Yáñez M, Roa I, Roa J C, Villaseca M, García M
Unidad de Anatomía Patológica Citopatología, Hospital Regional Temuco, Facultad de Medicina, Universidad de la Frontera, Chile.
Rev Med Chil. 1999 May;127(5):600-3.
Chronic sclerosing unspecific sialadenitis or Küttner tumor, is an infrequent inflammatory lesion of submandibular gland. We report a 60 years old male presenting with a slowly growing, painless, bilateral submandibular tumor of two years of evolution. Pathological examinations showed marked atrophy of glandular parenchyma with increased fibrous connective tissue and an intense lymphocytic infiltration with lymphoid follicle formation. Lymphocyte population study with kappa, lambda, CD20 and CD45RO antibodies was similar to that observed in reactive lymph nodes. There was no over expression of Bcl-2 gene protein, involved in the phenomenon of apoptosis of glandular tissue, that could explain the pathogenesis of atrophy. This protein was positive only in lymphoid cells and glandular conducts. An immune etiology, with replacement of glandular tissue by lymphoid and fibrous connective tissue is suggested.
慢性硬化性非特异性涎腺炎或库特纳瘤是一种罕见的下颌下腺炎性病变。我们报告一例60岁男性,有一个缓慢生长、无痛的双侧下颌下肿物,病程两年。病理检查显示腺实质明显萎缩,纤维结缔组织增多,并有强烈的淋巴细胞浸润及淋巴滤泡形成。用kappa、lambda、CD20和CD45RO抗体进行的淋巴细胞群体研究与反应性淋巴结中观察到的情况相似。参与腺组织凋亡现象的Bcl-2基因蛋白没有过度表达,无法解释萎缩的发病机制。该蛋白仅在淋巴细胞和腺导管中呈阳性。提示存在一种免疫病因,即腺组织被淋巴和纤维结缔组织替代。