Barbuscia M A, Caizzone A, Vecchio D A, Mirone S, Putortì A, Cingari E A, Scardigno M R, Ilaqua A, Cavallari V
University of Messina, Italy.
G Chir. 2011 Oct;32(10):429-33.
A recent case led the authors to re-examine the clinical characteristics of the cervical ectopia of the major salivary glands. These glands develop in the embryo between the sixth and seventh week, starting with the formation of endodermal invaginations of the branchial section of the floor of the primitive mouth. These cell cords, initially solid, proliferate in the underlying mesenchyme, starting from the opening of the future excretory duct, and subsequently branch and canalize. During embryogenesis, the endodermal invaginations become closely interconnected with the adjacent lymphatic tissue. It is thus possible for lymphoid tissue to migrate into the parotid or the other major salivary glands, or conversely, for salivary tissue to become included in the cervical lymph nodes. Very rarely, ectopic salivary gland tissue can also be found in other unusual locations, including the neck region, as a result of a developmental abnormality of the branchial apparatus. The base of the neck is the most common location, while ectopia of the mid third of the neck is quite rare. The authors discuss the clinical details and diagnostic procedure leading to preoperative diagnosis. This congenital anomaly can, albeit rarely, degenerate into cancer, and surgical excision is thus imperative.
最近的一个病例促使作者重新审视大唾液腺颈部异位的临床特征。这些腺体在胚胎发育的第六至第七周开始形成,起始于原始口腔底部鳃部内胚层的内陷。这些最初为实性的细胞索在未来排泄管开口处开始在其下方的间充质中增殖,随后分支并形成管道。在胚胎发生过程中,内胚层内陷与相邻的淋巴组织紧密相连。因此,淋巴组织有可能迁移到腮腺或其他大唾液腺中,反之,唾液组织也可能被纳入颈部淋巴结。由于鳃器发育异常,极罕见情况下,异位唾液腺组织也可在其他不寻常的部位发现,包括颈部区域。颈部底部是最常见的部位,而颈部中三分之一处的异位则相当罕见。作者讨论了导致术前诊断的临床细节和诊断程序。这种先天性异常虽然很少见,但可能恶变为癌症,因此手术切除势在必行。