph node diameter (P<0.001). Multivariate Logistic regression analysis suggested a significant correlation only between the diameter of the level II lymph nodes and level Ib lymphadenopathy (P=0.013).

CONCLUSIONLevel Ib lymphadenopathy is positively correlated with the size of ipsilateral level II lymph nodes in NPC patients.

Carcinoma ; Humans ; Lymph Nodes ; pathology ; Lymphatic Diseases ; epidemiology ; Lymphatic Metastasis ; Nasopharyngeal Neoplasms ; epidemiology ; Neck ; Paranasal Sinuses ; Risk Factors ; Submandibular Gland

BACKGROUND: Controversy exists concerning the utility of fine needle aspiration cytology (FNAC) in diagnosing salivary masses. Thus, the goal of this study was to evaluate the efficacy of preoperative fine needle aspiration cytology compared with those of frozen section (FS) and final histopathologies in terms of sensitivity, specificity, accuracy and pitfalls. METHODS: A total of 66 aspirates were from the salivary gland, 50 (75.8%) from the parotid gland and 16 (24.2%) from the submandibular gland, from Jan. 1990 to Jul. 1998. The results from 49 of 66 aspirates were compared with the results from frozen-section pathology. RESULTS: The 66 cases included 59 cases of benign lesions (49 cases of pleomorphic adenomas, 4 cases of basal cell adenomas, 3 cases of Warthin's tumors, and 3 cases of other benign tumors) and 7 cases of malignant lesions (3 cases of mucoepidermoid carcinomas and 4 cases of other malignant tumors). The accuracy in distinguishing malignant from benign lesions was 89.4% for FNAC. The sensitivity, the specificity, and the type-specific accuracy of FNAC were 89.7%, 96.3%, and 70.0%, respectively. A comparison of the cytopathologic diagnosis and the FS diagnosis was made. The accuracy of the FS in distinguishing malignant lesions was 93.8%. The sensitivity, the specificity, and the type-specific accuracy of FS were 80.0%, 95.4%, and 87.7%, respectively. The salivary gland tumors mainly misdiagnosed in FNAC were basal-cell adenomas and Warthin's tumor in benign disease and mucoepidermoid carcinomas in malignant tumors. CONCLUSION: Though FNAC still has some problems and pitfalls, the comparative accuracies of FNAC and FS are similar. A review of the value of FS diagnosis in the surgical treatment of salivary gland lesions suggests that FS diagnosis alone should not determine the surgical management of salivary gland tumors. FNAC is a sensitive and specific diagnostic tool and is complementary to a frozen section biopsy of a salivary gland mass.
Adenoma ; Adenoma, Pleomorphic ; Biopsy ; Biopsy, Fine-Needle* ; Carcinoma, Mucoepidermoid ; Diagnosis ; Frozen Sections ; Parotid Gland ; Pathology ; Salivary Glands* ; Sensitivity and Specificity ; Submandibular Gland

OBJECTIVETo further understanding of lymphoma of salivary gland through clinicopathologic analysis.

METHODSClinical findings, pathologic features, clinical staging, therapy and prognosis of 4 cases were reviewed and clinically analysed.

RESULTSDifferent treatment were received by the 4 patients, one had stage IIIA disease and three had stage IE disease. All patients got their illness completely remitted.

CONCLUSIONMucosa-associated lymphoid tissue lymphoma of the salivary glands is an indolent disease. Different treatments can all result in prolonged remission, and it has better outcome than other NHL.

Aged ; Female ; Humans ; Lymphoma, B-Cell, Marginal Zone ; diagnosis ; pathology ; therapy ; Middle Aged ; Parotid Neoplasms ; diagnosis ; pathology ; therapy ; Prognosis ; Submandibular Gland Neoplasms ; diagnosis ; pathology ; therapy

OBJECTIVE: Lymphoepithelial carcinoma (LEC) of salivary glands is a rare malignant neoplasm. The purpose of this research was to investigate the clinicalpathologic features and treatment methods of this rare disease. METHOD: The clinical data and treatment outcomes of 17 patients from 2006 to 2012 were reviewed retrospectively. RESULT: Ten males and seven females with a ratio of 1. 43:1 were involved. The II, III, IV stage cases were 7 (41.2%), 4 (23.5%), 6 (35.3%), respectively. The average follow-up duration was 2.56 years, and 12 patients had no evidence of recurrence. Five patients had local recurrence and (or) distant metastases within three years after surgery, including 4 deaths. CONCLUSION LEC in salivary gland is a high grade malignant tumor in oral and maxillofacial region, occurring predominately in parotid gland and submandibular gland. To prevent distant metastasis, radical surgery combined with chemoradiotherapy should be adopted.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasms, Squamous Cell ; pathology ; secondary ; Parotid Neoplasms ; pathology ; Rare Diseases ; pathology ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; Salivary Glands ; pathology ; Submandibular Gland Neoplasms ; pathology ; Treatment Outcome