Cases reported "Salivary Gland Diseases"

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1/50. Necrotizing sialometaplasia.

    Two cases of necrotizing sialometaplasia are reported together with a review of the literature. This self-limiting benign lesion is easily confused with malignant tumors. The lesions are characterized histologically by an extensive necrosis of the salivary gland tissue together with squamous metaplasia of the ducts. The present report of two females who had intense pain in the initial phase differs from previous reports concerning age and symptoms. The importance of rather extensive biopsy specimens is stressed. Antibiotic treatment appears to be insignificant. A clinical history of allergy and a dominance of eosinophilic granulocytes in the inflammatory exudate in both cases may indicate an allergic etiology.
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2/50. mucocele of the anterior lingual salivary glands (glands of Blandin and Nuhn): report of 5 cases.

    The anterior lingual salivary glands (glands of Blandin and Nuhn) are mixed mucous and serous glands that are embedded within the musculature of the anterior tongue ventrum. Five cases of mucocele of the glands of Blandin and Nuhn are presented. These mucoceles on the anterior tongue ventrum were exophytic and resembled pyogenic granulomata, polyps, or squamous papillomata. In 2 cases, the onset of the mucocele was associated with trauma to the anterior tongue. All cases were mucus extravasation phenomena. A history of trauma and recovery of mucus with fine needle aspiration are helpful in the clinical diagnosis of mucocele of the glands of Blandin and Nuhn, as are the following characteristics of the mucocele: rapid onset, increase and reduction in size, bluish color, and fluid-filled consistency. During surgery, the glands that are deep in the tongue musculature are commonly left behind, resulting in persistence of the lesion. Careful clinical evaluation of these lesions and preoperative awareness of the surgical anatomy of the glands of Blandin and Nuhn may minimize the need for repeated surgical procedures.
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3/50. diagnosis and treatment of strictures and kinks in salivary gland ducts.

    PURPOSE: This article describes the use of sialoendoscopy for diagnosis and treatment of strictures and kinks in the major salivary glands ducts. patients AND methods: Thirty-four salivary glands with obstruction were diagnosed as having ductal kinks or strictures. Strictures were diagnosed by sialography and sialoendoscopy, kinks were diagnosed mainly by sialography, whereas endoscopy was used to rule out other pathology and to locate the kink. There were strictures in 25 salivary glands (14 male and 11 females; aged 25 to 60 years), 14 in the parotid and 11 in the submandibular gland, and kinks in 9 salivary glands (5 males 4 females; aged 40 to 55 years). Seven kinks were found in the submandibular gland and 2 in the parotid. Treatment of strictures was performed by dilatation procedures with saline under pressure, balloon techniques, and forced manipulation. After these procedures, a polyethylene stent was inserted for 2 weeks. Kinks were treated by advancement ductoplasty and balloon contouring to overcome the acute angle. RESULTS: Twenty of 25 cases of stricture became completely asymptomatic in a follow-up of 8 to 36 months after treatment. In 4 cases, further revisional dilatation was needed, and in 1 case treatment failed and the gland had to be removed. All 9 cases of kinks became completely asymptomatic in a follow-up of 6 to 24 months after treatment. CONCLUSION: Strictures and kinks should be considered when salivary gland obstruction is present without sialolithiasis.
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4/50. Salivary duct cyst: its frequency in a certain Japanese population group (Tohoku districts), with special reference to adenomatous proliferation of the epithelial lining.

    It is reported in the European and American literature that salivary duct cysts constitute about 10% of all cysts of the salivary glands, although they appear to be rare in japan. Between 1975 and 1999, only 3 (0.5%) of 586 salivary gland cysts were diagnosed as salivary duct cysts at the Division of Clinical pathology, Iwate Medical University Hospital. Histologically, two cases appeared as a unilocular lesion lined by double- and multi-layered epithelium. The other case showed marked, intraluminar and intramural adenomatous proliferation of the epithelial lining, suggesting that the lesion was a benign tumor. A review of the literature yielded only two cases of tumors arising in pre-existing salivary duct cysts.
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5/50. Plunging ranula as a complication of intraoral removal of a submandibular sialolith.

    Mucous cysts in the submandibular region--so-called 'plunging' ranula--are relatively uncommon. We report a case of a plunging ranula that complicated excision of an intraductal sialolith of the submandibular gland.
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6/50. cheilitis glandularis: an unusual histopathologic presentation.

    cheilitis glandularis (CG) is an uncommon disease that usually affects the lower lip of adults. It is characterized by enlargement and eversion of the lip in association with excretory duct dilatation. The presence of minor salivary gland hyperplasia is controversial. Three types of CG have been described in the literature; the classification is based on the common clinical and histopathologic findings (ie, simple, superficial, and deep). This report is of an unusual case of CG simplex for which the initial histopathologic diagnosis was papillary cystadenoma, a neoplastic process. The lesion was completely excised, and final microscopic review of a larger specimen revealed chronic sclerosing sialadenitis, dilated salivary secretory ducts with oncocytic change and periductal inflammation, and foci of adenomatous hyperplasia consisting of enlarged ducts exhibiting squamous epithelial metaplasia and hyperplasia with papillary architecture. The latter proliferative pattern is an unusual finding in what is otherwise clinically diagnosed as CG.
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7/50. Adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland.

    We described an extremely rare case of adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland of a 40-year-old Japanese woman. The tumor was growing from the cyst wall and almost occluded the cyst lumen. The epithelium lining the cyst lumen contained both keratin 19-positive cells and alpha-smooth muscle actin-positive cells, indicating the cyst being derived from the acinus/intercalated duct of the sublingual gland. Therefore, our case has presented for the first time a direct evidence that adenoid cystic carcinoma arises from acinus/intercalated duct.
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ranking = 7
keywords = duct
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8/50. Submaxillary gland mucocele: presentation of a case.

    The term mucocele is referred to two concepts: the extravasation cysts resulting from salivary glandular duct rupture, with mucin leakage into the surrounding peri-glandular soft tissue, and the retention cysts, caused by a glandular duct obstruction and resulting in a decrease or even an absence of glandular secretion. mucocele can not be considered as a true cyst because its wall lacks an epithelial lining. These lesions are very common in the minor salivary glands (particularly in the labial glands), but are very infrequent in the major salivary glands--including the submaxillary glands. The present study describes a clinical case of a right submaxillary gland mucocele resolved by surgical treatment and reviews the differential diagnosis with other clinical entities.
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keywords = duct
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9/50. Sclerosing polycystic adenosis of the salivary gland: a report of 16 cases.

    Sclerosing polycystic adenosis is a recently described, extremely rare, reactive, sclerosing, inflammatory process somewhat similar to fibrocystic changes and adenosis tumor of the breast. To date, there have been 22 cases described in the literature. Because of the infrequency of this lesion, we describe our combined experience with 16 cases, 1 of which has been previously reported. Thirteen tumors arose in the parotid gland, two involved the submandibular gland, and one arose in the buccal mucosa. There were 9 men and 7 women. patients ranged in age from 9 to 75 years. Fourteen patients presented with a primary mass. Two were incidental findings in patients with a mixed tumor and an oncocytoma. Tumors ranged in size from 0.3 to 6 cm in greatest dimension. They are typically well circumscribed and are composed of densely sclerotic lobules with prominent cystic change. hyperplasia of ductal and acinar elements and areas of apocrine-like metaplasia are frequent. Foci with mild ductal epithelial atypia were frequent with >50% of cases demonstrating at least focal areas of duct epithelial hyperplasia with atypia. Follow-up ranged from 1.5 to 40 years. One tumor recurred twice; no patient has developed metastases or died of disease.
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10/50. Submandibular sialogram performed through a Wharton's duct fistula: technical adaptation of conventional technique.

    We report a case of submandibular duct fistula in which a sialogram was performed through the fistulous opening after attempt of sialography through the Wharton's duct had failed. To our knowledge, this technical modification in obtaining a sialogram has not been described previously in scientific literature. Blunt-tipped needles and polythene catheters are commonly used for cannulation of the submandibular duct orifice for obtaining a sialogram. However, in this case, a larger gauge metallic cannula was employed to opacify the ductal system through the fistula.
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