Lombardi Tommaso, Samson Jacky, Küffer Roger
Oral Histopathology Laboratory, Division of Stomatology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Arch Otolaryngol Head Neck Surg. 2003 Sep;129(9):972-5. doi: 10.1001/archotol.129.9.972.
To report our experience of subacute necrotizing sialadenitis (SANS), an unusual lesion of the minor salivary palatal glands, and to discuss its relationship with necrotizing sialometaplasia (NS).
A retrospective review of records for patients with SANS identified between 1996 and 2001.
Academic center, referral center, and an ambulatory care center.
Three patients (1 woman, 2 men), aged 22, 23, and 40 years at diagnosis.
All 3 patients underwent incisional biopsy.
Clinical description of SANS, ability to make the diagnosis preoperatively, clinical evolution, histologic features, and comparison with the much more frequent NS.
Three patients presented with a lateral palatal nodule (1 case bilateral, 1 case ulcerated) of 7 to 10 days' duration, 0.8 to 1.0 cm in size, slightly or not painful. No patient was correctly diagnosed prior to undergoing a biopsy. In all 3 cases, the biopsy specimen showed acinic necrosis surrounded by a dense polymorphous inflammatory infiltrate with atrophy of ductal cells but no squamous metaplasia. Healing occurred without any further treatment in up to 3 weeks. No recurrence was observed in 2 cases; 1 patient was lost to follow-up.
SANS is a painful spontaneously resolving necrosis of the palatal salivary glands, easily misdiagnosed preoperatively. The main differences from NS are smaller size of lesion, scarcity of ulceration, and absence of squamous metaplasia. Although initially described as a new autonomous entity, SANS might be an early or minimal form of NS.
报告我们关于亚急性坏死性涎腺炎（SANS）的经验，这是一种少见的小唾液腺腭腺病变，并探讨其与坏死性涎腺化生（NS）的关系。
对1996年至2001年间确诊为SANS的患者记录进行回顾性分析。
学术中心、转诊中心及门诊护理中心。
3例患者（1例女性，2例男性），诊断时年龄分别为22岁、23岁和40岁。
所有3例患者均接受了切开活检。
SANS的临床描述、术前诊断能力、临床演变、组织学特征以及与更为常见的NS进行比较。
3例患者均表现为腭部外侧结节（1例双侧，1例溃疡），病程7至10天，大小为0.8至1.0厘米，轻微疼痛或无疼痛。所有患者在活检前均未得到正确诊断。所有3例活检标本均显示腺泡坏死，周围有密集的多形性炎症浸润，导管细胞萎缩，但无鳞状化生。未经进一步治疗，3周内均愈合。2例未观察到复发；1例患者失访。
SANS是腭部涎腺的一种疼痛性、可自发缓解的坏死，术前易误诊。与NS的主要区别在于病变较小、溃疡少见以及无鳞状化生。尽管最初被描述为一种新的独立实体，但SANS可能是NS的早期或轻微形式。
