Late effects of chronic graft-vs.-host disease in minor salivary glands

BACKGROUND: The established pathologic criteria for minor salivary gland (MSG) involvement in chronic graft-vs.-host disease (cGVHD) could play a role in monitoring response to therapy. METHODS: We evaluated MSG sequential biopsies during cGVHD therapy in 14 allogeneic bone marrow transplantation (BMT) patients. Nine patients that did not develop GVHD after BMT entered the control group. Biopsies were examined using hematoxylin-eosin, Periodic acid-Schiff (PAS) and leukocyte common antigen staining. RESULTS: A significant loss of PAS+ acinar volume was observed at the diagnosis of cGVHD as much as at the end of treatment when compared with the control group. In the second evaluation, the inflammatory infiltrate was still greater than control group. CONCLUSIONS: The results suggest that persistent xerostomia after cGVHD treatment is because of maintenance of lymphocytic infiltrate and consequent absence of MSG secretory unit recovery. This data may be useful to provide improved insight into the histopathology of this organ involvement.     

口腔粘膜良性淋巴组织增生病淋巴细胞性质的研究

目的研究口腔粘膜良性淋巴组织增生病(benign lymphoadenosis of oral mucosa,BLOM)中增生的淋巴细胞的性质。方法采用免疫组化SP法检测14例口腔粘膜良性淋巴组织增生病、9例粘膜良性淋巴组织增生病伴上皮异常增生、11例口腔粘膜良性淋巴组织增生病发生癌变者及10例正常口腔粘膜组织中淋巴细胞CD20和CD45RO的表达。结果正常粘膜中有8例出现CD45RO阳性染色,且染色强度和阳性细胞数并不均一;未见CD20阳性染色。口腔粘膜良性淋巴组织增生病发生癌变组中有一例CD20阴性,其余各组均可见CD20和CD45RO阳性染色,细胞分布呈现出明显的规律性,CD20主要见于淋巴滤泡内或呈灶性聚集的淋巴细胞中,在周围的组织中阳性细胞较少,CD45RO则主要出现在固有层,淋巴滤泡内也可见部分阳性细胞。结论BLOM中浸润的淋巴细胞既有T细胞,亦有B细胞,属于多克隆增生,是一种淋巴细胞的反应性增生性疾病     

Sebaceous lymphadenoma of the lip: report of a case of minor salivary gland origin

A case of sebaceous lymphadenoma occurring in the lip of a 73-year-old female is described. The patient had noticed a painless mass in the region of her upper lip for a year. The surgically removed tumor, measuring about 10 mm in diameter, was located just beneath the lip mucosa, expanding into the submucosal and muscle layer. Histologically, the tumor was well encapsulated and consisted of scattered round-shaped islands of small squamous epithelial cells with focal but apparent sebaceous differentiation in a background of lymphoid stroma. This is the first case report of sebaceous lymphadenoma of minor salivary gland origin.     

颊部小唾液腺黏液囊肿误诊1例报告

小唾液腺黏液囊肿好发于下唇,颊部较为少见.颊部黏液囊肿通常位于黏膜下层颊肌肌束间,作为黏液囊肿的临床表现并不典型,临床上容易产生误诊.本文报告1例颊部小唾液腺黏液囊肿误诊为脂肪瘤的病例,以期为颊部肿物的诊疗提供经验.     

唾液腺纤维肉瘤的临床与病理分析——附2例报告

目的报告2例唾液腺罕见纤维肉瘤。方法对2例唾液腺纤维肉瘤患者的病史、诊断、治疗、病理特征与预后,进行报告与分析。结果原发于腮腺1例术后4周化疗,随访至今仍存活。原发于颌下腺1例术后4月死亡。结论纤维肉瘤极少发生于唾液腺,但恶性程度较高,应提高警惕。     

口腔粘膜良性淋巴组织增生症的临床病理和免疫组化分析

目的明确口腔粘膜良性淋巴组织增生症（BLOM）的临床病理特征及其本质。方法收集分析6例BLOM的临床病理资料，并进行文献复习；对该组病例的组织标本进行免疫组化研究。结果发生在唇部和其它口腔解剖部位的口腔粘膜良性淋巴组织增生症的临床表现和诊断各有其特点；B淋巴细胞是淋巴滤泡和浸润炎症细胞的主要细胞万分。结论BLOM分为唇型和非唇型两种临床类型；BLOM是一种B淋巴细胞介导的增殖性局部体液免疫反应疾病。     

Vascular endothelial growth factor in minor salivary glands: effect of ageing

Morphological and physiological age changes are described in human salivary glands. Vascular endothelial growth factor (VEGF) is neoangiogenic growth factor found in normal salivary glands. Considering the neoangiogenic properties of VEGF and its important function in inflammation, repair and, probably, in oral mucosa homeostasis, the purpose of the present study was to evaluate the effect of ageing on the immunolocalization of VEGF in minor salivary glands. Paraffin-embedded tissue blocks containing normal labial salivary glands were retrieved and classified according to the patients' age in two groups (< 20 and > 40-year-old). The biotin-streptavidin-peroxidase system was used to detect the VEGF antigen. The results demonstrated that the mean level of VEGF immunoreaction in the young group was not statistically different from the old group when compared by the Mann-Whitney U-test (P = 0.54). This may indicate that although salivary flow reduction may develop in old patients, some properties of the salivary glands may not be affected.     

The evaluation of anxiety and salivary cortisol levels in patients with oral lichen planus

OBJECTIVE: The aim of this study was to determine any association between anxiety and salivary cortisol levels in oral lichen planus (OLP) patients by the case-control method. DESIGN RELEVANT: Forty patients with OLP were evaluated. The OLP diagnosis was established through a composite of accepted clinical and histopathological characteristics. Forty patients from the register of patients who obtained general dental care were selected as controls. MATERIAL AND METHOD: The saliva samples collected between 9:00 and 9:15 am were analysed for the level of cortisol with Cortisol EIA that used competitive enzyme-linked immunosorbent assay method. Trait and state anxiety levels of 80 patients were measured using the Spielberger's State-Trait Anxiety Inventory. RESULTS: The mean level of cortisol from 40 saliva samples in study group was 1.46 and 0.93 microg dl(-1) in 40 controls (P=0.001). The mean level for state anxiety in the study group were 48.85 and 39.45 in control group (P=0.001). Trait anxiety levels in study group were 49.77 and 38.51 in control group (P=0.001). We found that salivary cortisol, state and trait anxiety levels in OLP group were significantly higher than in the control group. CONCLUSION: Because of the fact that the level of anxiety and salivary cortisol of OLP patients were high, our findings concluded that this disease is closely related with stress. Thus besides traditional treatment of OLP patients, our findings suggest that psychological support is also needed.     

Tissue engineering: state of the art in oral rehabilitation

Summary  More than 85% of the global population requires repair or replacement of a craniofacial structure. These defects range from simple tooth decay to radical oncologic craniofacial resection. Regeneration of oral and craniofacial tissues presents a formidable challenge that requires synthesis of basic science, clinical science and engineering technology. Identification of appropriate scaffolds, cell sources and spatial and temporal signals (the tissue engineering triad) is necessary to optimize development of a single tissue, hybrid organ or interface. Furthermore, combining the understanding of the interactions between molecules of the extracellular matrix and attached cells with an understanding of the gene expression needed to induce differentiation and tissue growth will provide the design basis for translating basic science into rationally developed components of this tissue engineering triad. Dental tissue engineers are interested in regeneration of teeth, oral mucosa, salivary glands, bone and periodontium. Many of these oral structures are hybrid tissues. For example, engineering the periodontium requires growth of alveolar bone, cementum and the periodontal ligament. Recapitulation of biological development of hybrid tissues and interfaces presents a challenge that exceeds that of engineering just a single tissue. Advances made in dental interface engineering will allow these tissues to serve as model systems for engineering other tissues or organs of the body. This review will begin by covering basic tissue engineering principles and strategic design of functional biomaterials. We will then explore the impact of biomaterials design on the status of craniofacial tissue engineering and current challenges and opportunities in dental tissue engineering.     

Localization of glycosaminoglycans (GAGs) in pleomorphic adenoma (PA) of salivary glands: an immunohistochemical and histochemical evaluation

The tumor matrix of salivary pleomorphic adenoma (PA) is characteristically rich in glycosaminoglycans (GAGs), which contribute to its complex histoarchitecture. This study evaluated the microscopic localization of various GAGs in 17 PAs, using a panel of anti-GAG monoclonal antibodies and biotinylated hyaluronic acid (HA)-binding protein. Both epithelial and mesenchymal-like tissues were confirmed to contain GAGs. Luminal epithelial cells mostly lacked GAGs, whereas GAGs were seen both in the cytoplasm and cell membrane of non-luminal epithelial cells. In addition, small intercellular accumulations of GAGs were often present in solid epithelial areas, implying the epithelial origin of GAGs. GAGs did not appear to be a main component of the hyaline matrix. The myxoid region was consistently stained for both chondroitin 6-sulfate (CS-6) and HA but variably for chondroitin 4-sulfate (CS-4), dermatan sulfate (DS) and keratan sulfate (KS); heparan sulfate (HS) was not detected. The chondroid region showed increased staining for CS-6 but reduced staining for HA when compared with the myxoid region. In addition, CS-4, DS and KS were seen both in chondroid cells and the territorial matrix, whereas HS was present only in the cells. It is suggested that GAGs in PA are mainly produced by non-luminal cells and influence the proliferation, differentiation, secretory activity and shape of tumor cells, thus contributing to the morphological diversity of this tumor.     

Adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma of minor salivary glands: a comparative immunohistochemical study using the epithelial membrane and carcinoembryonic antibodies

OBJECTIVE: The purpose of this study was to investigate immunohistochemically the expression of epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) in adenoid cystic carcinoma (AdCC) and polymorphous low-grade adenocarcinoma (PLGA) in an attempt to assess the ability of these markers to distinguish AdCC from PLGA when the histological features on routine hematoxylin and eosin are equivocal. MATERIALS AND METHODS: Fourteen specimens of AdCC, 10 PLGA, and five normal minor salivary glands fixed in 10% formalin and embedded in paraffin, were retrieved from the files of our department and were retrospectively studied with the streptavidin-biotin complex method using the epithelial membrane and carcinoembryonic antibodies. RESULTS: The immunoreactivities and the expression patterns of EMA and CEA in AdCC and PLGA were similar. CONCLUSIONS: The results of this study suggest that the immunostaining of AdCC and PLGA with EMA and CEA could not offer an adjunctive aid in differential diagnosis between these two tumors.     

Immunohistochemical evaluation of the small and large proteoglycans in pleomorphic adenoma of salivary glands

This study investigated the immunolocalization of small and large proteoglycans (PGs), including decorin, biglycan, PG-M/versican and aggrecan, in salivary pleomorphic adenoma (PA) using monoclonal and polyclonal antibodies. In addition, a polyclonal antibody, A0082, recognizing blood vessels was also used to help identify truly mesenchymal tissues in PA. Decorin reactivity was detected only in tumor capsule and interstitial tissue of non-neoplastic salivary gland, but not in the tumor tissue. Biglycan was frequently revealed throughout the matrix of small chondroid regions and in the peripheral portion of larger chondroid regions. PG-M/versican was mainly localized to the truly mesenchymal tissues in PA and the innermost portion of tumor capsule. On the contrary, aggrecan was extensively expressed in the non-luminal epithelial areas as well as in the myxoid and chondroid areas, but not in the truly mesenchymal tissues. These findings suggest that aggrecan is the most widely distributed PG in PA and may be produced mainly by non-luminal tumor cells. The absence of aggrecan from the truly mesenchymal tissues argues against its origin from this source. Both aggrecan and biglycan may play important roles in the chondroid differentiation and morphogenesis of PA.     

CD44与CD33在77例口腔黏膜良性淋巴组织增生病中的表达及临床意义

目的：探讨CD44与CD33在口腔黏膜良性淋巴组织增生病（benign lymphoadenosis of oral mucosa,BLOM）中的表达及临床意义。方法：选择2017年1月—2020年3月青岛市中医医院病理科77例BLOM蜡块作为实验组,另取同时间段63例正常口腔黏膜组织蜡块作为对照组。采用免疫组织化学法检测2组CD44、CD33阳性表达情况,采用Spearman分析BLOM患者病变组织中CD33与CD44阳性表达的相关性。收集患者一般资料,分析BLOM患者病变组织中CD33、CD44表达与临床病理特征的关系。采用SPSS 21.0软件包对数据进行统计学分析。结果：对照组、实验组CD33阳性表达率分别为95.24%、63.64%,差异有统计学意义（P<0.05）;CD44阳性表达率分别为93.65%、67.53%,差异有统计学意义（P<0.05）。Spearman分析结果显示,BLOM患者病变组织中CD33与CD44阳性表达呈正相关（r=0.834,P=0.002）;CD33、CD44表达与临床分型、炎症程度、有无淋巴滤泡、淋巴细胞浸润有关（P<0.05...     

Two-phase appearance of oral epithelial dysplasia resulting from focal proliferation of parabasal cells and apoptosis of prickle cells

BACKGROUND: One of the histologic characteristics of epithelial dysplasias of the oral mucosa is droplet-shaped rete processes resulting from a solid proliferation of basaloid cells. These basaloid cells are suddenly changed into an overlay of parakeratotic cells. However, it is unknown how this characteristic two-phase appearance is generated. METHODS: Formalin-fixed paraffin sections of the oral mucosal specimens with normal, hyperplastic, dysplastic epithelia and squamous cell carcinomas were examined for apoptosis by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) method and for lymphoid cells by immunohistochemistry. RESULTS: Apoptotic cells were only located in the keratinized layer of normal/hyperplastic epithelia. However, in epithelial dysplasias, apoptotic cells were scattered in the middle or even in the lower parts of the epithelial layer with frequent vacuolation changes of epithelial cells. Within the epithelial layer of dysplasias, there were increased number of lymphocytes, which were immunopositive for CD45RO, CD8, and CD57- and CD68-immunopositive (+), S-100 protein-positive and major histocompatibility complex (MHC) class II-positive monocytic lineages. They increased in number with the severity of dysplastic degrees, and they were often located in the vicinity of apoptotic epithelial cells, but decreased in carcinomas in situ and invasive carcinomas, which contained fewer numbers of apoptotic figures. CONCLUSION: The findings indicate that intraepithelial infiltrations of both cytotoxic T cells and natural killer cells are closely related to the apoptotic phenomena of prickle cells, which may result in the characteristic 'two-phase appearance' of epithelial dysplasia.     

Perforin and granzyme B involvement in oral lesions of lichen planus and chronic GVHD

J Oral Pathol Med (2010) 39 : 741–746 Background: Oral lesions of lichen planus and chronic graft‐vs.‐host disease (cGVHD) have similar clinical and histological features, but distinct etiology. Apoptosis induced by cytotoxic T lymphocyte has been proposed as a mechanism of keratinocytes death. Cytotoxicity can be mediated by granules containing granzyme B and perforin. Since common features can reflect similarities in immunological mechanisms, we studied the role of those molecules in both diseases. Methods: We analyzed 29 cases of oral lichen planus and 27 of oral cGVHD. The sections were studied on H&E, perforin and granzyme B staining. Results: The total means (epithelium plus connective tissue number) of the granzyme B‐ and perforin‐positive cells were significantly higher in cGVHD than in oral lichen planus lesions (P < 0.05). Also, it was found that the higher the number of perforin+ cells, the higher the number of granzyme‐B+ cells in the epithelium and in the connective tissue for both groups (P < 0.05). In oral lichen planus, the number of single apoptotic bodies had a positive correlation with connective tissue granzyme immunostaining and a negative correlation with perforin (P < 0.01). On the contrary, in oral cGVHD, the number of apoptotic body clusters presented a positive correlation with connective tissue perforin (P < 0.01). Conclusions: Our findings indicate that apoptosis in oral lichen planus seems to be correlated with granzyme B release, while in oral cGVHD, perforin seems to be more important. Although these diseases present clinical and histological similarities, subtle differences seem to exist in their pathogenetic mechanisms.     

Immunohistochemical demonstration of bone morphogenetic protein-2 and type II collagen in pleomorphic adenoma of salivary glands

Immunohistochemical investigation of bone morphogenetic protein-2 (BMP-2) and type II collagen, two cartilage-associated proteins, was undertaken using monoclonal antibodies in 20 cases of salivary pleomorphic adenoma (PA) in order to explore their possible roles in chondroid differentiation of this tumor. Other salivary gland tumors, including adenoid cystic carcinoma (17 cases), polymorphous low-grade adenocarcinoma (10 cases), basal cell adenoma (3 cases), basal cell adenocarcinoma (1 case), and epithelial-myoepithelial carcinoma (2 cases), were also examined for comparison. In PA, BMP-2 immunoreactivity was detected in the luminal and non-luminal cells of the tubulo-ductal structures, plasmacytoid cells, and other scattered tumor cells in solid areas. In addition, tumor cells in chondroid areas in most cases (14/15), and stellate cells in myxoid areas in many cases (7/19), were also intensely labeled for BMP-2. Furthermore, BMP-2 was also detected in the non-neoplastic ductal cells in salivary glands, whereas no other salivary gland tumors were positively stained for this protein. Type II collagen was localized in the intercellular matrix of chondroid areas and in a few chondroid differentiating cells in myxoid areas, confirming its cartilage-specificity. A proportional relationship was observed between BMP-2 expression and chondroid formation, although BMP-2 was also stained in occasional PAs without chondroid formation. It is speculated that BMP-2 might be secreted by tumor cells and play a role in chondroid formation in PA by inducing some tumor cells to produce type II collagen and other chondroid matrical substances, like glycosaminoglycans. The expression of BMP-2 is specific to PA and may possibly be used as a useful marker in differentiating PA from other salivary gland tumors.