We investigated the clinical and biological significance of germinal centers (GC) present in the minor salivary glands of patients with Sjogren's syndrome (SS). Minor salivary gland tissue biopsies from 93 patients with SS were used to identify GC-like structures, which were confirmed by CD21-positive follicular dendritic cell networks. Patients were compared based upon sociodemographics, glandular and extraglandular manifestations, and laboratory findings including autoantibody profiles, complement, and immunoglobulin levels; EULAR SS disease activity index (ESSDAI) and SS disease damage index (SSDDI) were also measured. GC-like structures were observed in 28 of 93 SS patients (30.1%). Mean focus scores and CRP levels were significantly higher in GC-positive patients than in GC-negative patients; GC-positive patients also exhibit a higher prevalence of rheumatoid factor and anti-SS-A/Ro antibodies compared to GC-negative patients. No differences in glandular or extra-glandular manifestations were evident between groups. In conclusion, SS patients with GC-like structures in the minor salivary glands exhibited laboratory profiles significantly different from those of their GC-negative counterparts. Long-term follow-up of these patients will be necessary to determine whether these laboratory abnormalities are predictive of clinical outcomes.
Adult ; Autoantibodies/blood ; C-Reactive Protein/analysis ; Demography ; Female ; Germinal Center/*pathology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Receptors, Complement 3d/metabolism ; Retrospective Studies ; Salivary Glands, Minor/*pathology ; Sjogren's Syndrome/immunology/metabolism/*pathology

We investigated the clinical and biological significance of germinal centers (GC) present in the minor salivary glands of patients with Sjogren's syndrome (SS). Minor salivary gland tissue biopsies from 93 patients with SS were used to identify GC-like structures, which were confirmed by CD21-positive follicular dendritic cell networks. Patients were compared based upon sociodemographics, glandular and extraglandular manifestations, and laboratory findings including autoantibody profiles, complement, and immunoglobulin levels; EULAR SS disease activity index (ESSDAI) and SS disease damage index (SSDDI) were also measured. GC-like structures were observed in 28 of 93 SS patients (30.1%). Mean focus scores and CRP levels were significantly higher in GC-positive patients than in GC-negative patients; GC-positive patients also exhibit a higher prevalence of rheumatoid factor and anti-SS-A/Ro antibodies compared to GC-negative patients. No differences in glandular or extra-glandular manifestations were evident between groups. In conclusion, SS patients with GC-like structures in the minor salivary glands exhibited laboratory profiles significantly different from those of their GC-negative counterparts. Long-term follow-up of these patients will be necessary to determine whether these laboratory abnormalities are predictive of clinical outcomes.
Adult ; Autoantibodies/blood ; C-Reactive Protein/analysis ; Demography ; Female ; Germinal Center/*pathology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Receptors, Complement 3d/metabolism ; Retrospective Studies ; Salivary Glands, Minor/*pathology ; Sjogren's Syndrome/immunology/metabolism/*pathology

Pleomorphic adenoma is the most common tumour of the salivary gland. While the majority arises from the parotid gland, only a small percentage arises from the minor salivary glands. The cheek, however, is a rarely affected site with respect to pleomorphic adenomas of the minor salivary glands. Herein, we report a case of pleomorphic adenoma of the cheek, which presented with intraoral swelling, and conclude that complete surgical excision can be a curative treatment for this benign tumour.
Adenoma, Pleomorphic ; pathology ; Adult ; Biopsy, Fine-Needle ; Cheek ; Diagnosis, Differential ; Humans ; Male ; Salivary Gland Neoplasms ; pathology ; Salivary Glands, Minor ; pathology

OBJECTIVETo investigate the prognosis of adenoid cystic carcinoma (ACC) in minor salivary glands and its influencing factors.

METHODSClinical data of 52 patients with ACC in minor salivary glands were reviewed. The distribution of stage was as follows: stage I (6%), stage II (21%), stage III (27%) and stage IV (46%). Counting data was analyzed by χ(2) test or Fisher's exact. Survival rates were calculated by Kaplan-Merier method. Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model.

RESULTSAll patients underwent primary tumor radical resection, 39 patients (75%) received postoperative radiation. The regional recurrence rate was 37% and distant metastasis rate was 21%. The 5-, 10-year cumulative local control rate were 68% and 63% respectively. The 5-, 10-year cumulative distant control rate were 86%, 68% respectively. The 5-, 10-year tumor specific survival rates were 70% and 54% respectively. Multivariate analysis showed that T stage, lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands.

CONCLUSIONSRecurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands. T stage, lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands. Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.

Adult ; Aged ; Carcinoma, Adenoid Cystic ; pathology ; radiotherapy ; secondary ; surgery ; Cobalt Radioisotopes ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Particle Accelerators ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Salivary Gland Neoplasms ; pathology ; radiotherapy ; surgery ; Salivary Glands, Minor ; Survival Rate ; Young Adult

OBJECTIVETo analyze the clinicopathologic features of salivary malignant pleomorphic adenoma (MPA) (the subtype of the malignant component was classified as non-specific adenocarcinoma).

METHODSThe clinical and pathological characteristics of 115 salivary gland tumors histologically diagnosed as MPA were analyzed.

RESULTSIn all the 65 MPA cases, there were 58 male and 7 female patients, and the mean age was 57 years (from 23 to 83). Sixty-one tumors were located in major salivary glands, and 4 in minor. Histologically the malignant components of 39 tumors were high-grade, 14 intermediate-grade, and 12 low-grade. Thirty-seven tumors were invasive carcinoma, 13 minimally invasive, and 15 non-invasive. The high-grade tumors had positive correlation with the invasive carcinomas (P < 0.05). The invasive carcinomas had positive correlation with TNM clinical stage (P < 0.05). The invasive carcinoma and the high-grade tumor had correlation with cervical lymph node metastasis (P < 0.05).

CONCLUSIONSNon-specific adenocarcinoma are the most common malignant subtype in MPA. The invasive and the high-grade types are more likely to metastasize to cervical lymph node.

Adenocarcinoma ; pathology ; Adenoma, Pleomorphic ; pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; Salivary Glands ; pathology ; Salivary Glands, Minor ; pathology ; Young Adult

Adenocarcinoma ; pathology ; Adenoma ; pathology ; Carcinoma, Adenoid Cystic ; epidemiology ; genetics ; metabolism ; pathology ; Carcinoma, Basosquamous ; pathology ; DNA, Mitochondrial ; genetics ; Diagnosis, Differential ; Humans ; Immunohistochemistry ; Incidence ; Proto-Oncogene Proteins c-kit ; metabolism ; Salivary Gland Neoplasms ; epidemiology ; genetics ; metabolism ; pathology ; Salivary Glands, Minor ; pathology ; beta-Defensins ; genetics

AIMTo detect the expression of nerve growth factor (NGF) and vascular endothelial growth factor (VEGF) in salivary adenoid cystic carcinoma (SACC) tissues, as well as to determine the correlation between growth factor expression and prognosis in SACC.

METHODOLOGYMedical records of 63 patients surgically treated for SACC between January 1988 and October 2005 were reviewed. Immunohistochemistry was performed to examine the expression of NGF and VEGF in tumor tissues. Kaplan-Meier analysis and Cox's proportional hazard regression model were applied to assess predictors of survival.

RESULTSNGF and VEGF were overexpressed in SACC tissues, compared with those in normal salivary tissues (P < 0.05), and the staining intensity of these two factors was stronger in groups of solid subtype, advanced TNM stage, perineural invasion and recurrence. Patients with high-expression of NGF and VEGF, solid subtype, advanced stage, perineural invasion, recurrence and extended resection alone had worse survival rates (P < 0.05).

CONCLUSIONNGF and VEGF are expressed increasingly in the tissues of SACC cases with invasion and metastasis. NGF expression and VEGF expression are independent

Adult ; Aged ; Carcinoma, Adenoid Cystic ; pathology ; surgery ; Cranial Nerves ; pathology ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Nerve Growth Factor ; analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; surgery ; Salivary Glands ; pathology ; Salivary Glands, Minor ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; analysis ; Young Adult

INTRODUCTIONClear cell carcinoma is a rare low-grade carcinoma that almost exclusively occurs in the minor salivary glands. This tumour is one of the new additions in the recent World Health Organization (WHO) classification of salivary gland tumours.

CLINICAL PICTUREA 50- year-old woman presented with a gradually enlarging painless submucosal mass of 3 months' duration over the left side of the palate.

TREATMENT AND OUTCOMEA preoperative diagnosis of primary clear cell carcinoma of salivary gland with focal surface epithelial dysplasia was rendered after thorough clinical examination to rule out renal origin. The lesions were excised with wide surgical margins and 3 years into the postoperative period, the patient was disease-free.

CONCLUSIONWe report a case of clear cell carcinoma of intra-oral minor salivary gland and draw comparisons with metastatic clear cell carcinoma of renal origin.

Adenocarcinoma, Clear Cell ; pathology ; surgery ; Female ; Humans ; Middle Aged ; Salivary Gland Neoplasms ; pathology ; surgery ; Salivary Glands, Minor

Background: The minor salivary gland biopsy is an important diagnostic criterion of Gougerot-Sj\xf6gren syndrome. Objective: To describe histopathological characteristics of minor salivary gland of Gougerot-Sj\xf6gren syndrome combined to rheumatoid arthritis. Subjects and method: A prospective, descriptive, cross-sectional study included 108 patients with rheumatoid arthritis, who treated at Department of Rheumatology of Bach Mai hospital, from 1998 to 2003. The patients were divided into 2 groups: 50 patients with Gougerot-Sj\xf6gren syndrome and 58 patients without Gougerot-Sj\xf6gren syndrome. Results: Characteristics of minor salivary gland biopsy were lymphocytic infiltration of minor salivary glands (96%) with various distribution: periductal (86%), periacinic (72%), perivascular (36%). 78% of cases were plasmocytic infiltration, with periductal distribution (70%). 82% of cases were 3, 4 stages according to Chilsom clsssification. 67.5% of cases had ductal abnormality, glandular atrophy (62%), vascular edema (58%). Conclusion: Incidence of 3, 4 stages according to Chilsom classification was 82% in rheumatoid arthritis patients with Gougerot-Sj\xf6gren syndrome.
Arthritis ; Rheumatoid/ pathology ; diagnosis ; Sjogren's Syndrome/ pathology ; diagnosis ; Salivary Glands ; Minor/ pathology

OBJECTIVETo analyze the clinical features, morphology and biologic behavior of primary malignant myoepithelioma (MME) of salivary glands.

METHODSThe H&E sections of 16 MME cases were reviewed. Immunohistochemical study using EnVision method for cytokeratin (CK), epithelial membrane antigen (EMA), vimentin, S-100 protein, desmin, muscle-specific actin (MSA), smooth muscle actin (SMA), Myo, proliferation cell nuclear antigen (PCNA), leukocyte common antigen (LCA) and glial fibrillary acidic protein (GFAP) was carried out.

RESULTSOf the 16 patients studied, 6 were males and 10 were females. Their ages ranged from 12 to 65 years (with an average age of 44 years). The tumor occurred predominantly in the parotid gland and minor salivary gland of the palate. Common clinical features included sudden and rapid tumor growth, superficial ulceration, bony destruction and nerve infiltration. Seven of the 16 patients developed local recurrences, while 2 patients had metastasis in the lymph nodes of submandibular or other cervical regions. Most tumors infiltrated adjacent normal salivary gland, adipose, muscular and bony tissues. The extent of local invasion however varied. Histologically, MME showed a wide range of morphologic appearance, with various combinations of clear, spindle, epithelioid or plasmacytoid cells. The tumor cells were atypical and demonstrated high mitotic activity. In this study, 9 cases were composed predominantly of clear tumor cells. Immunohistochemically the tumor cells were positive for CK, EMA, MSA, desmin and S-100 protein.

CONCLUSIONSIn general, MME is a rare and low-grade malignant salivary gland tumor. It carries a low potential for lymph node or distant metastasis but relatively high tendency for local recurrences, resulting in destruction of adjacent soft and bony tissues. The biologic behavior also varies, depending on the site of involvement. Morphologic diagnosis of MME can be difficult in view of the wide spectrum of histologic changes. A definitive diagnosis however is possible with the application of immunohistochemistry.

Adolescent ; Adult ; Aged ; Cytokines ; metabolism ; Desmin ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Myoepithelioma ; metabolism ; pathology ; Neoplasm Recurrence, Local ; Parotid Neoplasms ; metabolism ; pathology ; Retrospective Studies ; Salivary Gland Neoplasms ; metabolism ; pathology ; Salivary Glands, Minor ; pathology