Salivary Gland Lesions Research Articles

McH-lpr/lpr-RA1 mice: A novel spontaneous mouse model of autoimmune sialadenitis

Many studies of the autoimmune disease Sjögren's syndrome have been performed using spontaneous mouse models. In the present study, we describe the characteristics of McH/lpr-RA1 mice and propose their use as a novel murine model of autoimmune sialadenitis. The McH/lpr-RA1 mouse is a recombinant congenic strain derived from generation F54 or more of MRL-Faslpr x (MRL- Faslpr x C3H- Faslpr) F1. We show for the first time that this mouse spontaneously develops autoimmune sialadenitis and vasculitis in submandibular gland tissues. Sialadenitis was accompanied by extensive inflammatory cell infiltration and tissue destruction. Immunohistochemical studies revealed that the salivary gland lesions strongly expressed four sialadenitis-related molecules: SSA and SSB (autoantigens of Sjögren's syndrome), gp91phox (an accelerator of reactive oxygen species production) and single strand DNA (a marker of apoptotic cells). In contrast, expression of aquaporin-5 (AQP5), which stimulates salivary secretion was weak or negligible. Statistical correlation analyses indicated that the apoptosis of salivary gland cells provoked by oxidative stress contributed to the severe sialadenitis and reduced expression of AQP5. Our study has demonstrated that McH/lpr-RA1 mice spontaneously develop the pathognomonic features of autoimmune sialadenitis and thus could be used as a new animal model of Sjögren's syndrome.

SALIVARY GLAND LESIONS WITH ONCOCYTIC CHANGE: A 20-YEAR RETROSPECTIVE EVALUATION

Background Oncocytic change, a manifestation of abundant mitochondria within a cell, often occurs in salivary gland lesions. This phenomenon is thought to represent an adaptive or metaplastic change associated with increasing age or exposure to agents that induce senescence. A 20-year retrospective study was carried out on salivary gland lesions diagnosed at University College London Hospitals with a view to evaluating the incidence and prevalence of oncocytic change. Objective To characterize the types of salivary gland lesions diagnosed, showing oncocytic change, based on their nature (neoplastic or nonneoplastic) and patient demographic characteristics. Methods A database search and analysis were performed on salivary gland lesions from 2000 to 2020 at University College London Hospitals. Results One hundred sixty-eight of the 1263 salivary gland lesions showed oncocytic change (13.3%); 145 were neoplastic (86.3%), of which 115 were benign (68.5%) and 30 were malignant (17.9%) lesions. Eleven were nonneoplastic lesions (6.5%) and 12 indeterminate (7.1%) because they were core biopsy samples. Oncocytic change was seen almost exclusively in lesions of the parotid gland (98.8%), and the remaining occurred in the submandibular gland (1.2%). Twenty-two oncocytic neoplasms were identified (1.7%; 15 women, 7 men): 8 oncocytomas (0.63%), 2 oncocytic carcinomas (0.16%), and 12 oncocytic neoplasm, not otherwise specified (0.95%; their subtype could not be ascertained from the core biopsy). Patient age ranged from 27 to 84 years. Conclusions Oncocytic salivary gland tumors are rare and occur almost exclusively in the parotid gland. There is a female predilection and the mean age at diagnosis was in the sixth decade. The conclusions mirror previous findings in the literature. Oncocytic change, a manifestation of abundant mitochondria within a cell, often occurs in salivary gland lesions. This phenomenon is thought to represent an adaptive or metaplastic change associated with increasing age or exposure to agents that induce senescence. A 20-year retrospective study was carried out on salivary gland lesions diagnosed at University College London Hospitals with a view to evaluating the incidence and prevalence of oncocytic change. To characterize the types of salivary gland lesions diagnosed, showing oncocytic change, based on their nature (neoplastic or nonneoplastic) and patient demographic characteristics. A database search and analysis were performed on salivary gland lesions from 2000 to 2020 at University College London Hospitals. One hundred sixty-eight of the 1263 salivary gland lesions showed oncocytic change (13.3%); 145 were neoplastic (86.3%), of which 115 were benign (68.5%) and 30 were malignant (17.9%) lesions. Eleven were nonneoplastic lesions (6.5%) and 12 indeterminate (7.1%) because they were core biopsy samples. Oncocytic change was seen almost exclusively in lesions of the parotid gland (98.8%), and the remaining occurred in the submandibular gland (1.2%). Twenty-two oncocytic neoplasms were identified (1.7%; 15 women, 7 men): 8 oncocytomas (0.63%), 2 oncocytic carcinomas (0.16%), and 12 oncocytic neoplasm, not otherwise specified (0.95%; their subtype could not be ascertained from the core biopsy). Patient age ranged from 27 to 84 years. Oncocytic salivary gland tumors are rare and occur almost exclusively in the parotid gland. There is a female predilection and the mean age at diagnosis was in the sixth decade. The conclusions mirror previous findings in the literature.

CYTOPATHOLOGICAL SPECTRUM OF FNAC IN PALPABLE HEAD AND NECK LESIONS

Introduction: Head and neck lesions comprises a large number of congenital, inammatory or neoplastic lesions including different anatomic sites and originating in different tissues and organs. Fine needle aspiration cytology (FNAC) is a simple, quick, feasible, repeatable and outpatient procedure with minimal risk of complication. Aim: To study the role of FNAC and its utility in diagnosis of palpable head neck masses and to determine the spectrum of various lesions. Materials And Methods: A retrospective study was conducted in pathology department of Shaheed Nirmal Mahato Medical College, Dhanbad, Jharkhand from January 2016 to December 2020 on patients with palpable head and neck swelling. Detailed clinical history of patient was noted. Aspirations were done by using 10 ml syringe and 22/23 gauge needles. Smears were stained with PAP, Haematoxylin and Eosin and Leishman stain. Cytomorphological diagnosis was given. Results: Out of 562 patients of head and neck swelling, 61.92% (348 cases) were of lymph node, 20.28% (114 cases) were of thyroid, 3.38% from salivary gland (19 cases), 14.06% (79 cases) from skin and soft tissue swellings. The most common diagnosis was reactive lymphadenitis (32.74%) followed by granulomatous lymphadenitis (18.33%). The mean age of study population was 32 years. There was female preponderance (88.59%) in thyroid lesions whereas lymph node lesions (60.91%), salivary gland lesions (73.68%) and soft tissue swellings (59.49%) were more common in males. Conclusion: From our study we concluded that FNAC is simple, quick, inexpensive, repeatable and minimally invasive rst line investigation for differential diagnosis of head and neck lesions.

The effectiveness of the Milan system for risk stratification of salivary gland lesions: The 10-year cytohistopathological correlation results of salivary gland FNA cytology at a tertiary center.

The Milan system reporting salivary gland cytopathology (MSRSGC) is a tiered classification scheme that is based on risk stratification. The aim of the current study was to assess the risk of malignancy (ROM) and risk of neoplasia (RON) in each of the diagnostic categories proposed by the MSRSGC. A retrospective analysis and categorization according to the MSRSGC was made of salivary gland fine needle aspirations (FNA) performed from January 2007 to December 2017. The FNA cytology results were correlated with subsequent histological follow-up. A total of 578 FNAs were evaluated and histopathology was available for 198 cases (34.2%). The RON and ROM for individual diagnostic categories were: Non-diagnostic: 52.2% to 13%, non-neoplastic: 21.4% to 10.7%, atypia of undetermined significance: 74% to 22.2%, benign neoplasm: 100% to 1.1%, salivary gland neoplasm of uncertain malignant potential: 93.3% to 53.3%, suspicious for malignancy (SFM): 100% to 100%, and malignant: 100% to 100%. A diagnosis of 'SFM' or 'malignant' with FNA cytology carried a 100% risk for malignancy, while a diagnosis of "non-neoplastic," "benign neoplasm" reduced the probability of malignancy to 3.4%. The MSRSGC is useful for the management of salivary gland lesions as it can successfully differentiate between benign and malignant cases. It will bring uniformity in salivary gland FNA cytology reporting across various institutions globally.

The Milan System, from Its Introduction to Its Current Adoption in the Diagnosis of Salivary Gland Cytology

Salivary gland masses are often encountered in the everyday practice of cytopathology. It is commonly known that the cytologic interpretation of these lesions can pose diagnostic problems due to overlapping cytomorphologic features. Fine needle aspiration (FNA) of salivary lesions shows good to excellent sensitivity and specificity in differentiating a neoplastic from a non-neoplastic process and in diagnosing common tumors such as pleomorphic adenoma. However, its value is limited in diagnosing specific neoplastic entities especially those with well-differentiated morphology. In light of this gap, an international group of pathologists has proposed a management-oriented, tiered classification for reporting salivary gland FNA specimens, “The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)”. Similar to other classification systems, the MSRSGC scheme comprises six diagnostic categories, which were linked with a specific risk of malignancy (ROM) and management. In this review article, the author evaluated the published literature on FNA in diagnosing salivary gland lesions with the adoption of the Milan system since its introduction in the daily practice of salivary cytopathology.

The Milan System for Reporting Salivary Gland Cytopathology: An outcome of retrospective application to three years' cytology data of a tertiary care hospital.

Objectives:Fine-needle aspiration cytology (FNAC) of the salivary gland lesions has diverse and sometimes overlapping features that pose a diagnostic challenge for the cytopathologists. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has been introduced to bring uniformity in the reporting of salivary gland FNAC and improve the clinic-pathologic communication resulting in better patient management. The aim of the present study was to assess the application of the MSRSGC on FNAC specimens of salivary gland lesions at a tertiary care hospital.Material and Methods:All salivary gland aspiration cytology cases along with histopathology follow-up of salivary gland lesions, wherever available, over a period of 36 months were analyzed and re-categorized according to MSRSGC into six categories and the risk of malignancy (ROM) was computed.Results:Of the 123 patients, 23 (18.69%) were classified as non-diagnostic, 39 cases (31.7%) as non-neoplastic, one (0.81%) as atypia of undetermined significance (AUS), benign neoplasm in 49 (39.8%) cases, uncertain malignant potential in two cases (1.63%), suspicious of malignancy in two cases, and malignant in seven cases (5.69%). Out of 123 cases, histopathological correlation was available in 34 cases, for which the ROM was calculated. The ROM was 0% for non-neoplastic, 11.1% for benign neoplasm, and 100% each for salivary neoplasm of uncertain neoplastic potential, and 100% for malignant categories.Conclusion:In the present study, the distribution of cases according to MSRSGC was comparable with the previous studies. The proportion of cases classified as AUS was within the goal set by MSRSGC at less than 10%. A risk-based stratification of salivary gland lesions in the form of MSRSGC is essential in the present era to guide and alert the clinician about the subsequent management plan and convey the ROM.

English

BACKGROUND Neoplasms of salivary gland account for 2 - 6.5 % of all head and neck neoplasms. Fine needle aspiration cytology (FNAC) is sufficiently sensitive and relevant to the diagnosis and treatment of salivary gland pathologies for salivary gland lesions. The Milan system for reporting salivary gland cytopathology (MSRSGC) represents a stage for a structured, evidence-based international reporting system for salivary gland fine-needle aspiration (FNA). This system provides a guidance for diagnosis and management according to the risk of malignancy (ROM) in different categories. We wanted to study the various cytomorphological lesions of salivary gland and their cytological categorisation based on the MILAN system of reporting. METHODS A 2-year record-based study (January 2018 to December 2019) was conducted on FNAC of salivary gland lesions in the Department of Pathology, VSSIMSAR (Veer Surendra Sai Institute of Medical Sciences and Research), Burla, Odisha. Based on the classical system, all smears were studied and re-categorized into six groups according to the MILAN classification. Histological correlation was carried out in the available cases. RESULTS A total of 103 FNA cases were examined and 20 different categories were there in the original diagnosis. As per the categorisation based on MILAN System there were six categories, maximum cases were non-neoplastic 34 (33.0 %) followed by benign neoplasms 22 (21.35 %), malignant 14 (13.5 %), non-diagnostic 10 (9.7 %), atypia of undetermined significance 9 (8.7 %), suspicious for malignancy 8 (7.7 %) and neoplasms of uncertain malignant potential 6 (5.8 %). 43 cases (80.4 %) were found to be concordant out of 54 histopathology correlated cases. CONCLUSIONS The Milan system of reporting salivary gland cytopathology provided a uniform system of reporting salivary gland cytomorphology that may increase the effectiveness. KEYWORDS Milan System, Salivary Gland Lesions, FNAC, Risk of Malignancy (ROM)

Diagnostic performance of Milan system for reporting salivary gland cytopathology: A prospective study.

Fine-needle aspiration (FNA) is a well-established modality for diagnosing salivary gland pathologies. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides a standardized uniform framework leading to an evidence-based risk of malignancy (ROM). Based on the current literature, ROM in the 6-tier MSRSGC ranges from <5% for neoplasm-benign to >90% for the malignant category. Here, we report our institutional experience adopting MSRSGC. The cytopathology group at our institution implemented MSRSGC at the end of 2018. Through a query of our laboratory information system, we identified all salivary gland FNA cases from 27 November 2018 to 26 October 2020. The pertinent surgical pathology follow-up was also extracted. After manual curation, data was analyzed in Rv4.0.2. Our cohort comprised of 315 patients undergoing 343 salivary gland FNA biopsies, predominantly on the parotid (90%), 162 with a surgical pathology follow-up. The risk of malignancy ranged from 3.2% in neoplasm-benign (IVA) to 100% in suspicious for malignancy (V) and malignant (VI) categories. ROM in the other categories was: 12.5% for non-diagnostic, 0 for non-neoplastic, 33.3% for atypia of undetermined significance, and 41.9% for salivary gland neoplasm of uncertain malignant potential (SUMP). Most SUMP cases had a basaloid or oncocytoid cytomorphology with similar ROM. In distinguishing benign and malignant salivary gland lesions, FNA had adequacy of 93.6%, a diagnostic yield of 62.2%, a sensitivity of 93.1% and a specificity of 100%. MSRSGC was successfully adopted by our cytology group and clinicians, with overall diagnostic performance similar to previous studies.

English

BACKGROUND Fine needle aspiration cytology (FNAC) is a method for the diagnosis of superficial lesions like swellings of the salivary glands since many years. The present study was undertaken to identify the patterns of salivary gland lesions (SGL) on FNAC and histopathology specimens and also describe the age and sex distribution of SGL. METHODS A total 319 cases of SGL were studied from June 2009 to July 2019 which included both retrospective and prospective cases. A detailed history was taken, clinical and necessary laboratory investigations were done; and then FNAC of salivary gland was done. Histopathology examination of specimens was done whenever available; FNAC and histopathology slides of retrospective cases were reviewed. Correlation between cytomorphology and histomorphology was done only where available. RESULTS The majority of cases was in the age group of 21 - 40 years (42.98 %) with female predominance (53 %) and commonest gland involved was parotid gland (52.97 %) in both the sexes. 138 (43 %) cases were non-neoplastic lesions and 181 (57 %) were diagnosed as neoplastic lesions. Of the 138 non neoplastic lesions, on cytology and histopathology, sialadenitis constituted 110 (79.71 %) cases; most being chronic sialadenitis (107). Out of 181 neoplastic lesions, 142 (77.78 %) were benign while 39 (22.22 %) cases were malignant. Pleomorphic adenoma was the commonest benign neoplasm (71.27 %) and mucoepidermoid carcinoma (66.69 %) was the commonest malignant neoplasm. Histopathological correlation was available in 37 cases. CONCLUSIONS FNAC is useful as an outdoor diagnostic procedure because of the availability of earlier diagnosis in comparison with the histopathological diagnosis. Histopathology correlation is helpful in cases where diagnosis at FNAC is difficult. KEYWORDS FNAC, Salivary Glands, Histopathology, Specimens, Cytomorphology, Sialadenitis, Pleomorphic Adenoma, Mucoepidermoid Carcinoma

“ROLE OF FNAC IN THE DIAGNOSIS OF SALIVARY GLAND LESION”

Background: Fine needle aspiration cytology (FNAC) has been used for diagnosis of salivary gland lesions for many years. Various studies in the existing literature have shown a wide range of sensitivity and diagnostic accuracy of cytologic diagnosis. FNAC is a safe, simple, cost effective, 1-4 accurate and minimal invasive procedure for the evaluation of salivary gland lesions. FNAC is not only useful in planning denitive preoperative 2,5-6 diagnosis but also can prevent unnecessary surgical intervention. Salivary gland swelling occur more commonly in 3rd decade of life with equal sex incidence. Parotid is one of the most commonly involved glands in the head &amp; neck region swellings. FNAC appears to be highly sensitive for benign tumours and highly specic for malignant tumors and it should be the rst line of investigation in evaluating the salivary gland pathologies. 7 Early diagnosis and appropriate management carries good prognosis. Methods: Patients with suspected salivary gland enlargements, referred for FNAC, were included in this study. FNAC was performed by using the standard procedure. Cytologic diagnosis was compared with histopathologic diagnosis wherever it was available. Results: In the present study conducted in the department of pathology, Shyam Shah Medical College Rewa MP, over a period of 5 years, 152 Patients with suspected salivary gland enlargements were retrospectively appraised. The benign lesions of salivary gland were 133 (87.5%), out of which Pleomorphic adenoma was diagnosed in 75 (56.39%) cases, clinical correlation was found in 58 (77.33%) cases. 29 cases were subsequently correlated with histopathological examination 26 correctly correlated and the diagnostic accuracy of FNAC was found to be 89.65%. Inammatory lesions were proved correct in 08 out of 10 cases after histopathology. Therefore, accuracy of FNAC was 80.0%. Malignant lesions of salivary gland were found in 19 cases, out of which 15 (78.94%) cases correlated with clinical diagnosis. 13 cases were subjected to histopathology 10 correctly correlated and the diagnostic accuracy of FNAC was found to be 76.92%. Overall diagnostic accuracy of FNAC was 84.61%. Conclusion:In conclusions it can be established that FNAC is an efcient and accurate procedure with high sensitivity index, and its usefulness is enhanced due to it being a relatively easy procedure which can be carried out even on outdoor patients.

RISK STRATIFICATION UTILIZING THE MILAN SYSTEM OF CLASSIFICATION FOR SALIVARY GLAND CYTOLOGY : A CYTOHISTOLOGICAL CORRELATION STUDY IN TERTIARY CARE HOSPITAL IN HIMACHAL PRADESH

Introduction- Milan system is an evidence based system derived from the literature which correlates diagnostic categories with risk of malignancy and clinical management strategies. The goals of this system were to standardize salivary gland cytology reporting across institutions and provide a framework for guiding clinical management. It is a tier based classication having six diagnostic categories. The conventional system was used for diagnosis before the advent of Milan system. In this study, FNAC done for all sa Material and methods- livary gland lesions over a period of two years from 2018 - 2020 in department of pathology, IGMC Shimla are included. All cases are categorized according to MSRSGC and correlated with histopathological follow up wherever available. We calculated the sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of FNA using the Milan system. We also calculated the ROM was for each category. All the cases were Results: categorized as per MSRSGC and were 14%, 45.4%, 0%, 31.4%, 0.6%, 0.6% and 8% in category I, II, III, IVA, IVB, V and VI respectively. ROM for category I, II, IVA, IVB, V and VI was 0%, 0%, 2.6%, 0%, 100% and 87.5% respectively. The sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy was 98.51%, 66.67%, 98.51%, 66.67% and 97.14% respectively. Milan system is an Discussion: effective tool for diagnosing salivary gland lesions. It offers advantages over the conventional system such as risk of malignancy, management options for each category and a better communication both institute wise and between clinicians and cytopathologists.

Histopathological spectrum of salivary gland lesions in rural India

Background: Salivary gland lesions are of a wide spectrum and affect all the major and minor salivary glands in varying proportions. This study, performed in a rural medical college in Maharashtra, India is intended to see the histopathologic spectrum of salivary gland lesions in the rural population and how it is related to the data from other parts of the country and of the world. &#x0D; Materials and Methods: This is a retrospective study done in the Department of Pathology of a rural-based medical college, Indian Institute of Medical Science and Research, Warudi, Maharashtra, India for a period of 6 years, from January 2014 to January 2020. Age, sex, location of the lesion, gross and microscopic findings were noted.Results: A total of 71 lesions were received in the department of pathology during this period. Samples were received from age 11 years to 75 years. Female preponderance with a male: female ratio of 1:1.15 was seen. 57.7% (n=41) were benign, 15.5% (n=11) were malignant and the rest (n=19) were inflammatory in nature. A maximum number of lesions (50.7%) were detected in the Parotid gland. The most common lesion seen was Pleomorphic adenoma (36.62%, n=26) and the most common malignant lesion was Mucoepidermoid carcinoma.Conclusions: Present study showed benign and non-neoplastic lesions outnumbering the malignant lesions, with female predominance, and a low mean age for malignant lesions of 38.2years. Comparison with other studies within and outside India showed a similar pattern of distribution of salivary gland lesions in the rural population.

Correlation Between Fine Needle Aspiration Cytology (FNAC) and Permanent Histopathology Results in Salivary Gland Masses

ObjectiveFine-needle aspiration cytology (FNAC) has been widely accepted as a diagnostic safe method for preoperative assessment of salivary gland lesions. This diagnostic tool is inexpensive, easy to perform, relatively painless and it provides useful information to differentiate between benign and malignant salivary gland tumors that helps in the management and surgical planning. This study was undertaken to compare FNAC results with permanent histopathological findings of salivary gland tumors in order to assess its diagnostic accuracy.Materials and methodsA total of 37 archived salivary gland FNAC specimens collected between January 2001 and January 2018 were correlated with proven histopathology findings. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated. False negative and false positive cases were determined.ResultsThere were 20 female and 17 male patients. Parotid tumors count for 62.2% and submandibular tumors 37.8%. All cases of malignancy on FNAC were proven to be malignant on the final pathology findings. All cases that were suspicious for malignancy on FNAC were proven to be malignant as well. In addition, three false negative cases were seen and no false positive cases among all FNAC cases. In our series, the overall sensitivity and specificity were 90.3% and 100%, respectively. The positive and negative predictive values were 100% and 57.1%, respectively. The diagnostic accuracy was 91.4%.ConclusionThis study demonstrated that FNA cytology of the salivary gland is a useful technique for diagnosis of salivary gland lesions. Insufficient cellularity was the most important factor that resulted in incorrect cytological interpretation.

Histopathological study of salivary gland lesions-an institutional study

Background: The salivary glands are the site of origin of a variety of neoplasm and are also relatively uncommon accounting for Materials and Methods: this study was conducted for two years (Nov 2018-Nov 2020) in the department of pathology KBNIMS, kalaburagi. Total number of salivary gland lesions included were 50. Specimens were processed and stained by hematoxylin and eosin stain followed by microscopic examination. Results: out of total 50 cases 54% were non neoplastic and 46% were neoplastic. Predominantly salivary gland lesions were found in the 3rd -4th decade. Male predominance was seen in all salivary gland lesions. In non neoplastic lesions chronic sialadenitis was predominant (32%) followed by mucocele (10%). In neoplastic lesions, Pleomorphic adenoma was commonest benign tumor accounting for 22%. Mucoepidermoid carcinoma was most common malignant salivary gland tumor. Most of the salivary gland lesions were found in the submandibular gland. Conclusion: Histopathological examination remains gold standard because of their varied histomorphological features Keywords: Sialadenitis, Salivary gland lesions, Pleomorphic adenoma, Mucoepidermoid carcinoma.

Excision of Lower Lip Mucocele Using Scalpel and Diode Laser: Two Case Reports

The term “Mucocele” originates from Latin words ‘mucus’ which means ‘fluid’ and ‘coele’ which means ‘cavity’. It is defined as the accumulation of mucus in the oral cavity’s subepithelial tissue secreted from salivary glands and their ducts. It is a frequently occurring salivary gland lesion which is seen in the oral cavity. They occur as mucus extravasation and mucus retention type. They may be obstructive in nature and occur due to trauma to a minor salivary gland duct which results in pooling in the epithelial tissue. Clinically, a mucocele appears as a typical blue colored dome shaped swelling which is soft in consistency and contains salivary fluid. It lies superficial or deeply attached to the tissues.&#x0D; &#x0D; Management of mucocele includes surgical excision, marsupialization, micro marsupialization, cryosurgery, laser vaporization, and laser excision. Recently, high - intensity lasers have been proven to be more beneficial than conventional surgery as it causes prompt hemostasis, minimal blood loss and reduced healing time of the site.

Rare submandibular gland metastasis of hepatocellular carcinoma: case report and review of the literature

Hepatocellular carcinoma (HCC), the most common primary hepatic tumor, metastasizes in more than 50% of cases. However, metastasis of HCC to the submandibular glands is very rare. HCC rarely metastasizes to the salivary glands; only six cases of metastasis to the parotid gland have been reported in the English-language literature. Moreover, only one case of metastasis of HCC to the submandibular glands has been reported to date, and the affected patient died of hepatic failure. This clinical report describes a 55-year-old man who had undergone two surgeries for liver cancer and subsequently presented with a 2-week history of a right submandibular mass. We performed dissection of the right submandibular triangle, and metastatic HCC of the submandibular gland was diagnosed. Although HCC metastases to the oral cavity have been reported, this is only the second case of HCC metastasis to the submandibular gland. Fine-needle aspiration biopsy is recognized as a simple, direct approach for morphologic diagnosis of salivary gland lesions; however, histological and immunohistochemical examination of the surgical specimen remains necessary.

Actual applications of magnetic resonance imaging in dentomaxillofacial region.

Magnetic resonance imaging (MRI) is a versatile imaging modality utilized in various medical fields. Specifically used for evaluation of soft tissues, with non-ionizing radiation and multiplanar sections that has provided great guidance to diagnosis. Nowadays, use of MRI in dental practice is becoming more pervasive, especially for the evaluation of head-and-neck cancer, detection of salivary gland lesions, lymphadenopathy, and temporomandibular joint disorders. Understanding the basic principles, its recent advances, and multiple applications in dentomaxillofacial region helps significantly in the diagnostic decision making. In this article, the principle of MRI and its recent advances are reviewed, with further discussion on the appearance of various maxillofacial pathosis.

Remote cytological diagnosis of salivary gland lesions by means of precaptured videos

The objective of this study was to investigate the feasibility of implementing videos captured by static telecytological applications for remote cytological diagnosis of fine needle aspiration (FNA) specimens from salivary gland lesions. The current study was performed on 102 specimens from patients referred to the Alpha Prolipsis Cytopathology Department for preoperative evaluation of salivary gland lesions. In all cases, surgical excision followed the initial cytological diagnosis. (benign lesions, 11; benign neoplasms, 68; malignant neoplasms, 23). Videos were transferred via file transfer protocol to password-protected accounts for remote review by three independent cytopathologists. In addition to diagnosis, reviewers commented on overall digital video quality. Contributor's and reviewer's diagnoses were collected, recorded and statistically evaluated. Statistical evaluation of cytological diagnoses detected no significant difference in diagnostic accuracy between the diagnoses proffered on the basis of precaptured videos and conventional slides. The overall interobserver agreement was ranging from substantial to almost perfect with κ values of 0.71-0.89. Videos production by static telecytology applications can be used as an alternative method for telecytological diagnosis of salivary glands FNAs. Videos of salivary glands FNAs can be used for accurate diagnosis, educational and second opinion purposes,. They can also be used for archiving, teleconsultation and educational purposes, improving the performance of the already existing static telecytology stations and small cytology departments' quality indices.

Estudo Retrospectivo de Lesões das Glândulas Salivares em uma População Brasileira num Período de 10 Anos

Objective: This study aimed to analyze the clinical characteristics of salivary gland lesions diag-nosed in an Oral Medicine center in Brazil from 2010 to 2019. Material and Methods: The files describing all cases classified as salivary glands lesions at the Stomatology of the Polyclinic Pi-quet Carneiro of the State University of Rio de Janeiro from 2010 to 2019 (a 10-year period) were reviewed for the purposes of this study. Data were tabulated and analyzed descriptively and comparatively using Pearson's Chi-Square Test and Fisher's Exact Test using the Graph Pad Prism program (Version 6.07 by Windows, San Diego, California, USA), with a significance lev-el of 5% (p<0.05). Results: The analysis of 2,134 medical records - 166 (7.78%) presented with salivary glands lesions in which 117 were women (70.48%) and 49 men (29.52%); the mean age of patients was 39.30; the most common clinical lesion of the salivary glands observed was mu-cocele representing 59 cases (35.54%), followed by sialadenitis with 33 cases (19.88%). Conclu-sions: According to all data gathered in this work, we concluded that the salivary gland lesions show a low prevalence and affect more white female patients in the sixth decade of life.

Implementation of pre-captured videos for remote cytological evaluation of salivary gland lesions

Objective The objective of this study was to examine the feasibility of implementing videos captured by static telecytological applications for remote cytological evaluation of fine needle aspiration specimens from salivary gland lesions. Methods The current study was carried out on 102 fine needle aspiration specimens from salivary gland lesions with histological confirmation (benign lesions, 11; benign neoplasms, 68; malignant neoplasms, 23), retrospectively selected from the department’s registry. Videos were transferred via file transfer protocol to password-protected accounts for remote review by three independent cytopathologists. In addition to diagnosis, reviewers commented on overall digital video quality. Contributor’s and reviewer’s diagnoses were collected, recorded and statistically evaluated. Results Statistical evaluation of cytological diagnoses detected no significant difference in diagnostic accuracy between the diagnoses proffered on the basis of pre-captured videos and conventional slides. The overall interobserver agreement was ranging from substantial to almost perfect with κ values of 0.71–0.89. Conclusions Video production by static telecytology applications can be used as an alternative method for telecytological diagnosis of salivary gland fine needle aspirations. Videos of salivary gland fine needle aspirations can be used for rapid and accurate diagnosis, by diminishing turn-around times and improving the quality indices of small cytology departments. They can also be used for archiving, teleconsultation, educational and second opinion purposes, improving the performance of the already existing static telecytology stations.