Unsuitable Terminology.

Abstract

Referring to manifestations of IgG4-associated disease of the salivary glands, the authors (1) use the terms Mikulicz disease and Kuttner’s tumor; however, this is somewhat unfortunate as it may cause misunderstandings. Therefore, we see the need to comment on it. The so-called Mikulicz disease is a synonym for various inflammatory salivary gland conditions, and, as its meaning is rather obscure, has led to confusion over decades. Recently, evidence was provided that the case described by Mikulicz in 1892 of a man with multifocal tumor-like swellings of the salivary and lacrimal glands was very likely the presentation of a multifocal MALT lymphoma of the salivary glands (2, 3). The preserved histological drawings show that in the original case presented by Mikulicz, the patient did not have an IgG4-associated disease. For the reasons stated above, there is a consensus that this term should no longer be used. Unfortunately, the historical term of Mikulicz disease is currently experiencing a renaissance in the context of IgG4-associated disease for no good reason. The term “Kuttner’s tumor“ is a historical synonym for severe late manifestations of chronic sclerosing sialadenitis of the submandibular gland, frequently associated with sialolithiasis. Only a presumably small percentage of these cases of chronic sclerosing sialadenitis (2% in a European study) showed a histomorphologic overlap with IgG4-associated disease. Therefore, the term Kuttner’s tumor cannot be used as a general synonym for IgG4-associated disease of the salivary glands (4). Based on an international consensus, the general term “IgG4-associated disease of…..” should be used together with the affected organ, for example, the salivary glands. The two historical terms should not be used as synonyms.