Kontaxis A, Zanarotti U, Kainz J, Beham A
Universitätsklinik Graz - HNO.
Laryngorhinootologie. 2004 Mar;83(3):185-8. doi: 10.1055/s-2004-814267.
Oncocytes are epithelial cells characterized by an granular, eosinophilic cytoplasma, and a centrally situated, pycnotic nucleus. These cells were first observed by Hamperl 1931 in the salivary glands. Ultrastructural studies have shown that the cytoplasma of these cells is filled with numerous large and bizarre mitochondria. The exact biological significance of oncocytes is unknown - Becker, Donath and Seifert suggest an intracellular metabolic disturbance associated with mitochondriopathy, caused by an age dependent metabolic defect. Oncocytes are not specific for the salivary glands; they are also found in the thyroid gland, parathyroid gland, liver, pancreas, esophagus and the kidney. Solitary oncocytes appear most often as incidental findings in aging salivary tissue, they are present in persons older than 70 years up to 80 %. The diffuse hyperplastic oncocytosis of the parotid gland represents an extremely rare, non-tumorous alteration of the parotid gland. Caused by an extensive metaplasia of acinic and ductal cells nearly the entire gland consists of oncocytes. Clinically it is characterized by swelling of the parotid gland. Oncocytic adenomatous hyperplasia is a different disease. It represents a multifocal oncocytic proliferation of the duct system. In contrast to diffuse oncocytosis remnants of the original salivary tissue with acini and fatty tissue are usually present between the oncocytic nodules. Typical oncocytomas may possibly develop from such oncocytic proliferation by a tendency to confluent growth.
Cases of diffuse hyperplastic oncocytosis of the parotid gland were identified by literature review.
Worldwide diffuse hyperplastic oncocytosis of the parotid gland has been observed in 8 cases (Fig. ) as of today.
We report and discuss the case of a 78-year-old male, who was refered to our hospital because of a painless mass of the left parotid gland. MRI showed a tumorous lesion with a diameter of about 5 cm. Lateral parotidectomy was performed. Histology revealed an extremely rare case of diffuse hyperplastic oncocytosis. There has been no recurrence of tumor after 2 years.
Diffuse hyperplastic oncocytosis of the parotid gland is an extremely rare benign disorder, complete excision of the tumor-like lesion is curative. In literature there has been no report of recurrence, malignant transformation or metastasizing illness.
嗜酸性细胞是一种上皮细胞，其特征为细胞质呈颗粒状、嗜酸性，细胞核位于中央且固缩。这些细胞于1931年由汉佩尔首次在唾液腺中观察到。超微结构研究表明，这些细胞的细胞质中充满了大量形态怪异的大线粒体。嗜酸性细胞的确切生物学意义尚不清楚——贝克尔、多纳特和赛弗特认为这与线粒体病相关的细胞内代谢紊乱有关，是由年龄依赖性代谢缺陷引起的。嗜酸性细胞并非唾液腺所特有；它们也见于甲状腺、甲状旁腺、肝脏、胰腺、食管和肾脏。单个嗜酸性细胞最常作为衰老唾液组织中的偶然发现出现，在70岁以上人群中其出现率高达80%。腮腺的弥漫性增生性嗜酸性细胞增多症是一种极其罕见的腮腺非肿瘤性改变。由腺泡细胞和导管细胞的广泛化生引起，几乎整个腺体都由嗜酸性细胞组成。临床上其特征为腮腺肿胀。嗜酸性细胞腺瘤样增生是一种不同的疾病。它表现为导管系统的多灶性嗜酸性细胞增殖。与弥漫性嗜酸性细胞增多症不同，嗜酸性细胞结节之间通常存在带有腺泡和脂肪组织的原始唾液组织残余。典型的嗜酸性细胞瘤可能由这种嗜酸性细胞增殖通过融合生长的趋势发展而来。
通过文献回顾确定腮腺弥漫性增生性嗜酸性细胞增多症的病例。
截至目前，全世界已观察到8例腮腺弥漫性增生性嗜酸性细胞增多症（图）。
我们报告并讨论一例78岁男性患者，因左侧腮腺无痛性肿块转诊至我院。磁共振成像显示一个直径约5厘米的肿瘤性病变。行腮腺外侧切除术。组织学检查发现一例极其罕见的弥漫性增生性嗜酸性细胞增多症。2年后肿瘤无复发。
腮腺弥漫性增生性嗜酸性细胞增多症是一种极其罕见的良性疾病，将肿瘤样病变完整切除可治愈。文献中尚无复发、恶变或转移疾病的报道。
