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1.
Medicine (Baltimore) ; 99(41): e22671, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031333

RESUMO

Epithelial-myoepithelial carcinoma (EMC) is a rare neoplasm of the salivary glands. The aim of this study is to review and evaluate clinicopathological features and treatment of EMC of salivary gland for better sensitivity and specificity of the diagnosis.The clinical and pathological data of the 10 salivary gland EMC cases from 2008 to 2017 were analyzed.Six cases of EMC were diagnosed to be originated from parotid gland and 4 cases were from the minor salivary gland including palate, tongue, and oropharynx. Seven cases were performed radical surgery and 3 cases had radiotherapy postoperation, 2 cases had a local recurrence. The follow-up period was 4 to 104 months and the survival rate was 100%. Histopathology showed the tumors had a dominant prototypical biphasic tubular structure consisting of inner, cuboidal ductal cells and an outer layer of clear, myoepithelial cells, which grew infiltratively. The immunohistochemistry (IHC) showed the marker proteins CK, S-100, CD117, and Calponin were strongly positive in most EMC.EMC is a rare and low-grade malignant tumor with good overall survival but relatively high tendency for local recurrence. Surgery is the priority choice for EMC therapy. Complete surgical excision and negative margins are necessary for good prognosis. Imaging techniques should be used to assess the neck dissection and it is unclear whether adjuvant radiotherapy is beneficial. To ensure the sensitivity and specificity of the EMC diagnosis, we should perform both pathological and IHC analysis.


Assuntos
Carcinoma/patologia , Mioepitelioma/patologia , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mioepitelioma/terapia , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/terapia
2.
Rev Med Suisse ; 16(709): 1860-1864, 2020 Oct 07.
Artigo em Francês | MEDLINE | ID: mdl-33026728

RESUMO

Sjögren Syndrome is an autoimmune disorder presenting as Sicca syndrome (dry-eye, dry mouth) and most often multiorgan involvement with various clinical manifestations. The diagnostic criteria defined by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) include biologic, histologic parameters and functional measurements. Part of this workup can be performed by the ENT specialist. It encompasses minor salivary gland biopsy, sialometry, Schirmer lacrymal test and major salivary gland ultrasound. These tests and their performances are described. The growing importance of major salivary gland ultrasound as a follow-up and diagnostic tool is also discussed in this article.


Assuntos
Orelha , Nariz , Faringe , Papel do Médico , Reumatologia , Síndrome de Sjogren/diagnóstico , Biópsia , Humanos , Glândulas Salivares/diagnóstico por imagem , Glândulas Salivares/patologia , Síndrome de Sjogren/diagnóstico por imagem , Síndrome de Sjogren/patologia , Ultrassonografia
3.
Rev Med Suisse ; 16(709): 1870-1875, 2020 Oct 07.
Artigo em Francês | MEDLINE | ID: mdl-33026730

RESUMO

IgG4-related disease is a rare multi-organic inflammatory disease that frequently involves the ENT and head and neck areas. In these cases, salivary gland and lacrimal gland involvement is very common and includes enlargement, infiltration, and formation of pseudotumours. Diagnosis of IgG4 related disease remains a challenge and relies on several clinical, serological, radiological and histopathological criteria to differentiate from other diseases with similar clinical presentation. Histology reveals IgG4 positive lymphoplasmocytic infiltrates, storiform fibrosis and obliterative phlebitis. Glucocorticoids are the first line of treatment and can be combined with other immunosuppressants. The prognosis is favorable if treatment is initiated early. Recurrences are common. Delay in diagnosis can have severe multi-organic consequences.


Assuntos
Orelha , Doença Relacionada a Imunoglobulina G4/diagnóstico , Nariz , Faringe , Papel do Médico , Glucocorticoides/uso terapêutico , Humanos , Doença Relacionada a Imunoglobulina G4/imunologia , Doença Relacionada a Imunoglobulina G4/patologia , Aparelho Lacrimal/patologia , Prognóstico , Glândulas Salivares/patologia
4.
J Vet Diagn Invest ; 32(4): 604-610, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32687011

RESUMO

Salivary gland diseases are well characterized in human medicine but are uncommonly reported in dogs. Herein we describe the clinical and pathologic features of 179 canine salivary gland biopsy submissions to the Athens Veterinary Diagnostic Laboratory from 2010 to 2018. The mean age of affected dogs was 8.5 y; no sex or breed predisposition was evident. The main reason for sample submission was regional swelling (107 cases; 59.7%). Extraoral (major) salivary glands were affected in 125 cases (69.8%), and oral (minor) salivary glands were affected in 43 cases (24% of cases). The location of the lesion (extraoral or oral) was not specified in 11 cases (6.1%). The diagnoses included nonspecific sialoadenitis (89 cases; 49.7%), normal salivary gland (42 cases; 23.4%), neoplasia (36 cases; 20.1%), salivary gland lipomatosis (7 cases; 3.9%), necrotizing sialometaplasia (4 cases; 2.2%), and traumatic hemorrhage (1 case; 0.5%). Most cases of sialoadenitis (63 cases), neoplasia (23 cases), and lipomatosis (5 cases), as well as all cases of necrotizing sialometaplasia and the only case of traumatic hemorrhage, affected extraoral glands. Most neoplasms (32 cases, 88.8% of the tumors) were epithelial and malignant, followed by round cell tumors (2 cases; 5.5%), a carcinosarcoma (1 case; 2.7%), and a tumor of undetermined histogenesis (1 case; 2.7%).


Assuntos
Doenças do Cão/patologia , Doenças das Glândulas Salivares/veterinária , Glândulas Salivares/patologia , Animais , Biópsia/veterinária , Doenças do Cão/classificação , Cães , Feminino , Georgia , Masculino , Estudos Retrospectivos , Doenças das Glândulas Salivares/classificação , Doenças das Glândulas Salivares/patologia
5.
Acta Cytol ; 64(6): 520-531, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32526741

RESUMO

BACKGROUND: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. SUMMARY: This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. Key Messages: MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.


Assuntos
Biópsia por Agulha Fina , Carcinoma Mucoepidermoide/patologia , Segunda Neoplasia Primária/patologia , Neoplasias das Glândulas Salivares/patologia , Adenoma Pleomorfo/patologia , Adolescente , Biópsia por Agulha Fina/métodos , Criança , Feminino , Humanos , Masculino , Neoplasias Parotídeas/patologia , Glândulas Salivares/patologia
6.
Medicine (Baltimore) ; 99(26): e20788, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590759

RESUMO

BACKGROUND: Treatment for most patients with head and neck cancers includes ionizing radiation with or without chemotherapy. This treatment causes irreversible damage to salivary glands in the irradiation field accompanied by a loss of fluid-secreting acinar cells and a considerable decrease of saliva secretion. There is currently no adequate conventional treatment for this condition. In recent years, we developed an effective culture method to enhance the anti-inflammatory and vasculogenic phenotypes of peripheral blood mononuclear cells (PBMNCs), and such effectively conditioned PBMNC (E-MNC) therapy has shown promising improvements to the function of radiation-injured salivary glands in preclinical studies. However, the safety and effect of E-NMC therapy have yet assessed in human. The objective of this ongoing first-in-man study is to assess the safety, tolerability, and in part the efficacy of E-MNC therapy for treating radiation-induced xerostomia. METHODS/DESIGN: This phase 1 first-in-man study is an open-label, single-center, two-step dose escalation study. A total of 6 patients, who had no recurrence of head and neck cancer over 5 years following radiation therapy and suffered from radiation-induced xerostomia, will receive a transplantation of E-NMCs derived from autologous PBMNCs to a submandibular gland. The duration of the intervention will be 1 year. To analyze the recovery of salivary secretion, a gum test will be performed. To analyze the recovery of atrophic salivary glands, computed tomography (CT), and magnetic resonance imaging (MRI) of salivary glands will be conducted. The primary endpoint is the safety of the protocol. The secondary endpoints are the changes from baseline in whole saliva secretion and salivary gland atrophy. DISCUSSION: This will be the first clinical study of regenerative therapy using E-MNCs for patients with severe radiation-induced xerostomia. The results of this study are expected to contribute to developing the low-invasive cell-based therapy for radiation-induced xerostomia. TRIAL REGISTRATION: This study was registered with the Japan Registry of Clinical Trials (http://jrct.niph.go.jp) as jRCTb070190057.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos/métodos , Leucócitos Mononucleares/transplante , Lesões por Radiação , Glândulas Salivares , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Imagem por Ressonância Magnética/métodos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Lesões por Radiação/terapia , Projetos de Pesquisa , Glândulas Salivares/diagnóstico por imagem , Glândulas Salivares/patologia , Glândulas Salivares/fisiopatologia , Glândulas Salivares/efeitos da radiação , Tomografia Computadorizada por Raios X/métodos , Transplante Autólogo/métodos , Resultado do Tratamento , Xerostomia/diagnóstico , Xerostomia/etiologia , Xerostomia/fisiopatologia , Xerostomia/terapia
7.
J Oral Pathol Med ; 49(7): 606-616, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32430929

RESUMO

OBJECTIVE: Elective neck dissection in patients with salivary gland carcinoma and clinically negative lymph nodes is controversial. Reported proportion of occult nodal metastases vary with histological subtype, tumour classification and preoperative diagnostic methods. This is a systematic review and meta-analysis on the role of END in salivary gland carcinoma. METHODS: A search in PubMed, Embase and Cochrane was performed. Original articles in English with data on tumour characteristics, clinical and pathological N-classification, and neck dissection were included. Reporting Items for Systematic Reviews and Meta-analyses were followed. Random effect modelling was performed to pool the data. Meta-analysis of proportions was performed for occult metastases overall, for T3/T4 versus T1/T2 tumours and for tumours with high-grade versus low-grade histology. Heterogeneity across studies was assessed with I-squared statistics. RESULTS: We included 22 articles in the qualitative synthesis and meta-analysis. The pooled proportion of occult metastases was 21%. In patients with T3/T4 tumour, the pooled proportion of occult metastases was 36%, and in patients with high-grade histology, it was 34%. Most studies concluded that END should be performed in patients with advanced T-classification and high-grade histology tumours. Nine studies assessed occult metastases per level. CONCLUSION: The overall occult metastases proportion does not require END in all patients with salivary gland carcinoma. We recommend END in patients with high-grade or unknown histology or T3/T4 tumours. END should involve level II and III, and level I should be included in tumours in the submandibular gland, sublingual gland and minor oral salivary glands.


Assuntos
Esvaziamento Cervical , Neoplasias das Glândulas Salivares , Procedimentos Cirúrgicos Eletivos , Humanos , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/cirurgia , Glândulas Salivares/patologia
8.
Cancer Cytopathol ; 128(6): 392-402, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32267606

RESUMO

BACKGROUND: Fine needle aspiration (FNA) is commonly used for the preoperative evaluation of salivary gland tumors. Tumor grade is a key factor influencing clinical management of salivary gland carcinomas (SGCs). To assess the ability to grade nonbasaloid SGCs in FNA specimens, an international panel of cytopathologists convened to review and score SGC cases. METHODS: The study cohort included 61 cases of primary SGC from the pathology archives of 3 tertiary medical centers. Cases from 2005 to 2016 were selected, scanned, and digitized. Nineteen cytopathologists blinded to the histologic diagnosis reviewed the digitized cytology slides and graded them as low, high, or indeterminate. The panelists' results were then compared to the tumor grades based on histopathologic examination of the corresponding resection specimens. RESULTS: All but 2 of the 19 (89.5%) expert panelists review more than 20 salivary gland FNAs per year; 16 (84.2%) of the panelists work at academic medical centers, and 13 (68.4%) have more than 10 years' experience. Participants had an overall accuracy of 89.4% in the grading of SGC cases, with 90.2% and 88.3% for low- and high-grade SGC, respectively. Acinic cell carcinoma and mucoepidermoid carcinoma had the highest degree of accuracy, while epithelial-myoepithelial carcinoma and salivary duct carcinoma had the lowest degree of accuracy. As expected, the intermediate-grade SGC cases showed the greatest variability (high-grade, 42.1%; low-grade, 37.5%, indeterminate, 20.4%). CONCLUSION: This study confirms the high accuracy of cytomorphologic grading of primary SGC by FNA as low- or high-grade. However, caution should be exercised when a grade cannot be confidently assigned.


Assuntos
Citodiagnóstico/métodos , Patologistas/estatística & dados numéricos , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Biópsia por Agulha Fina , Estudos de Coortes , Humanos , Cooperação Internacional , Gradação de Tumores , Patologia Clínica/métodos , Reprodutibilidade dos Testes , Neoplasias das Glândulas Salivares/diagnóstico , Sensibilidade e Especificidade
9.
Cient. dent. (Ed. impr.) ; 17(1): 73-78, ene.-abr. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-189752

RESUMO

El carcinoma mucoepidermoide (CME) se define como una neoplasia maligna epitelial de glándulas salivales, caracterizada histopatológicamente por la proliferación de células mucosecretoras, intermedias y epidermoides. Se presenta en glándulas salivales mayores como la parótida y cuando afecta a las glándulas salivales menores, el paladar es el sitio más comúnmente afectado, aunque también puede encontrarse a nivel del labio inferior, suelo de boca y trígono retromolar. El objetivo de este trabajo es describir el caso de un paciente varón de 67 años que acudió al Servicio de Cirugía del Hospital Virgen de la Paloma, presentando una lesión localizada en el trígono retromolar derecho de aproximadamente 7 meses de evolución. Su historial médico no refiere ningún antecedente personal ni familiar de especial importancia. En el examen clínico extraoral no se encontró ningún hallazgo patológico de interés, e intraoralmente presentaba una lesión tumoral con forma irregular y superficie lisa, localizada en el trígono retromolar derecho, de color rojo parduzco, de consistencia blanda y dolorosa a la palpación. Se solicitó radiografía panorámica en la cual no se observó ningún hallazgo patológico, por lo que se procedió a realizar una biopsia incisional para su estudio histopatológico. La histopatología reveló la presencia de fragmentos con una proliferación neoplásica maligna en la que se reconocen células claras de aspecto mucoso, estructuras glandulares y otras con cierta disposición quística, al igual que la presencia de placas epiteliales de aspectos epidermoides, con células intermedias y un epitelio mucoso superficial con paraqueratosis, obteniéndose finalmente un diagnóstico definitivo de CME. El CME se considera una neoplasia maligna agresiva, que obliga a dar seguimiento a cualquier lesión sospechosa para poder descartar o corroborar esta entidad


Mucoepidermoid carcinoma (MEC) is defined as a epithelial malignant neoplasm of the salivary glands, characterised histopathologically by the proliferation of mucus-secreting, intermediate and epidermoid cells.It appears in major salivary glandes such as the parotid gland and when it affects the minor salivary glands, the palate is the most commonly affected site, although it can also be found at the level of the lower lip, floor of the mouth and retromolar trigone. The objective of this paper is to describe the case of a male patient of 67 years of age who came to the surgical service, presenting a lesion located in the right retromolar trigone of approximately 7 months of evolution.His medical history does not report any personal or family background of special importance. During the extraoral clinical examination, no pathological finding of interest was found; intraorally he presented a tumoral lesion with an irregular shape and smooth surface, located in the right retromolar trigone, of a dark red colour, soft consistency and tender to touch. A panoramic x-ray was requested in which no pathological finding was observed, for which reason an incisional biopsy was performed for its histopathological study. The histology revealed the presence of fragments with a malignant neoplastic proliferation in which clear cells of a mucous appearance, glandular structures and others with a certain cystic arrangement were recognised, as well as the presence of epithelial plaques of an epidermoid appearance, with intermediate cells and superficial mucous epithelium with parakeratosis, finally obtaining a definitive diagnosis of Mucoepidermoid carcinoma MEC is considered an aggressive malignant neoplasm, which requires the monitoring of any suspicious lesion in order to be able to rule out or corroborate this entity


Assuntos
Humanos , Masculino , Idoso , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/cirurgia , Diagnóstico Precoce , Carcinoma Mucoepidermoide/patologia , Glândulas Salivares/anatomia & histologia , Glândulas Salivares/patologia , Radiografia Panorâmica
10.
Int J Mol Sci ; 21(7)2020 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-32218158

RESUMO

Radiation therapy is a standard treatment for patients with head and neck cancer. However, radiation exposure to the head and neck induces salivary gland (SG) dysfunction. Alpha lipoic acid (ALA) has been reported to reduce radiation-induced toxicity in normal tissues. In this study, we investigated the effect of ALA on radiation-induced SG dysfunction. Male Sprague-Dawley rats were assigned to the following treatment groups: control, ALA only (100 mg/kg, intraperitoneally), irradiation only, and ALA administration 24 h or 30 min prior to irradiation. The neck area, including SGs, was irradiated evenly at 2 Gy/min (total dose, 18 Gy) using a photon 6 MV linear accelerator. The rats were sacrificed at 2, 6, 8, and 12 weeks after irradiation. Radiation decreased SG weight, saliva secretion, AQP5 expression, parasympathetic innervation (GFRα2 and AchE expression), regeneration potentials (Shh and Ptch expression), salivary trophic factor levels (brain-derived neurotrophic factor and neurturin), and stem cell expression (Sca-1). These features were restored by treatment with ALA. This study demonstrated that ALA can rescue radiation-induced hyposalivation by preserving parasympathetic innervation and regenerative potentials.


Assuntos
Lesões Experimentais por Radiação/tratamento farmacológico , Glândulas Salivares/efeitos dos fármacos , Ácido Tióctico/farmacologia , Animais , Peso Corporal/efeitos dos fármacos , Masculino , Tamanho do Órgão/efeitos dos fármacos , Lesões Experimentais por Radiação/patologia , Ratos Sprague-Dawley , Glândulas Salivares/patologia
11.
Proc Natl Acad Sci U S A ; 117(12): 6630-6639, 2020 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-32161138

RESUMO

Aging elicits quantitative and qualitative changes in different immune components, leading to disruption of tolerogenic circuits and development of autoimmune disorders. Galectin-1 (Gal1), an endogenous glycan-binding protein, has emerged as a regulator of immune cell homeostasis by shaping the fate of myeloid and lymphoid cells. Here, we demonstrate that aged Gal1-null mutant (Lgals1 -/- ) mice develop a spontaneous inflammatory process in salivary glands that resembles Sjögren's syndrome. This spontaneous autoimmune phenotype was recapitulated in mice lacking ß1,6N-acetylglucosaminyltransferase V (Mgat5), an enzyme responsible for generating ß1,6-branched complex N-glycans, which serve as a major ligand for this lectin. Lack of Gal1 resulted in CD11c+ dendritic cells (DCs) with higher immunogenic potential, lower frequency of Foxp3+ regulatory T cells (Tregs), and increased number of CD8+ T cells with greater effector capacity. Supporting its tolerogenic activity, Gal1 expression decreased with age in autoimmunity-prone nonobese diabetic (NOD) mice. Treatment with recombinant Gal1 restored tolerogenic mechanisms and reduced salivary gland inflammation. Accordingly, labial biopsies from primary Sjögren's syndrome patients showed reduced Gal1 expression concomitant with higher number of infiltrating CD8+ T cells. Thus, endogenous Gal1 serves as a homeostatic rheostat that safeguards immune tolerance and prevents age-dependent development of spontaneous autoimmunity.


Assuntos
Doenças Autoimunes/patologia , Galectina 1/fisiologia , Tolerância Imunológica/imunologia , Glândulas Salivares/patologia , Sialadenite/patologia , Síndrome de Sjogren/patologia , Linfócitos T Reguladores/imunologia , Adulto , Fatores Etários , Animais , Doenças Autoimunes/imunologia , Doenças Autoimunes/metabolismo , Estudos de Casos e Controles , Células Dendríticas/imunologia , Feminino , Glicosilação , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos NOD , Camundongos Knockout , Pessoa de Meia-Idade , N-Acetilglucosaminiltransferases/fisiologia , Polissacarídeos/metabolismo , Glândulas Salivares/imunologia , Glândulas Salivares/metabolismo , Sialadenite/imunologia , Sialadenite/metabolismo , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/metabolismo
12.
Virchows Arch ; 477(3): 393-400, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32222825

RESUMO

Warthin tumour is the second most common benign neoplasm of salivary glands. Despite its relatively characteristic histology, it may sometimes mimic other lesions. Here, we report two female non-smoker patients diagnosed with low-grade mucoepidermoid carcinoma with oncocytic epithelium and prominent lymphoid (Warthin-like) stroma and with molecularly confirmed MAML2 rearrangement. In addition, we screened a consecutive series of 114 Warthin tumour cases by means of MAML2 break apart fluorescence in situ hybridization to assess its value in differential diagnosis. MAML2 rearrangement was detected in both mucoepidermoid carcinoma cases, while all Warthin tumours were negative. Taking into account the literature data, Warthin-like mucoepidermoid carcinomas are more frequently observed in women, while a slight male predominance and smoking history are typical for Warthin tumour. In addition, the patients with Warthin-like mucoepidermoid carcinoma were significantly younger than those with Warthin tumour. To conclude, Warthin-like mucoepidermoid carcinoma may usually be suspected based on histology, while the diagnosis can be confirmed by means of molecular assays such as FISH. The investigation of MAML2 status is particularly advised when Warthin tumour is considered in a young, non-smoking, female patient.


Assuntos
Adenolinfoma/diagnóstico , Carcinoma Mucoepidermoide/diagnóstico , Transativadores/genética , Adenolinfoma/genética , Adenolinfoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Carcinoma Mucoepidermoide/genética , Carcinoma Mucoepidermoide/patologia , Proteínas de Ligação a DNA/genética , Diagnóstico Diferencial , Feminino , Fusão Gênica , Rearranjo Gênico , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas Nucleares/genética , Glândulas Salivares/patologia , Fatores de Transcrição/genética
13.
PLoS One ; 15(3): e0230667, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32208441

RESUMO

Key events in the pathogenesis of SjÓ§gren syndrome (SS) include the change of salivary gland epithelial cells into antigen-presenting cell-like phenotypes and focal lymphocytic sialadenitis (FLS). However, what triggers these features in SS is unknown. Dysbiosis of the gut and oral microbiomes is a potential environmental factor in SS, but its connection to the etiopathogenesis of SS remains unclear. This study aimed to characterize the oral microbiota in SS and to investigate its potential role in the pathogenesis of SS. Oral bacterial communities were collected by whole mouthwash from control subjects (14 without oral dryness and 11 with dryness) and primary SS patients (8 without oral dryness and 17 with dryness) and were analyzed by pyrosequencing. The SS oral microbiota was characterized by an increased bacterial load and Shannon diversity. Through comparisons of control and SS in combined samples and then separately in non-dry and dry conditions, SS-associated taxa independent of dryness were identified. Three SS-associated species and 2 control species were selected and used to challenge human submandibular gland tumor (HSG) cells. Among the selected SS-associated bacterial species, Prevotella melaninogenica uniquely upregulated the expression of MHC molecules, CD80, and IFNλ in HSG cells. Concomitantly, P. melaninogenica efficiently invaded HSG cells. Sections of labial salivary gland (LSG) biopsies from 8 non-SS subjects and 15 SS patients were subjected to in situ hybridization using universal and P. melaninogenica-specific probes. Ductal cells and the areas of infiltration were heavily infected with bacteria in the LSGs with FLS. Collectively, dysbiotic oral microbiota may initiate the deregulation of SGECs and the IFN signature through bacterial invasion into ductal cells. These findings may provide new insights into the etiopathogenesis of SS.


Assuntos
Microbiota , Glândulas Salivares/patologia , Síndrome de Sjogren/patologia , Aquaporinas/metabolismo , Bactérias/genética , Bactérias/isolamento & purificação , Bactérias/patogenicidade , Proteínas de Bactérias/metabolismo , Estudos de Casos e Controles , Linhagem Celular Tumoral , Disbiose , Células Epiteliais/citologia , Células Epiteliais/metabolismo , Células Epiteliais/microbiologia , Humanos , Interferons/metabolismo , Prevotella melaninogenica/genética , Prevotella melaninogenica/isolamento & purificação , Prevotella melaninogenica/patogenicidade , RNA Ribossômico 16S/química , RNA Ribossômico 16S/genética , RNA Ribossômico 16S/metabolismo , Glândulas Salivares/microbiologia , Sialadenite/complicações , Sialadenite/microbiologia , Sialadenite/patologia , Síndrome de Sjogren/complicações , Síndrome de Sjogren/microbiologia
14.
Am J Clin Pathol ; 153(6): 719-724, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32076706

RESUMO

OBJECTIVES: Sjögren syndrome (SS) is considered as a major etiologic factor for primary salivary gland lymphoma (SGL). However, the percentage of SGL that is caused by SS (and thus the real impact of SS on SGL epidemiology) is unclear. We aimed to assess the prevalence of SS in patients with SGL through a systematic review and meta-analysis. METHODS: Electronic databases were searched for studies assessing the presence of SS in patients with SGL. Pooled prevalence of SS in SGL was calculated, with a subgroup analysis based on histotype (mucosa-associated lymphoid tissue [MALT] vs non-MALT). RESULTS: Sixteen studies with 665 SGLs were included. Pooled prevalence of SS in SGL was 18.2%, with high heterogeneity among studies. In MALT SGL, the prevalence of SS was 29.5%, with moderate heterogeneity. In non-MALT SGL, the prevalence of SS was 0%, with null heterogeneity. CONCLUSIONS: SS seems to be responsible for a significant but minor portion of SGLs. SS appears involved in MALT-type SGL but not in other histotypes.


Assuntos
Linfoma/etiologia , Neoplasias das Glândulas Salivares/etiologia , Glândulas Salivares/patologia , Síndrome de Sjogren/complicações , Humanos , Linfoma/patologia , Neoplasias das Glândulas Salivares/patologia , Síndrome de Sjogren/patologia
15.
Cancer Cytopathol ; 128(5): 348-358, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32022995

RESUMO

BACKGROUND: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) aims to provide a common language for risk stratification and management. We examine the incidence of MSRSGC categories and the corresponding risk of malignancy (ROM) within a tertiary referral centre in Southeast Asia. METHODS: Salivary gland fine needle aspirations (FNAs) performed within a 10-year period were classified retrospectively according to the MSRSGC. Cytohistologic correlation was performed. The results were compared with the existing literature, including Asian and Western studies. RESULTS: A total of 1384 salivary gland FNAs were evaluated, 421 with corresponding histology. The category distribution was: nondiagnostic, 28.9%; nonneoplastic, 18.0%; atypia of undetermined significance (AUS), 9.8%; benign neoplasm, 32.9%; salivary gland neoplasm of uncertain malignant potential (SUMP), 5.7%; suspicious for malignancy, 1.6%; and malignant, 3.2%. The ROMs were: nondiagnostic, 10.0%; nonneoplastic, 17.5%; AUS, 29.5%; benign neoplasm, 0.5%; SUMP, 17.1%; suspicious for malignancy, 83.3%; and malignant, 100.0%. Our relatively high nondiagnostic rate likely reflects preanalytical factors, whereas our low malignancy rate may be related to population and health care accessibility. Our nonneoplastic ROM was 17.5% compared with 5% to 10% in the literature, likely due to the relatively small number of excised cases; the ROM for SUMP was 17.1% versus 21% to 44% in the literature, possibly reflecting a significant proportion of benign basaloid neoplasms on histology. Interestingly, all false-negative cases in the nonneoplastic category were lymphoid-rich lesions. CONCLUSION: This is one of the largest single-institution studies in the existing literature documenting both the incidence and ROMs of MSRSGC categories. We also highlight specific challenges surrounding lymphoid-rich lesions.


Assuntos
Citodiagnóstico/métodos , Lesões Pré-Cancerosas/diagnóstico , Medição de Risco/métodos , Neoplasias das Glândulas Salivares/diagnóstico , Glândulas Salivares/patologia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia Sudeste/epidemiologia , Biópsia por Agulha Fina , Criança , Pré-Escolar , Feminino , Seguimentos , Instalações de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Prognóstico , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/epidemiologia , Adulto Jovem
17.
Sci Rep ; 10(1): 2967, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-32076051

RESUMO

Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease, with only palliative treatments available. Recent work has suggested that increased bone morphogenetic protein 6 (BMP6) expression could alter cell signaling in the salivary gland (SG) and result in the associated salivary hypofunction. We examined the prevalence of elevated BMP6 expression in a large cohort of pSS patients and tested the therapeutic efficacy of BMP signaling inhibitors in two pSS animal models. Increased BMP6 expression was found in the SGs of 54% of pSS patients, and this increased expression was correlated with low unstimulated whole saliva flow rate. In mouse models of SS, inhibition of BMP6 signaling reduced phosphorylation of SMAD1/5/8 in the mouse submandibular glands, and led to a recovery of SG function and a decrease in inflammatory markers in the mice. The recovery of SG function after inhibition of BMP6 signaling suggests cellular plasticity within the salivary gland and a possibility for therapeutic intervention that can reverse the loss of function in pSS.


Assuntos
Receptores de Ativinas Tipo I/antagonistas & inibidores , Proteína Morfogenética Óssea 6/metabolismo , Pirazóis/administração & dosagem , Pirimidinas/administração & dosagem , Quinolinas/administração & dosagem , Glândulas Salivares/patologia , Síndrome de Sjogren/tratamento farmacológico , Receptores de Ativinas Tipo I/metabolismo , Adulto , Idoso , Animais , Proteína Morfogenética Óssea 6/análise , Proteína Morfogenética Óssea 6/genética , Linhagem Celular , Feminino , Voluntários Saudáveis , Humanos , Masculino , Camundongos , Camundongos Transgênicos , Pessoa de Meia-Idade , Fosforilação/efeitos dos fármacos , Recuperação de Função Fisiológica/efeitos dos fármacos , Saliva/imunologia , Saliva/metabolismo , Glândulas Salivares/efeitos dos fármacos , Glândulas Salivares/metabolismo , Glândulas Salivares/fisiopatologia , Transdução de Sinais/efeitos dos fármacos , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/patologia , Síndrome de Sjogren/fisiopatologia , Proteínas Smad Reguladas por Receptor/metabolismo , Adulto Jovem
18.
Eur J Immunol ; 50(3): 418-425, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32012252

RESUMO

To investigate the role of lymphotoxin (LT) in Sjögren's syndrome (SS) and in mucosal associated lymphoid tissue (MALT)-lymphoma, we made transgenic mice (Amy1-LTαß) that targeted LTα and LTß to the salivary and lacrimal glands. Amy1-LTαß mice developed atrophic salivary and lacrimal glands that contained tertiary lymphoid organs (TLOs) and had reduced tear production. Amy1-LTαß mice developed cervical lymphadenopathy but not MALT-lymphoma. TLO formation in the salivary and lacrimal glands of Amy1-LTαß was not sufficient to induce autoimmunity as measured by autoantibody titres.


Assuntos
Aparelho Lacrimal/patologia , Linfadenopatia/patologia , Linfotoxina-alfa/metabolismo , Glândulas Salivares/patologia , Estruturas Linfoides Terciárias/patologia , Animais , Linfadenopatia/genética , Linfoma de Zona Marginal Tipo Células B/genética , Linfoma de Zona Marginal Tipo Células B/imunologia , Linfoma de Zona Marginal Tipo Células B/patologia , Linfotoxina-alfa/genética , Camundongos , Camundongos Transgênicos , Síndrome de Sjogren/genética , Síndrome de Sjogren/imunologia , Síndrome de Sjogren/patologia , Lágrimas/metabolismo , Estruturas Linfoides Terciárias/genética
20.
Ann Pathol ; 40(1): 46-58, 2020 Jan.
Artigo em Francês | MEDLINE | ID: mdl-31917017

RESUMO

The salivary glands cytology is one of the most challenging area in cytopathology because of the wide diversity of benign and malignant tumors also because of their heterogeneity. However, fine needle aspiration cytology, with magnetic resonance imaging, represents a first-line examination to guide a possible surgical procedure and its extent. An accurate diagnosis of a specific tumor is sometimes difficult to assess in cytology. Also, as for gynecological, thyroid or urinary cytologies, a panel of experts met to develop a cytological classification of salivary gland lesions associated with a risk of malignancy and management proposals. The Milan System for Reporting Salivary Gland Cytopathology was published in 2018. The French Society of Clinical Cytology (SFCC) offers here an official summarized French version oh this terminology and recommends its use.


Assuntos
Biópsia por Agulha Fina , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Terminologia como Assunto , Humanos , Imagem por Ressonância Magnética , Cálculos das Glândulas Salivares/diagnóstico por imagem , Cálculos das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/classificação , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Glândulas Salivares/diagnóstico por imagem , Sialadenite/patologia
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