Salivery gland lesions: a Jamaican perspective

A retrospective analysis of the spectrum and relative frequency of salivary gland lesions diagnosed inthe Department of Pathology, University of the West Indies, Kingston, Jamaica between 1965 and 1994, is reported. Four hundred and sixty-four salivary gland biopsies were received. Of these 99 (21.3 percent) were non-neoplastic and the remaining 365 (78.7 percent) were neoplasm: 261 (71.5 percent) were benign and 104 (28.5 percent) malignant. Benign mixed tumour (BTM)/ pleomomorphic adenoma (PA) was the most common neoplasm (63.3 percent) while mucoepidermoid carcinoma (MEC) was the most common malignant neoplasm (9.6 percent), followed by adenoid cystic carcinoma (ACC) (7.4 percent). The increased frequency of MEC over ACC is at variance with other reported series but the preponderance of pleomorphic adenoma is consistent. In the major salivary glands, benign neoplasms predominate at a rotio of 3:1, while a higher proportion of minor salivary gland neoplasms was malignant, ratio 1.2:1 (p=0.003). These data represent the first attemp to document the spectrum of disease related to oral and maxillofacial pathology in jamaica. (AU)

Warthin's tumour in Jamaica: incidence, electron microscopy and immunoenzyme studies

Warthin's tumour has traditionally had a strong male association, and has been said to be rare in Blacks. Current studies describe a newtrend; a rise in females, strongly linked to cigarette smoking. The tumour has eosinophilic epithelial cells packed with distinctive mitochondria, and a lymphoid stroma. Immunological investigations have demonstrated polyclonal B cells and macrophages. Views differ as to whether B or T cells predominate. Between 1958 and 1989, the Jamaica Cancer Registry recorded 491 benign and malignant salivary gland tumours. There were 18 cases of Warthin's tumour (3.7 percent), with a male:female ratio of 5:1. The low proportion of females is similar to the trend for female lung cancer in Kingston & St. Andrew. A case of Warthin's tumour was studied by light and electron microscopy and immunoenzyme methods. The epithelial cells contained numerous mitochondria with stacked cristae, as previously described. Similar morphology occurs in oncocytic tumours; riboflavin-deficient rats and mice; rats given non-lethal doses of hypoglycin; dogs treated with annatto extracts; and hibernating or starving frogs. The mitochondrial changes may be an adaptive response. The immunoenzyme studies utilized newly available monoclonalantibodies: UCHLI, L26, 4KB5, MT1 and LN2. The reaction patterns indicate a distribution of B and T cells in a manner expected in a lymph node. The interaction between mitochondrial changes adaptive metabolic pathways, the immune cells and tobacco raises some interesting questions (AU)

Tumors of salivary gland origin

In 64 patients, an unusually high percentage of salivary gland tumors occurred in accessory salivary tissue, ectopic sites, and in accessory salivary tissue, ectopic sites, and sublingual gland, corroborating experiences in other tropical hospitals. The incidence of all tumors was: parotid 57.8 per cent, submaxillary 17.2 per cent, sublingual 4.7 per cent, and accessory and ectopic sites 20.1 per cent. The ratio of benign to malignant tumors was 3 to 1. Two benign tumors occurred in unusual sites which were the external auditory canal and the lacrimal gland. Recurrences, particularly in the parotid gland, resulted from inadequate excision. Facial nerve palsy occurred postoperatively in 7.8 percent of the patients. One patient died as a result of surgery. Mucoepidermoid carcinoma was the commonest type of malignant tumor found, involving particularly the parotid and subligual glands. The sentinel node of the parotid gland was found to be a useful guide, and frozen sections of tumor were not altogether reliable. The method of treatment of malignant tumors of salivary gland origin should be based largely on the histology, and more radical operations should be adopted (AU)