DOCSLIB.ORG

Kuttner's Tumour: Chronic Sclerosing Sialadenitis- a Mimicker of Malignancy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Kuttner's Tumour: Chronic Sclerosing Sialadenitis- a Mimicker of Malignancy International Surgery Journal Sahoo PK et al. Int Surg J. 2020 Feb;7(2):514-519 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 DOI: http://dx.doi.org/10.18203/2349-2902.isj20200307 Original Research Article Kuttner’s tumour: chronic sclerosing sialadenitis- a mimicker of malignancy Prakash Kumar Sahoo, Suman Saurav Rout*, A. Apalla Naidu, K. Ujwal Reddy, Vishnu Teja Muddu Department of Surgery, Institute of Medical sciences and SUM Hospital, Bhubaneswar, Odisha, India Received: 06 August 2019 Revised: 30 December 2019 Accepted: 02 January 2020 *Correspondence: Dr. Suman Saurav Rout, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Kuttner’s tumour is a condition of the submandibular gland which is underreported as a distinct entity. Also called as the chronic sclerosing sialadenitis it resembles a plasmocytic and lymphocytic inflammatory process and presents as a hard and painful mass which clinically mimics a malignancy and raises significant concerns. The objective of the present study was to evaluate cases of Kuttner’s tumor and discuss its clinical and pathological aspects to distinguish it from a definite malignancy and create a grown acceptance of the presence of such an entity in our setting. Methods: We collected 170 cases of submandibular swellings and evaluated in detail the clinical and pathological aspects of eight cases out of them which were later diagnosed to as Kuttner’s tumour. Results: The age of the patients varied between 23 to 61 years (mean age 42.5 years) with 3 males and 5 females. 6 patients reported with a firm to hard painless submandibular mass (5 left sided; 3 right sided) while 2 patients experienced intermittent discomfort. The mean duration of presentation of symptoms was 5.3 months. Fine needle aspiration cytology was done in 6 cases preoperatively. Following submandibular sialadenectomy histopathology showed salivary gland tissue with preserved lobular architecture, but with marked fibrosis, acinar atrophy, and a dense lymphoplasmacytic infiltrates. Conclusions: Kuttner’s tumor may be pre operatively distinguished from a malignancy with improved imaging and a good image guided FNA Cytology saving the clinician and the patient from a lot of dilemma. However, histopathology and immunohistochemistry would be the key in establishing the diagnosis. Keywords: Kuttner's, Chronic sclerosing sialadenitis, Submandibular tumour INTRODUCTION inflammatory lesions of the salivary glands more than anything else. This lesion has been recognised as a Kuttner first defined chronic sclerosing sialadenitis (CSS) distinct clinicopathological entity in the latest edition of of submandibular gland when he described 4 of such World Health Organisation classification of salivary cases of chronic inflammatory salivary gland disease in gland tumors.2 CSS is clinically characterised by a firm, 1896.1 occasionally painful mass of the submandibular glands. Fine needle aspiration cytology (FNAC) being a simple Difficult to distinguish these lesions from malignancies and effective modality to work up salivary gland masses, of salivary glands clinically and dreaded, such masses its efficacy in diagnosing this particular entity is still 3-5 have been now been described and proven to be as questionable. Plasmocytic and lymphocytic periductal International Surgery Journal | February 2020 | Vol 7 | Issue 2 Page 514 Sahoo PK et al. Int Surg J. 2020 Feb;7(2):514-519 infiltrate which eventually lead to the encasement of METHODS ducts with thick fibrous tissue of the salivary glands are the characteristic features of Kuttner’s tumor. This clinicopathological study entails 8 cases of Kuttner’s tumor, which were treated at Institute of Medical Although described more than a century ago, this clinical Sciences and SUM Hospital, Bhubaneswar, Odisha, entity is still under-reported and preoperatively it remains India, a tertiary care hospital, during the period from July unrecognised by many surgeons. The submandibular 2014 to January 2019. We evaluated and followed up 170 masses are often removed following a preliminary cases which presented with submandibular masses with diagnosis of carcinoma, thus inciting substantial worry to or without pain. All the cases were clinically assessed, both patients and clinicians. This state of affairs is preliminary cytology done and subjected to surgery attributed to the under-reporting of Kuttner’s tumor in which was then followed by a histopathology. Out of literature. We report here a series of cases of CSS and these, 8 patients were diagnosed as CSS (Kuttner’s discuss its clinical and pathological aspects to create a tumor) histopathologically and thus were included in the clearer picture and a grown acceptance of the presence of present study (Table 1). Due consent was taken from each such an entity in our setting. of the above patient before any investigations, surgery and inclusion in the above study. The statistical analysis Objectives was done using SPSS. The objectives of the present study were to evaluate cases RESULTS of Kuttner’s tumor and discuss its clinical and pathological aspects to distinguish it from a definite The incidence of Kuttner’s tumor in our setting was malignancy and a grown acceptance of the presence of <0.05% of all submandibular masses encountered during such an entity in our setting. the above time period (i.e., exactly 0.04%; 8 out of 170) (Figure 1 and 2). Figure 1: Epidemiology of firm painless, submandibular masses. 70 60 50 40 30 number of pts number 20 10 0 male female benign 46 62 malignant 34 20 kuttner's tumor 3 5 Figure 2: Incidence of various submandibular pathologies. International Surgery Journal | February 2020 | Vol 7 | Issue 2 Page 515 Sahoo PK et al. Int Surg J. 2020 Feb;7(2):514-519 The age of the patients varied between 23 to 61 years Six patients reported with a firm to hard painless (mean age 41.5 years) with 3 males and 5 females. The submandibular mass (5 left sided; 3 right sided) while 2 age distribution is shown in Figure 3 with a 50% patients experienced intermittent discomfort. The mean incidence in 5th decade of life. duration of presentation of symptoms was 5.3 months. Table 1: Clinical details of patients with Kuttner’s tumor (CSS). Case Age Side Clinical manifestations FNAC findings Calculi no. /sex affected Scanty acini and normal-looking Painless, firm, non-tender, Left sided ductal cells, with a variable 1 45/M Left Absent submandibular mass for 6 months degree of chronic inflammatory cell infiltration Recurrent occurring firm, slightly tender Epithelial proliferation; chronic 2 23/F with intermittent discomfort left sided Left inflammation Present submandibular mass for 8 months Painless, firm nontender right sided Variable degree of chronic 3 36/F Right Absent submandibular mass for 2 months inflammatory cell infiltration Painless, firm to hard, nontender left 4 50/F submandibular mass; intermittent Left Not done Present discomfort for 6 months Recurrent occurring soft to firm, non- Epithelial proliferation with 5 43/M tender left submandibular mass for 4 Left Absent chronic inflammation months Painless, firm to hard non tender right Lymphoproliferative lesion 6 44/M Right Absent submandibular mass for 1 year scanty acini and normal-looking Painless, firm non tender left ductal cells, with a variable 7 30/F Left Absent submandibular mass for 3 months degree of chronic inflammatory cell infiltration Painless, firm nontender right sided Epithelial proliferation; chronic 8 61/F Right Absent submandibular mass for 2 months inflammation FNAC was done in all 6 cases pre operatively (Figure 4 4 and 5). Only 1 patient on FNAC had features suggestive of a lympho-proliferative disease though malignancy was not 2 ruled out. 1 1 0 21-30 31-40 41-50 51-60 61-70 kuttner's tumor Figure 3: Age distribution of patients with Kuttner’s tumor. All the patients were subjected to ultrasonography of the submandibular region of both the sides. Calculi were detected in 2 cases along with dilated duct which were confirmed by submandibular sialography and computed Figure 4: FNAC the aspirate is moderately cellular tomography imaging (Figure 5). and shows ducts scattered in a background of inflammatory cells. International Surgery Journal | February 2020 | Vol 7 | Issue 2 Page 516 Sahoo PK et al. Int Surg J. 2020 Feb;7(2):514-519 Table 2: Fine needle aspiration findings. duct was duely identified and secured. The gross samples were firm, indurated, lobulate yellowish white. Variable degree of chronic inflammation with scanty Histopathology showed salivary gland tissue with acini (Figure 4). preserved lobular architecture including the lobular septa. Normal looking ductal cells (Figure 4). Marked periductal fibrosis was noted in all cases though Tubular ductal elements surrounding collagen fibres the extent varied in each case. Dense lymphoplasmocytic around Plasmolymphocytic cells (Figure 5). infiltrate (Figure 7) was noted both within and in between the lobules. There was acinar atrophy with residual ducts being encased by thick collagen bundles. Figure 5: FNAC numerous lymphoid cells admixed with plasma cells and histiocytes. Figure 7: Histopathology of the gland showing chronic plasmolymphocytic infiltrate with acinar atrophy and ductal sclerosis. DISCUSSION CSS is an inflammatory process that primarily affects the submandibular gland of middle aged adults and presents clinically as a painful swelling .The inflammatory lesions in Küttner's tumor may occur on one side (unilateral) or both sides (bilateral), predominantly involving the submandibular gland, but is also known to occur in other major and minor salivary glands including the parotid gland.6-9 Salivary tumors especially those of submandibular glands show a great deal of morphological diversity, as well as variations in the nature of the lesion (malignant vs benign) 35-40% of submandibular tumors.
Load more

Recommended publications
  • Sjogren's Syndrome an Update on Disease Pathogenesis, Clinical
    Clinical Immunology 203 (2019) 81–121 Contents lists available at ScienceDirect Clinical Immunology journal homepage: www.elsevier.com/locate/yclim Review Article Sjogren’s syndrome: An update on disease pathogenesis, clinical T manifestations and treatment ⁎ Frederick B. Vivinoa, , Vatinee Y. Bunyab, Giacomina Massaro-Giordanob, Chadwick R. Johra, Stephanie L. Giattinoa, Annemarie Schorpiona, Brian Shaferb, Ammon Peckc, Kathy Sivilsd, ⁎ Astrid Rasmussend, John A. Chiorinie, Jing Hef, Julian L. Ambrus Jrg, a Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA b Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39th Street, Philadelphia, PA 19104, USA c Department of Infectious Diseases and Immunology, University of Florida College of Veterinary Medicine, PO Box 100125, Gainesville, FL 32610, USA d Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA e NIH, Adeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, Building 10, Room 1n113, 10 Center DR Msc 1190, Bethesda, MD 20892-1190, USA f Department of Rheumatology and Immunology, Peking University People’s Hospital, Beijing 100044, China g Division of Allergy, Immunology and Rheumatology, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA 1. Introduction/History and lacrimal glands [4,11]. The syndrome is named, however, after an Ophthalmologist from Jonkoping, Sweden, Dr Henrik Sjogren, who in Sjogren’s syndrome (SS) is one of the most common autoimmune 1930 noted a patient with low secretions from the salivary and lacrimal diseases. It may exist as either a primary syndrome or as a secondary glands.
    [Show full text]
  • Oral Manifestations of Systemic Disease Their Clinical Practice
    ARTICLE Oral manifestations of systemic disease ©corbac40/iStock/Getty Plus Images S. R. Porter,1 V. Mercadente2 and S. Fedele3 provide a succinct review of oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease. While the majority of disorders of the mouth are centred upon the focus of therapy; and/or 3) the dominant cause of a lessening of the direct action of plaque, the oral tissues can be subject to change affected person’s quality of life. The oral features that an oral healthcare or damage as a consequence of disease that predominantly affects provider may witness will often be dependent upon the nature of other body systems. Such oral manifestations of systemic disease their clinical practice. For example, specialists of paediatric dentistry can be highly variable in both frequency and presentation. As and orthodontics are likely to encounter the oral features of patients lifespan increases and medical care becomes ever more complex with congenital disease while those specialties allied to disease of and effective it is likely that the numbers of individuals with adulthood may see manifestations of infectious, immunologically- oral manifestations of systemic disease will continue to rise. mediated or malignant disease. The present article aims to provide This article provides a succinct review of oral manifestations a succinct review of the oral manifestations of systemic disease of of systemic disease. It focuses upon oral mucosal and salivary patients likely to attend oral medicine services. The review will focus gland disorders that may arise as a consequence of systemic upon disorders affecting the oral mucosa and salivary glands – as disease.
    [Show full text]
  • Lymphoepithelial Cyst of the Salivary Gland in a Small Ruminant Lentivirus-Positive Goat
    animals Case Report Lymphoepithelial Cyst of the Salivary Gland in a Small Ruminant Lentivirus-Positive Goat Izabella Dolka 1,* , Marek Tomaszewski 2, Daria Wola 2, Michał Czopowicz 3 and Jarosław Kaba 3 1 Department of Pathology and Veterinary Diagnostics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159c, 02-776 Warsaw, Poland 2 The Scientific Society of Veterinary Medicine Students, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159, 02-787 Warsaw, Poland; [email protected] (M.T.); [email protected] (D.W.) 3 Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159c, 02-776 Warsaw, Poland; [email protected] (M.C.); [email protected] (J.K.) * Correspondence: [email protected] Received: 7 August 2020; Accepted: 30 August 2020; Published: 1 September 2020 Simple Summary: This study presents the first case of a lymphoepithelial cyst (LEC) adjacent to the salivary gland in a goat seropositive for the small ruminant lentivirus (SRLV). Immunohistochemistry detected the antigen of caprine arthritis-encephalitis virus (CAEV) in the LEC, salivary gland, and lung tissue. In human patients, a LEC of the major salivary gland is an uncommon benign lesion and may be the early clinical manifestation of human immunodeficiency virus (HIV) infection. The present report provides useful information on the comparative aspect of LEC in an animal infected with CAEV, one of the SRLVs usually associated with chronic infection. Although many hypothetic theories were proposed, the etiopathogenesis of LEC is still debated. In this study, we present the histopathological description of LEC, supported by histochemistry and immunohistochemistry.
    [Show full text]
  • Prevalence of Salivary Gland Disease in Patients Visiting a Private Dental
    European Journal of Molecular & Clinical Medicine ISSN 2515-8260 Volume 07, Issue 01, 2020 PREVALENCE OF SALIVARY GLAND DISEASE IN PATIENTS VISITING A PRIVATE DENTAL COLLEGE 1Dr.Abarna Jawahar, 2Dr.G.Maragathavalli, 3Dr.Manjari Chaudhary 1Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India 2Professor, Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai, India 3Senior Lecturer, Department of Oral Medicine and Radiology, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences(SIMATS), Saveetha University, Chennai, India [email protected] [email protected] [email protected] ABSTRACT: The aim of the study was to estimate the prevalence of salivary gland diseases in patients visiting a private dental college. A retrospective analysis was conducted on patients who visited the Department of Oral Medicine from March 2019 to March 2020.Clinically diagnosed cases of salivary gland diseases which included salivary gland neoplasms, xerostomia, necrotizing sialometaplasia, mucocele, ranula, sjogren’s syndrome, sialodochitis, sialadenitis were included in the study.The details of each case were reviewed from an electronic database.From the study we found that 17 patients were diagnosed with salivary gland disease.The most commonly observed salivary gland disease was mucocele of the lip with a frequency of 41.17% in the study population followed by xerostomia (17.65%).Salivary gland disease can occur due to variable causes and might significantly affect the quality of life and daily functioning.Only with a thorough knowledge of the subject it is possible to detect the diseases of the salivary gland in their early stage and manage them more efficiently.
    [Show full text]
  • Salivary Gland Imaging in Sjogren's Syndrome
    REVIEW Salivary gland imaging in Sjogren’s syndrome Susan I Lemon, Sjogren’s syndrome (SS) is a systemic connective tissue disease characterized by a Steven G Imbesi & progressive immune-mediated impairment of the exocrine glands. The high prevalence in Alexander R Shikhman† the general population of sicca and other symptoms mimicking SS has increased the need †Author for correspondence for accurate tools in its diagnosis. Imaging may be substantially helpful in this regard, as Scripps Clinic, Member of the well as in the assessment of acute and chronic complications of the disease. A future Division of Rheumatology, MS113, 10666 North Torrey, application of salivary imaging in SS may be guiding therapeutics by enabling Pines Road, La Jolla, radiographic monitoring of treatment responsiveness. This review of salivary gland imaging CA 92037, USA in SS summarizes the types of information yielded by currently available modalities and Tel.: +1 858 554 8562; suggests their proper clinical application. It emphasizes recent advances in noninvasive Fax: +1 858 554 6763; imaging, including magnetic resonance sialography, ultrasonography and nuclear [email protected] medicine techniques. Sjogren’s syndrome (SS) is a systemic connective atrophic and, finally, destroyed [8]. Eventually, the tissue disease characterized by a progressive only remaining ductal epithelium consists of iso- immune-mediated impairment of the exocrine lated cell clusters of epithelial and myoepithelial glands [1,2]. Common clinical manifestations of cells surrounded by a dense lymphocytic infiltra- exocrine involvement in SS include keratocon- tion (a benign lymphoepithelial lesion) [9]. These junctivitis sicca, xerostomia and episodic glandu- pathological changes lead to salivary gland hypo- lar swelling.
    [Show full text]
  • A Guide to Salivary Gland Disorders the Salivary Glands May Be Affected by a Wide Range of Neoplastic and Inflammatory
    MedicineToday PEER REVIEWED ARTICLE CPD 1 POINT A guide to salivary gland disorders The salivary glands may be affected by a wide range of neoplastic and inflammatory disorders. This article reviews the common salivary gland disorders encountered in general practice. RON BOVA The salivary glands include the parotid glands, examination are often adequate to recognise and MB BS, MS, FRACS submandibular glands and sublingual glands differentiate many of these conditions. A wide (Figure 1). There are also hundreds of minor sali- array of benign and malignant neoplasms may also Dr Bova is an ENT, Head and vary glands located in the mucosa of the hard and affect the salivary glands and a neoplasia should Neck Surgeon, St Vincent’s soft palate, oral cavity, lips, tongue and oro - always be considered when assessing a salivary Hospital, Sydney, NSW. pharynx. The parotid gland lies in the preauricular gland mass. region and extends inferiorly over the angle of the mandible. The parotid duct courses anteriorly Inflammatory disorders from the parotid gland and enters the mouth Acute sialadenitis through the buccal mucosa adjacent to the second Acute inflammation of the salivary glands is usu- upper molar tooth. The submandibular gland lies ally of viral or bacterial origin. Mumps is the most in the submandibular triangle and its duct passes common causative viral illness, typically affecting anteriorly along the floor of the mouth to enter the parotid glands bilaterally. Children are most adjacent to the frenulum of the tongue. The sub- often affected, with peak incidence occurring at lingual glands are small glands that lie just beneath approximately 4 to 6 years of age.
    [Show full text]
  • Chronic Sclerosing Sialadenitis (Küttner's Tumour) of the Parotid Gland
    Case Report Chronic Sclerosing Sialadenitis (Küttner’s tumour) of the Parotid Gland Güçlü Kaan BERIAT1, Sefik HalitA KMANSU1, Sinan KOCATÜRK1, Ömür ATAOGLU2 Submitted: 4 Dec 2009 1 Department of Otolaryngology, Faculty of Medicine, Ufuk University, No:86, Accepted: 18 Mar 2010 Konya Avenue, 06520 Balgat, Ankara, Turkey 2 Department of Pathology, Faculty of Medicine, Gazi University, No:43, Konya Avenue, 06100 Bahçelievler, Ankara, Turkey Abstract Chronic sclerosing sialadenitis is a chronic inflammatory salivary gland disease. Küttner reported 4 cases of submandibular gland lesions for the first time in 1896. Chronic sclerosing sialadenitis is a very rare inflammatory lesion of the parotid gland and cannot be easily distinguished from salivary malignant masses. We reported a 28-year-old male with a painful parotid tumour, which grew slowly for 4 years. Keywords: chronic illness, inflammation, oral surgery, parotid gland, sclerosis, sialadenitis Introduction Case Report A series of patients with unilateral, hard, A 28-year-old male was investigated at tumour-like masses of the submandibular the Otolaryngology Outpatient Department. gland were diagnosed with chronic sclerosing He first noted the mass 4 years earlier. Physical sialadenitis by Küttner in 1896 (1). This disease is examination revealed a tender, hard and fixed, clinically similar to salivary gland neoplasms and 3 x 2 cm mass at the angle of the left maxillary is classified as a tumour-like lesion of the salivary arch, and it seemed to be attached to underlying glands by the World Health Organization (2). structures. No other masses or adenopathy were Chronic sclerosing sialadenitis is clinically noted in the head or neck.
    [Show full text]
  • 3. Ellis GL. Lymphoid Lesions of Salivary Glands: Malignant And
    Med Oral Patol Oral Cir Bucal. 2007 Nov 1;12(7):E479-85. Lymphoid lesions of salivary glands Lymphoid lesions of salivary glands: Malignant and Benign Gary L. Ellis D.D.S. Adjunct Professor, University of Utah School of Medicine. Director, Oral & Maxillofacial Pathology. ARUP Laboratories. Salt Lake City, Utah, USA Correspondence: Gary L. Ellis, D.D.S. 500 Chipeta Way Salt Lake City, UT, USA E-mail: [email protected] Received: 20-05-2007 Ellis GL. Lymphoid lesions of salivary glands: Malignant and Benign. Accepted: 10-06-2007 Med Oral Patol Oral Cir Bucal. 2007 Nov 1;12(7):E479-85. © Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946 Indexed in: -Index Medicus / MEDLINE / PubMed -EMBASE, Excerpta Medica -SCOPUS -Indice Médico Español -IBECS ABSTRACT Lesions of salivary glands with a prominent lymphoid component are a heterogeneous group of diseases that include benign reactive lesions and malignant neoplasms. Occasionally, these pathologic entities present difficulties in the clinical and pathological diagnosis and prognosis. Lymphoepithelial sialadenitis, HIV-associated salivary gland disease, chronic sclerosing sialadenitis, Warthin tumor, and extranodal marginal zone B-cell lymphoma are examples of this pathology that are sometimes problematic to differentiate from one another. In this paper the author reviewed the main clinical, pathological and prognostic features of these lesions. Key words: Lymphoepithelial sialadenitis, HIV-associated salivary gland disease, chronic sclerosing sialadenitis, Warthin tumor, extranodal marginal zone B-cell lymphoma. INTRODUCTION tion of disease, and disease is often confined to the salivary Lymphocytic infiltrates of the major salivary glands are glands. Because normal parotid glands contain intra-paren- involved in a spectrum of diseases that range from reactive chymal nodal tissue, some parotid lymphomas have a nodal to benign and malignant neoplasms.
    [Show full text]
  • Salivary Glands
    Vinod K. Anand, MD, FACS Nose and Sinus Clinic Salivary Glands WHERE ARE SALIVARY GLANDS? The glands are located in and around the mouth and throat. The major salivary glands are called the parotid, submandibular and sublingual glands. They all secrete saliva into the mouth: the parotid through ducts near the upper teeth, submandibular into the front portion under the tongue, and the sublingual through multiple ducts in the floor of the mouth. In addition to these glands, there are hundreds of tiny glands called minor saliva glands located in the lips, inner check area (buccal mucosa) and extensively in other linings of the mouth and throat. Salivary glands produce the saliva used to moisten your mouth, initiate digestion, and help protect teeth from decay. WHAT CAUSES ABNORMAL GLANDS? Abnormalities of the salivary glands which cause clinical symptoms can be grouped as follows: 1. OBSTRUCTION: Obstruction to the flow of saliva most commonly occurs in the parotid and submandibular glands, usually due to stone formation. Symptoms typically occur when eating. Saliva production is initiated, but cannot exit the ductal system, leading to swelling of the involved gland and significant pain, sometimes with an infection. 2. INFLAMMATION: If stones are not totally obstructive, the major glands will swell during eating and then gradually subside after eating, only to enlarge again at the next meal. Infection often develops in the abnormally pooled saliva, leading to more severe pain and swelling in the glands. If untreated long enough, the glands may become abscessed. In some individuals the duct system of the major salivary glands may be abnormal.
    [Show full text]
  • Sjögren's Syndrome
    Journal of Case Reports and Studies Volume 4 | Issue 4 ISSN: 2348-9820 Case Report Open Access Sjögren’s Syndrome - Oral Changes, Advanced Diagnosis, and Management - A Case Report Minic I*1, Pejcic A1, Pesic Z2, Zivkovic V3, Ilic I3 and Zarev M2 1Department of Periodontology and Oral medicine, Medical Faculty, University of Niš, Serbia 2Department of Maxillofacial Surgery, Faculty of Medicine, University of Niš, Serbia 3Department for Pathology, Faculty of Medicine, University of Niš, Serbia *Corresponding author: Minic I, Department of Periodontology and Oral medicine, Medical Faculty, University of Niš, Serbia, E-mail: [email protected] Citation: Minic I, Pejcic A, Pesic Z, Zivkovic V, Ilic I, et al. (2016) Sjögren’s Syndrome - Oral Changes, Advanced Diagnosis, and Management - A Case Report. J Case Rep Stud 4(4): 405. doi: 10.15744/2348- 9820.4.4405 Received Date: April 21, 2016 Accepted Date: August 29, 2016 Published Date: August 31, 2016 Abstract Sjögren syndrome (SS) is chronic, systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands. It is an elaborate involvement of the lacrimal and salivary glands, which eventually lead to keratoconjunctivitis sicca and xerostomia. It may occur in two forms - Primary- occurs by itself and secondary, which is associated with another autoimmune disease, most commonly rheumatoid arthritis. Oral implications of SS are hyposalivation, xerostomia, inflamed and burning oral mucosa, rampant caries, sclerosis or growth of parotid gland, frequent manifestation of erythematous candidosis, angular cheilitis, increased plaque retention, and difficulty in swallowing. SS diagnosis is not easy. In addition to the many tests most important diagnostic method is a biopsy of the salivary gland.
    [Show full text]
  • Oral Health and Dentistry ISSN: 2573-4989
    Page 39 to 42 Volume 1 • Issue 1 • 2016 Case Report Oral Health and Dentistry ISSN: 2573-4989 Giant Sialolith Causing Chronic Ulcer on Lateral Border of Tongue Suresh K. Sachdeva1*, Sanjay Dutta2, Swati Saggar Sachdeva3 and Arshad Bin Hussain4 1Department of Oral Medicine and Radiology Surendera Dental College and Research Institute, Rajasthan, India 2Department of Oral Medicine and Radiology Regional Dental College and Hospital Guwahati, Assam, India 3Department of Prosthodontics, Eklavya Dental College & Hospital, Rajasthan, India 4Department of Oral Medicine and Radiology Regional Dental College and Hospital Guwahati, Assam, India *Corresponding Author: Suresh K. Sachdeva, Department of Oral Medicine & Radiology, Surendera Dental College & Research Insti- tute, Rajasthan, India. Received: September 05, 2016; Published: November 12, 2016 Abstract Sialolithiasis is a common disease of the salivary glands, commonly affects middle-aged person with male predominance. Subman- dibular gland or its duct is most commonly affected. The size of salivary calculi may vary from less than 1 mm to a few cm in the larg- sialolith causing ulcer on lateral border of right side of tongue. est diameter. Salivary stones that exceed 15 mm in any dimension are classified as giant. Here we present an unusual case of giant Keywords: Chronic; Giant; Sialolith; Ulcer Volume 1 Issue 1 November 2016 © All Copy Rights are Reserved by Suresh K. Sachdeva., et al. Introduction Sialolithiasis is the most common disease of salivary glands, accounts for more than 50% of the salivary gland diseases. Its estimated frequency is 1.2% in the adult population with male patients affected as twice as much as female patients.
    [Show full text]
  • Lymphoid Lesions of Salivary Glands: Malignant and Benign
    Med Oral Patol Oral Cir Bucal. 2007 Nov 1;12(7):E479-85. Lymphoid lesions of salivary glands Lymphoid lesions of salivary glands: Malignant and Benign Gary L. Ellis D.D.S. Adjunct Professor, University of Utah School of Medicine. Director, Oral & Maxillofacial Pathology. ARUP Laboratories. Salt Lake City, Utah, USA Correspondence: Gary L. Ellis, D.D.S. 500 Chipeta Way Salt Lake City, UT, USA E-mail: [email protected] Received: 20-05-2007 Ellis GL. Lymphoid lesions of salivary glands: Malignant and Benign. Accepted: 10-06-2007 Med Oral Patol Oral Cir Bucal. 2007 Nov 1;12(7):E479-85. © Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946 Indexed in: -Index Medicus / MEDLINE / PubMed -EMBASE, Excerpta Medica -SCOPUS -Indice Médico Español -IBECS ABSTRACT Lesions of salivary glands with a prominent lymphoid component are a heterogeneous group of diseases that include benign reactive lesions and malignant neoplasms. Occasionally, these pathologic entities present difficulties in the clinical and pathological diagnosis and prognosis. Lymphoepithelial sialadenitis, HIV-associated salivary gland disease, chronic sclerosing sialadenitis, Warthin tumor, and extranodal marginal zone B-cell lymphoma are examples of this pathology that are sometimes problematic to differentiate from one another. In this paper the author reviewed the main clinical, pathological and prognostic features of these lesions. Key words: Lymphoepithelial sialadenitis, HIV-associated salivary gland disease, chronic sclerosing sialadenitis, Warthin tumor, extranodal marginal zone B-cell lymphoma. INTRODUCTION tion of disease, and disease is often confined to the salivary Lymphocytic infiltrates of the major salivary glands are glands. Because normal parotid glands contain intra-paren- involved in a spectrum of diseases that range from reactive chymal nodal tissue, some parotid lymphomas have a nodal to benign and malignant neoplasms.
    [Show full text]