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PubMed1984

Advances in diagnosis and management of salivary gland diseases.

Salivary glands may be involved in a wide variety of diseases, which may be broadly grouped into (1) inflammatory, (2) noninflammatory, nonneoplastic and (3) neoplastic categories. Most inflammatory and noninflammatory, nonneoplastic diseases should be managed conservatively and symptomatically. The common exceptions are first-arch branchialcleft cysts and calculi. Neoplastic lesions always require resection if that is feasible. For benign tumors, simple excision with a cuff of normal tissue around it will usually suffice. The prevailing trend for treatment of malignant neoplasms is conservatism. No longer is the facial nerve routinely sacrificed. The resection done is dictated by the tumor size and the facial nerve is spared unless directly invaded. Postoperative radiation therapy is increasingly used.

Cysts↗
PubMed1986

Epithelial salivary gland tumors in children and adolescents. Analysis of 80 cases (Salivary Gland Register 1965-1984).

In the Salivary Gland Register (University of Hamburg), 9883 cases were recorded from 1965 to 1984. Among these cases there were 3,326 neoplasms, of which 3,017 were epithelial in origin. In this latter group, 80 neoplasms arose in children and adolescents. Among these 80 persons, there was a slight predominance of females; 57 tumors (71%) were localized in the parotid gland, and only 6 (8%) in the submandibular gland. The incidence of the tumor types was different in children and adolescents as compared to the incidence in adults: monomorphic adenomas were virtually absent in children (only 1 patient), and benign tumors were also less common (65%). The incidence of mucoepidermoid tumors was remarkable (12 cases, 15%). Acinic cell tumors occurred more frequently (5 cases, 6%). The neoplasms have been analyzed histologically. Two very rare tumors, a monomorphic salivary duct adenoma and an embryonal carcinoma, were also studied by electron microscopy and immunohistochemistry.

Adenoma↗
PubMed1996

The effects of a long-term powdered diet on the amounts of two principal neurotransmitters in the major salivary glands and on stimulated salivary secretion in mice.

The amounts of 2 principal neurotransmitters, acetylcholine (ACh) and norepinephrine (NE) in the 3 major salivary glands, and pilocarpine-, isoproterenol- and phenylephrine-induced salivation in male mice fed a powdered diet for 16 weeks were compared with those in mice fed a standard pellet diet (as control). There were no significant differences in the final body weights of mice fed the powdered diet and the control diet. The only salivary gland in the powdered diet fed mice to increase significantly in weight was the sublingual gland. Mice fed the powdered diet had significantly increased ACh concentrations and contents, but had decreased amounts of NE, in the submandibular and sublingual, but not the parotid glands. The salivation stimulated by pilocarpine was markedly decreased in mice fed the powdered diet, whereas the salivation stimulated by phenylephrine or isoproterenol was not. These findings indicate that reduced mastication affects not only the secretory function but also the amounts of these neurotransmitters in the salivary glands of mice.

Acetylcholine↗
PubMed1998

Salivary gland scintigraphy using technetium-99m-pertechnetate after autotransplantation of the submandibular salivary gland in the correction of dry eye.

The aim of the study was to determine whether salivary gland scintigraphy using technetium-99m pertechnetate is suitable for checking the vitality and function after autotransplantation of the submandibular salivary gland in patients with dry eye syndrome. To this end, 56 scintigraphic studies in 20 patients have so far been performed. In addition, these scans were evaluated by a region of interest (ROI) technique in order to examine tracer uptake in the early and late stages after surgery. We have been able to prove that in this special respect, too, the salivary gland scintigraphy is suitable for assessing reliably the vitality and function of the transplanted gland. The secretion into the eye and thus the patency of the efferent duct can also be displayed. This proved to be particularly valuable in those cases in which at first no secretion could be seen in the clinical examination. In patients with uncertain excretory function, we were able to distinguish between non-vitality and lack of patency of the secretory duct. Using ROI evaluation, no significant decrease in the salivary function has been detected in long-term follow-up, now extending to 1 year after surgery.

Adolescent↗
PubMed1987

Necrotizing sialometaplasia of major salivary glands.

Major salivary glands have been rarely reported as sites of necrotizing sialometaplasia, a disease primarily affecting minor salivary tissue, particularly that of the palate. Eight cases of necrotizing sialometaplasia of the parotid and submandibular glands are presented and added to six reported earlier by Donath (1979). The clinical and pathologic findings in the 14 cases give strong support to the vascular-based-infarct genesis of necrotizing sialometaplasia.

Adolescent↗
PubMed1982

5-HT-stimulated arachidonic acid release from labeled phosphatidylinositol in blowfly salivary glands.

In blowfly salivary glands, breakdown of phosphatidylinositol has been linked to the activation of hormone-sensitive Ca2+ channels. Addition of 5-hydroxytryptamine to blowfly salivary glands stimulated the breakdown of phosphatidylinositol prelabeled with 32P or [3H]arachidonic acid. This was associated with a transient accumulation of [3H]arachidonic-labeled diglyceride. There was no appreciable effect of 5-hydroxytryptamine on breakdown of phosphatidylethanolamine or phosphatidylcholine labeled with 32P or [3H]arachidonic acid, indicating that phosphatidylinositol was the immediate source of diglyceride. Extracellular Ca2+ was necessary for [3H]arachidonic acid but not 32P loss from phosphatidylinositol. Addition of arachidonic acid to salivary glands did not stimulate salivary gland secretion or 45Ca flux. In contrast, 5-hydroxytryptamine stimulated both salivary gland secretion and 45Ca flux. These results indicate that, although [3H]arachidonic acid is incorporated into phosphatidylinositol and its release from this phospholipid is increased by 5-hydroxytryptamine, the liberated arachidonic acid does not stimulate salivary gland secretion or 45Ca flux.

Animals↗
PubMed1993

Nitric oxide synthase activity from a hematophagous insect salivary gland.

The salivary glands of the hematophagous insect, Rhodnius prolixus, contain a nitrosylhemeprotein that dissociates its ligand, NO, to the host tissues while the insect is searching for a blood meal. We now report a salivary nitric oxide synthase activity in this insect. The activity is dependent on NADPH, FAD, tetrahydrobiopterin, calmodulin, Ca2+, and converts arginine to citrulline while producing vasorelaxing activity. Molecular sieving indicates a molecular weight of 185 kDa, coeluting with a diaphorase activity. Results indicate similarity of this insect activity to the vertebrate constitutive NO synthase, suggesting NO synthesis is an evolutionary old biological pathway.

Amino Acid Oxidoreductases↗
PubMed2002

Salivary gland tumours.

Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. Although most clinicians and pathologists will have encountered the more common benign neoplasms, few have experience of the full range of salivary cancers, which are best managed in specialist centres. This review considers some current areas of difficulty and controversy in the diagnosis and management of these neoplasms. The classification of these lesions is complex, encompassing nearly 40 different entities, but precise classification and terminology is essential for an accurate diagnosis and for the allocation of tumours to prognostic groups. For many salivary tumours diagnosis is straightforward but the wide range of morphological diversity between and within tumour types means that a diagnosis may not be possible on small incisional biopsies and careful consideration of the clinical and pathological features together is essential. Although tumour grading is important and helpful, it is not an independent prognostic indicator and must be considered in the context of stage. Large malignancies tend to have a poor prognosis regardless of grade and even high-grade neoplasms may do well when they are small. A helpful guide to management of salivary cancers is the '4 cm rule'.

Adenocarcinoma↗
PubMed2003

Structural and functional injury in minipig salivary glands following fractionated exposure to 70 Gy of ionizing radiation: an animal model for human radiation-induced salivary gland injury.

This study explored the feasibility of developing an animal model for radiation-induced salivary gland injury with a radiation protocol identical to current clinical practice. Three male Hanford minipigs were subjected to fractionated daily irradiation with a total dose of 70 Gy; structural and functional measures were compared with those of a control group of minipigs. We found that irradiated submandibular and parotid glands were one-third to one-half the gross size of control glands. Whereas no pathologic changes were noted in control glands, irradiated glands consistently demonstrated significant parenchymal loss with extensive acinar atrophy and interstitial fibrosis, enlarged nuclei in remaining acinar cells, and ductal dilatation and proliferation. Stimulated salivary flow was reduced by 81% in irradiated animals compared with preirradiation flow (P <.001); salivary flow in the control group increased by 30% during the same period (P <.001). The observed radiation-induced structural and functional salivary gland changes are comparable in every respect to those observed following irradiation of human salivary glands.

Animals↗
PubMed1997

[Primary salivary gland tumors in lymph nodes of the parotid gland. Report of 3 cases and review of the literature].

Multiple intra- and paraglandular lymph nodes develop in the parotid gland, including salivary gland tissue with acinar and ductal formations. In the same way heterotopic salivary gland tissue can be localized in cervical lymph nodes. Except for the frequently occurring Warthin tumours, primary salivary gland tumours, which develop in the lymph nodes of the parotid gland or the cervical lymph nodes, are rare. Examples of these are adenomas (pleomorphic adenoma, basal cell adenoma) and carcinomas (acinic cell carcinoma, mucoepidermoid carcinoma, sebaceous gland carcinoma). Three of our own observations (sebaceous lymphadenoma, acinic cell carcinoma, mucoepidermoid carcinoma) are analysed. The condition for the diagnosis of primary salivary gland tumour within a lymph node is reliable evidence that the salivary gland tissue is tumour-free and that no other occult carcinoma is present.

Adenoma↗
PubMed1990

Association of serum IgM kappa monoclonicity in patients with Sjögren's syndrome with an increased proportion of kappa positive plasma cells infiltrating the labial minor salivary glands.

Minor salivary gland biopsy specimens from 11 patients with primary Sjögren's syndrome with circulating monoclonal IgM kappa cryoglobulins, seven without cryoglobulins, and four patients with rheumatoid arthritis and Sjögren's syndrome (one with monoclonal and three with polyclonal cryoglobulins) were examined by the peroxidase antiperoxidase bridge technique, using antihuman kappa and lambda antibodies. In 6/11 patients with primary Sjögren's syndrome and in one patient with Sjögren's syndrome and rheumatoid arthritis with monoclonal cryoglobulins a predominance of plasma cells containing intracytoplasmic kappa light chains was found (kappa:lambda greater than 3:1). Two of those seven patients had immunohistological features of immunocytomas. In the other five patients with circulating monoclonal cryoglobulins the kappa:lambda ratio of positive cells did not exceed 3:1, while six out of seven patients without cryoglobulins and the patients with rheumatoid arthritis and Sjögren's syndrome with polyclonal cryoglobulins had almost equal numbers of kappa and lambda stained cells. One of seven patients with primary Sjögren's syndrome without cryoglobulins had an increased number of lambda light chain positive cells, indicating a non-secretory lambda monoclonal population. These findings suggest that the main area of B cell monoclonal expansion in primary Sjögren's syndrome may be the affected exocrine glands.

Adult↗