bromochloroacetic-acid and Parotid-Diseases

Significant progress in the diagnosis and therapy of salivary gland diseases has been made in recent years. The new technique of diagnostic and interventional sialendoscopy has made an important contribution and is indicated in every case of obstructive sialadenitis. The number of open resections of salivary glands due to stones will clearly decrease in the future in favor of endoscopic removal. Due to recent publications on the appropriate extent of salivary gland resection in benign tumors, more and more specimens with reduced cuffs of healthy salivary gland tissue will be sent to the pathologists. Ultrasound will stay the procedure of first choice for imaging of salivary gland diseases in Germany. In combination with fine-needle aspiration cytology high sensitivity and specificity for the assessment of salivary gland tumors can be achieved. Diffusion-weighted magnetic resonance imaging (MRI) is a new imaging tool and the power of distinction of pleomorphic adenoma from malignant tumors is promising. The use of botulinum toxin for salivary glands diseases is increasing. Intraglandular injections have been shown to induce salivary gland atrophy in animal experiments. The availability of biologicals is currently yielding new aspects for the treatment of Sjögren's disease.

Topics: AIDS-Related Opportunistic Infections; Biomarkers, Tumor; Cell Proliferation; Cell Transformation, Neoplastic; Cysts; Diagnosis, Differential; Epithelium; Humans; Keratins; Lymph Nodes; Lymphoma, B-Cell, Marginal Zone; Parotid Diseases; Salivary Ducts; Salivary Gland Neoplasms; Salivary Glands; Sialadenitis; Sjogren's Syndrome

We report a case of unilateral polycystic disease of the parotid gland. Only eight cases of this disease have previously been published in the English language literature, and seven of them were bilateral. Thus, we are reporting the second case of unilateral involvement. The disease is apparently limited to the parotid gland and to women. Clinically, a fluctuating, long-standing, nontender parotid gland swelling is usually noticed in adulthood. Histologically, there are numerous epithelial-lined cysts, which appear to be derived from intercalated ducts. This disease probably represents a developmental condition.

Topics: Actins; Aged; Cysts; Edema; Epithelium; Female; Fibrosis; Humans; Keratins; Parotid Diseases; S100 Proteins

Bilateral and multiple lymphoepithelial cysts (LECs) of major salivary glands, in particular of parotid glands, are quite rare and have been reported in human immunodeficiency virus (HIV) infected patients with an incidence of about 3-6%. These lesions represent an early manifestation of HIV infection and are rarely found in patients with advanced acquired immunodeficiency syndrome.. Two cases of parotid LECs, the first occurring in a middle-age white woman and the second in a young white boy, both in advanced phases of HIV infection, are reported.. Clinical, cytological, histological and immunohistochemical (cytokeratin AE1/AE3, CD20, CD45RA, CD8, kappa and lambda immunoglobulin light chains, S-100, MLA and Ki67) features are described.. Fine needle aspiration (FNA), a relatively non-traumatic procedure, could represent both a diagnostic and a therapeutic tool in parotid LECs. No surgical therapy is usually required for these lesions and aspiration of cystic fluid with FNA is quite resolutive, although evidence of further relapses does exist. Surgical excision may become necessary when pain, because of persistent and progressive swelling of the parotid gland, occurs.

Topics: Adolescent; B-Lymphocytes; Biopsy, Needle; CD8-Positive T-Lymphocytes; Cyst Fluid; Cysts; Epithelial Cells; Female; HIV Infections; Humans; Keratins; Ki-67 Antigen; Lymphocytes; Male; Middle Aged; Parotid Diseases; S100 Proteins

It is not clear, whether the so-called basal cells of the salivary striated ducts are an independent cell-type distinct from myoepithelial cells, making characterization of the cell proliferation typical of the duct lesions in Sjögren-type sialadenitis/benign lymphoepithelial lesion (BLEL) difficult. An immunohistochemical investigation including different cytokeratin subtypes, alpha-actin, Ki-67 and Bcl-2 was directed at the epithelial cytoskeleton in normal parotid parenchyma (n=8), BLEL (n=12), HIV-associated lymphoepithelial cysts (n=8) and palatine tonsils (n=8). There are profound morphological and functional differences between basal and myoepithelial cells in the normal salivary duct. Development of duct lesions in BLEL arises from basal cell hyperplasia of striated ducts with aberrant differentiation into a multi-layered and reticulated epithelium, characterized by profound alteration of the cytokeratin pattern. This functionally inferior, metaplastic epithelium is similar to the lymphoepithelial crypt epithelium of palatine tonsils. The often postulated participation of myoepithelial cells in duct lesions of Sjögren disease/BLEL cannot be supported. We regard the designations lymphoepithelial lesion and lymphoepithelial metaplasia as the most appropriate.

Topics: Adolescent; Adult; Aged; Biomarkers; Cytoskeleton; Epithelial Cells; Female; HIV Infections; Humans; Hyperplasia; Immunoenzyme Techniques; Keratins; Lymphocele; Male; Middle Aged; Palatine Tonsil; Parotid Diseases; Parotid Gland; Salivary Ducts; Sialadenitis; Sjogren's Syndrome

Acinar cell regeneration in the rat parotid gland after atrophy induced by a one week period of duct obstruction was examined using histology, immunohistochemistry and transmission electron microscopy (TEM). For immunohistochemistry, antibodies to 5-bromo-2'-deoxyuridine (BrdU), injected one hour before tissue collection, and cytokeratin were employed. When clips were removed from the duct, only ductal epithelial cells remained; all acinar cells had been deleted. Some duct cells were BrdU positive. After three days, newly-formed acini comprising immature acinar cells had appeared; many of the cells were BrdU positive and mitotic figures were readily identified. Thereafter progressive acinar cell maturation and proliferation occurred, parotid gland weight returning to control levels by 7 days. Peak BrdU labelling indices for duct and acinar cells were on days 0 and 4, respectively. By TEM, cytoplasmic organelles in epithelial cells of transitional duct-acinar structures seen at 2 days were poorly developed. Immature acinar cells seen on day 3 contained zymogen granules and had increased endoplasmic reticulum and mitochondria. By day 5, maturing acinar cells had abundant endoplasmic reticulum and zymogen granules, resembling acinar cells in control glands. These observations indicated origin of acinar cell precursors from duct cells during regeneration of the acinar cell-free atrophic gland. Subsequent expansion of the acinar cell population was dependent on maturation and proliferation of these newly-formed cells.

Topics: Animals; Atrophy; Cell Division; Constriction, Pathologic; Immunoenzyme Techniques; Keratins; Male; Organ Size; Parotid Diseases; Parotid Gland; Rats; Rats, Sprague-Dawley; Regeneration

Polycystic (dysgenetic) disease of the parotid glands is a rare disorder with only three fully documented reports in the literature containing a total of six cases. This developmental disorder of the distal ductal system appears limited to the parotid glands of female patients and is usually bilateral. We present two further cases with a confirmed familial background to add to the literature. This is the first documented report of familial polycystic disease of the parotid glands. The pathogenesis, mode of inheritance, clinical features, histological appearance and management of this interesting condition are discussed.

Topics: Adolescent; Cysts; Epithelium; Female; Humans; Keratins; Mucocele; Parotid Diseases; Parotid Gland