• Salivary gland mucosa-associated lymphoid tissue lymphoma immunoglobulin V(H) genes show frequent use of V1-69 with distinctive CDR3 features.

• Salivary gland B cell lymphoproliferative disorders in Sjogren's syndrome present a restricted use of antigen receptor gene segments

• Dedifferentiated acinic cell carcinoma of the parotid gland with myoepithelial features.

• In the eye of the beholder.

• The management of salivary gland neoplasms.

• Mucoepidermoid carcinoma of the salivary glands: clinicopathologic review of 108 patients treated at the National Cancer Institute of

• A case report of metachronous salivary gland neoplasia.

• Synchronous salivary gland neoplasia.

• Lymphadenoma arising in the parotid gland: a case report.

• Malignant lymphoma in the head and neck associated with benign lymphoepithelial lesion of the parotid gland.

• [A case of giant pleomorphic adenoma of the cheek with two malignant centers]

• Warthin's tumour: unusual vs. common morphological findings in fine needle aspiration biopsies.

• [Pleomorphic adenoma with bilateral pulmonary metastasis]

• Outcome of surgery for adenoid cystic carcinoma of head and neck region.

• Diagnosis of a gastric mucosa-associated lymphoid tissue lymphoma by endoscopic ultrasonography-guided biopsies in a patient with a parotid

• Application of immunohistochemistry to the diagnosis of salivary gland tumors.

• [Oncocytic adenocarcinoma of the submandibular gland]

1
UI - 10845923
AU - Miklos JA; Swerdlow SH; Bahler DW
TI - Salivary gland mucosa-associated lymphoid tissue lymphoma immunoglobulin V(H) genes show frequent use of V1-69 with distinctive CDR3 features.
SO - Blood 2000 Jun 15;95(12):3878-84
AD - Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Salivary gland mucosa associated lymphoid tissue (MALT) type lymphomas are B-cell neoplasms that develop out of a reactive infiltrate, often associated with Sjogren's syndrome. Previous reports from our laboratory involving 10 patients suggested these lymphomas expressed a restricted immunoglobulin (Ig) V(H) gene repertoire with over use of V1-69 gene segments. To better determine the frequency of V1-69 use and whether there may also be selection for CDR3 structures, we sequenced the V(H) genes from 15 additional cases. Over half of the potentially functional V(H) genes (8 of 14) used a V(H)1 family V1-69 gene segment, whereas the other cases used different gene segments from the V(H)1 (V1-46), V(H)3 (V3-7, V3-11, V3-30.3, V3-30.5), and V(H)4 (V4-39) families. The 8 V1-69 V(H) genes used 5 different D segments in various reading frames, but all used a J4 joining segment. The V1-69 CDR3s showed remarkable similarities in lengths (12-14 amino acids) and stretches of 2 to 3 amino acids between the V-D and D-J junctions. They did not resemble CDR3s typical of V1-69 chronic lymphocytic leukemias. This study extends our earlier work in establishing that salivary gland MALT lymphomas represent a highly selected B-cell population. Frequent use of V1-69 appears to differ from MALT lymphomas that develop at other sites. The high degree of CDR3 similarity among the V1-69 cases suggests that different salivary gland lymphomas may bind similar, if not identical epitopes. Although the antigen specificities are presently unknown, similar characteristic CDR3 sequences are often seen with V1-69 encoded antibodies that have anti-IgG or rheumatoid factor activity. (Blood. 2000;95:3878-3884)

2
UI - 11870635
AU - De Re V; De Vita S; Gasparotto D; Marzotto A; Carbone A; Ferraccioli G;
TI - Boiocchi M Salivary gland B cell lymphoproliferative disorders in Sjogren's syndrome present a restricted use of antigen receptor gene segments similar to those used by hepatitis C virus-associated non-Hodgkins's lymphomas.
SO - Eur J Immunol 2002 Mar;32(3):903-10
AD - Division of Experimental Oncology 1, Centro di Riferimento Oncologico, IRCS, Aviano, Italy.
Sjogren's syndrome (SS) represents a pathological model of the evolution from polyclonal B lymphocyte activation to oligoclonal/monoclonal B cell expansion, which may culminate in the development of a malignant lymphoproliferative disease. The different phases of this process are usually marked by the appearance of antigen-driven activated B cell clones, which are commonly IgM-positive and with rheumatoid factor (RF) activity. However, the agent(s) able to trigger B cell proliferation is still unknown. A similar pathogenetic mechanism exist in mixed cryoglobulinemia, another autoimmune disease that often evolves to non-Hodgkin's lymphoma (NHL) and in which hepatitis C virus (HCV) infection has been demonstrated to play an etiopathogenetic role. In the present study, we cloned and sequenced the antigen receptor (IgR) variable region genes of SS-associated monoclonal non-neoplastic lymphoproliferations and compared them with those of our previous reported HCV-associated NHL, to derive clues on the antigen(s) that sustains SS. The results obtained showed remarkable homologies between the antigen combinatory regions of the IgR expressed by both diseases. These homologies concern: a) the specific combinations of heavy and light variable region genes; b) the limited length of complementarity-determining regions (CDR3); c) the homology with antibodies with RF activity; d)the amino acid sequences of CDR3 in which common somatic mutations are present that possibly determine the antigen-binding specificity. In conclusion, although there are significant differences between SS and HCV-associated lymphoproliferative diseases, they share many molecular characteristics, which suggest an immunological cross-reactivity or molecular mimicry among the agents that underlie these disorders.

3
UI - 12204062
AU - Piana S; Cavazza A; Pedroni C; Scotti R; Serra L; Gardini G
TI - Dedifferentiated acinic cell carcinoma of the parotid gland with myoepithelial features.
SO - Arch Pathol Lab Med 2002 Sep;126(9):1104-5
AD - Department of Clinical Pathology, Division of Anatomic Pathology, Ospedale Santa Maria Nuova, Reggio Emilia, Italy. piana.simonetta@asmn.re.it
Dedifferentiated acinic cell carcinoma of the salivary gland is an uncommon variant of acinic cell carcinoma, characterized by the coexistence of both an usual low-grade acinic cell carcinoma and a high-grade dedifferentiated component, as well as by an accelerated clinical course. We describe a case of acinic cell carcinoma of the parotid gland in a 67-year-old woman, which recurred 4 times after surgery and radiotherapy. The recurrences consisted of residual foci of acinic cell carcinoma intermingled with a high-grade epithelial proliferation; the latter was focally constituted by cells with morphologic and immunohistochemical features of myoepithelium.

4
UI - 12189983
AU - McFarland J
TI - In the eye of the beholder.
SO - Nursing 2002 Jun;32(6):46-7
AD - St. Lawrence Seminary, Mt. Calvary, Wis., USA.

5
UI - 12169134
AU - Robson A
TI - The management of salivary gland neoplasms.
SO - Clin Otolaryngol 2002 Aug;27(4):285-90
AD - Department of Otolaryngology, Cumberland Infirmary, Carlisle, UK. andrew.robson@ncumbria-acute.nhs.uk

6
UI - 12167584
AU - Guzzo M; Andreola S; Sirizzotti G; Cantu G
TI - Mucoepidermoid carcinoma of the salivary glands: clinicopathologic review of 108 patients treated at the National Cancer Institute of Milan.
SO - Ann Surg Oncol 2002 Aug;9(7):688-95
AD - Department of Head and Neck Surgery, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1, 20133 Milan, Italy. marco.guzzo1@tin.it
BACKGROUND: Mucoepidermoid carcinoma (MEC) can have a variety of clinical outcomes, but prognosis seems to be related to the tumor grade. The system proposed by Auclair and Goode is useful, and our data lend further support to its application and validity in clinical practice. METHODS: We have clinicopathologically reviewed 108 cases of MEC originating in major (MASG) and minor (MISG) salivary glands that were treated at the National Cancer Institute of Milan between 1975 and 1995. Following the methods of Auclair and Goode, a quantitative grading system was used. The relationships between clinical and pathologic characteristics and survival rate were investigated. RESULTS: Twenty-six (44%) cases located in MASG and 19 (39%) cases in MISG were categorized as high-grade tumors. In patients with MASG tumors, the 5-year disease-free survival rate was 22.5% when the tumor was high grade and 97.0% if the tumor was low grade (P <.0001). For patients with a tumor of the MISG, the percentages were 35.3% for high-grade and 80.0% for low-grade tumors (P =.0066). CONCLUSIONS: Our study confirms that in MEC, tumor grade, subdividing cases into low and high grade by using the criteria delineated by Auclair and Goode, correlates well with prognosis.

7
UI - 8645675
AU - Shaw RJ
TI - A case report of metachronous salivary gland neoplasia.
SO - Br J Oral Maxillofac Surg 1996 Feb;34(1):135

8
UI - 9043013
AU - Curtis A; Baker NJ
TI - Synchronous salivary gland neoplasia.
SO - Br J Oral Maxillofac Surg 1997 Feb;35(1):73-4

9
UI - 12205744
AU - Kwon GY; Kim EJ; Go JH
TI - Lymphadenoma arising in the parotid gland: a case report.
SO - Yonsei Med J 2002 Aug;43(4):536-8
AD - Department of Pathology, Dankook University College of Medicine, 16-5 Anseo-Dong, Cheonan, Chungcheongnamdo 330-715, Korea.
We report a case of lymphadenoma arising in the parotid gland. A 53-year-old female patient presented with a mass in the parotid gland. Grossly, it was a well-demarcated solid mass measuring 3 cm in diameter. Microscopic examination revealed many cysts or duct-like structures in the background of the prominent lymphoid stroma, confirming a diagnosis of lymphadenoma. This particular case was thought to have arisen from an intraparotid lymph node. Lymphadenoma is a rare benign neoplasm of the salivary gland with partial resemblance to other salivary gland tumors, such as Warthin's tumor, cystadenoma, sebaceous lymphadenoma or mucoepidermoid carcinoma. Therefore proper recognition of this rare entity is warranted to avoid confusion in the diagnosis.

10
UI - 11893460
AU - Sato K; Kawana M; Sato Y; Takahashi S
TI - Malignant lymphoma in the head and neck associated with benign lymphoepithelial lesion of the parotid gland.
SO - Auris Nasus Larynx 2002 Apr;29(2):209-14
AD - Department of Otolaryngology, Niigata University School of Medicine, 1-757 Asahimachi, 951-8510, Niigata, Japan. katsuro@med.niigata-u.ac.jp
Lymphoepithelial lesion is a benign lymphoproliferative disease occasionally arises in the salivary glands, but association with malignant diseases or autoimmune diseases has also been discussed. We herein present three cases of malignant lymphoma arose in the parotid gland and the lacrimal gland, following parotid surgery for benign lymphoepithelial lesion (BLEL) of the parotid gland. Two cases had mucosa associated lymphoid tissue (MALT) lymphoma in the parotid gland; one arose in the ipsilateral parotid gland as a recurrent swelling, and the other arose in the contralateral parotid gland of the previous BLEL surgery. The third case of malignant lymphoma arose in the lacrimal gland on the ipsilateral side, and the following contralateral parotid gland remained BLEL. All three patients were female, and one patient had a past history of Sjogren's syndrome and Hashimoto's disease. All three patients were treated by chemotherapy and one patient received additional radiotherapy. To follow-up lymphoproliferative diseases in the salivary glands such as BLEL, careful observation should be made on the same gland, other major salivary glands, and other organs in the head and neck, especially in females with autoimmune diseases.

11
UI - 12162034
AU - Kaminski M; Janicki K
TI - [A case of giant pleomorphic adenoma of the cheek with two malignant centers]
SO - Otolaryngol Pol 2002;56(3):385-7
AD - Oddzial Laryngologii 111 Szpitala Wojskowego SP ZOZ w Poznaniu.
The authors present the case pleomorphic adenoma of a patient aged 77 of atypical location with two malignancy center. After performed diagnostic for an operation the tumor resected. The histopathologic examination proved in the pleomorphic adenoma the cylindromatosum and cancer solid vertens.

12
UI - 12269895
AU - Flezar M; Pogacnik A
TI - Warthin's tumour: unusual vs. common morphological findings in fine needle aspiration biopsies.
SO - Cytopathology 2002 Aug;13(4):232-41
AD - Department of Cytopathology, Institute of Oncology, Zaloska 2, SI-1105 Ljubljana, Slovenia. mfiezar@onko-l.sl
Fine needle aspiration biopsies (FNA) of 47 Warthin's tumours confirmed by histology were re-evaluated for cytomorphological findings. The majority of aspirates (37/47) contained a typical background with proteinaceous substance and cell debris, along with cellular elements represented by oncocytic, lymphoid, and mast cells with degranulated cytoplasm. Uncommon cellular findings were true squamous cells (1/47), atypical cells with vacuoles (1/47), osteoclastic giant cells (1/47), epithelioid cells (1/47), mast cells with preserved granules in cytoplasm (3/47), and siderophages (4/47). Uncommon findings in the background were corpora amylacea-like structures and homogeneous bright red droplets. Squamous cells and atypical cells with vacuoles caused diagnostic difficulties in distinguishing a Warthin's tumour from a squamous cell or mucoepidermoid carcinoma. However, other unusual cellular and background findings were not worrying; therefore, they are merely regarded as a curiosity in the cytomorphological appearance of the tumour.

13
UI - 11924231
AU - De Kerangal X; Poirrier P; Soulard R; Dot JM; Segneuric JB; L'Her P;
TI - Jancovici R; Saint-Blancart P [Pleomorphic adenoma with bilateral pulmonary metastasis]
SO - Rev Pneumol Clin 2001 Nov;57(5):352-4
AD - Service de Chirurgie Thoracique et Generale, Hopital d'instruction des armees Percy, 101 avenue H. Barbusse, 92141 Clamar. kerangal@hotmail.com
We report a new case of pleomorphous adenoma of the submaxillary glands with multiple lung metastases. Histological proof was obtained on the thoracoscopic surgical specimen. Clinically, this benign tumor presents as a malignant tumor. Diagnosis has been a subject of debate; surgical resection is indicated. Diagnosis is achieved by elimination in a patient with one or several nodules occurring in a context of recurrent pleomorphous adenoma.

14
UI - 12064885
AU - Maciejewski A; Szymczyk C; Wierzgon J
TI - Outcome of surgery for adenoid cystic carcinoma of head and neck region.
SO - J Craniomaxillofac Surg 2002 Feb;30(1):59-61
AD - Department of Oncological Surgery, Cancer Centre M. C. Skoldowska Memorial Institute, Gliwice, Poland.
INTRODUCTION: Adenoid cystic carcinoma is an uncommon malignant epithelial tumour of salivary glands. The treatment of choice for these tumours is considered by some to be radical surgery, combined in many centres with postoperative radiotherapy. The goal of such treatment is local control and preservation of function. AIMS: The aim of the retrospective study was to analyse the results of surgery for patients with adenoid cystic carcinoma treated at the Institute of Oncology in Gliwice during the period of 1970-1989. MATERIAL: The analysed group includes 47 patients with adenoid cystic carcinoma. All patients underwent macro- and microscopically proven radical resection of the primary lesion located in major or minor salivary glands. RESULTS: Five- and 10-year survival rate was 85% and 47%, respectively, and 5-year disease-free survival rate was 79%. As the group of patients treated with surgery and radiotherapy was too small (nine cases), the results of combined treatment were not analysed. Local recurrence after surgery occurred in 21% of patients in different time intervals (even as long as 10 years after completion of treatment). CONCLUSION: High risk of local recurrence after surgery suggests that postoperative radiotherapy should always be given. Late development of local recurrences suggests that follow-up should be for a minimum of 10 years. Copyright 2002 European Association for Cranio-Maxillofacial Surgery. Published by Elsevier Science Ltd. All rights reserved.

15
UI - 11989843
AU - Queneau PE; Helg C; Brundler MA; Frossard JL; Spahr L; Girardet C;
TI - Armenian B; Hadengue A Diagnosis of a gastric mucosa-associated lymphoid tissue lymphoma by endoscopic ultrasonography-guided biopsies in a patient with a parotid gland localization.
SO - Scand J Gastroenterol 2002 Apr;37(4):493-6
AD - Dept. of Internal Medicine, Hjpital Cantonal, Geneva, Switzerland. pierre-edouard.queneau@hcuge.ch
We report the case of a 32-year-old man with a low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the parotid gland associated with Sjogren syndrome. He underwent an upper endoscopy as part of the screening of a gastric localization which showed a diffuse non-specific gastritis. However, endoscopic ultrasonography (EUS) evidenced a focal wall thickening of the vertical portion of the smaller curvature. EUS-guided biopsies of this area disclosed a MALT lymphoma, whereas biopsies under endoscopy concluded to mild chronic gastritis. The search for Helicobacter pylori infection remained negative. Four months after treatment with anti-CD20 antibodies, EUS showed a diminution of the abnormal thickening of the second layer. Regression was confirmed histologically on new EUS-guided biopsies. MALT lymphoma is usually considered a localized disease; however, dissemination is probably more frequent than initially believed. Our case reflects the importance of a systematic screening for a gastric localization in patients with MALT lymphoma of the salivary glands. In this situation, association to autoimmune disease such as Sjogren syndrome is more likely to explain the gastric location than infection with H. pylori. Endoscopic ultrasonography has a major impact for the staging of gastric MALT lymphoma, but may also help diagnose focal infiltration by the disease.

16
UI - 10981871
AU - de Araujo VC; de Sousa SO; Carvalho YR; de Araujo NS
TI - Application of immunohistochemistry to the diagnosis of salivary gland tumors.
SO - Appl Immunohistochem Mol Morphol 2000 Sep;8(3):195-202
AD - Department of Oral Pathology, University of Sao Paulo, Brazil. vcaraujo@fo.usp.br
A panel of antibodies composed of the cytokeratins (CKs), vimentin, and actin was applied to 114 minor salivary gland tumors to evaluate its diagnostic value. The results revealed that luminal cells of intercalated duct-like structures, such as those seen in pleomorphic adenoma, basal cell adenoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma, expressed CKs 7, 8, 14, and 19. The outer cells of these structures exhibited vimentin or vimentin plus muscle-specific actin, but rarely CK14, which is seen particularly in pleomorphic adenoma, in the tubular type of basal cell adenoma, and seldom in the tubular type of adenoid cystic carcinoma. Modified myoepithelial cells of pleomorphic adenoma and myoepithelioma exhibited a variable immunoprofile. CKs 7 and 8 were also observed in acinar cell adenocarcinoma and polymorphous low-grade adenocarcinoma with vimentin in the latter. CK13 was expressed only by canalicular adenoma and mucoepidermoid carcinoma cells. This study showed that the panel of antibodies employed is effective in distinguishing among salivary gland tumors.

17
UI - 12168389
AU - Wischerath H; Brehmer D; Hesse G; Laubert A
TI - [Oncocytic adenocarcinoma of the submandibular gland]
SO - HNO 2002 Jun;50(6):565-9
AD - Universitats-HNO-Klinik Witten-Herdecke am St. Marienhospital der kath. Krankenhaus gem. GmbH Hagen.
BACKGROUND: Malignant oncocytic tumors rarely occur in major salivary glands and generally account for < 1% of all salivary tumors. There is no difference of both sexes and appearing mainly between 50 and 60 years of age. They comprise oncocytes, which are epithelial cells with abnormally formed cytoplasm and acidophilic granular cytoplasma. In the process of the malignant transformation the coexistence from oncocytic rests and untypical oncocytic carcinoma portions can be seen. The tumors show no capsule and an infiltrative local growth with perineural and vascular expansions. PATIENT AND METHOD: A rare case of a 59-year-old man with malignant oncocytoma is presented. The tumor was found in the left submandibular gland with one enlarged lymph node near by. RESULT AND CONCLUSIONS: A general overview of the available literature and the histological classification of oncocytomas is given. Therapy consists of surgical resection and radiotherapy. Close clinical controls are necessary.

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