Department of Biological Sciences, State University of Feira de Santana (UEFS), Feira de Santana, Bahia, Brazil.
Department of Pathology, School of Medical Sciences, State University of Campinas, Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Head Neck Pathol. 2024 May 13;18(1):42. doi: 10.1007/s12105-024-01651-4.
This study aimed to characterize the histopathological immunohistochemical features of chronic sclerosing sialadenitis, emphasizing the IgG4-related disease.
Seventeen cases of chronic sclerosing sialoadenitis were examined for histopathological aspects, (inflammation, fibrosis, glandular parenchyma, and lymphoid follicles) and immunohistochemistry (BCL2, CD3, CD20, CD34, CD163, p63, cyclin D1, mast cell, SMA, S100A4, IgG, and IgG4) which were scored. IgG4-related disease features were investigated. Demographic and clinical data were also collected.
Males predominated (10:7), with an average lesion size of 3.9 cm. Common histopathological findings included reduced acinar parenchyma, lymphoid follicle formation, and ductular proliferation. CD3-positive T lymphocytes and CD34- and SMA-positive stromal fibroblasts were abundant. Nine cases (53%) showed sialoliths and three cases met the criteria for IgG4-related disease.
CSS of the submandibular gland represents a reactive pattern rather than IgG4-RD as only 3 cases seemed to be related to IgG4-RD. The immunohistochemical profile revealed an abundant population of CD3-positive T lymphocytes, as opposed to regulatory proteins such as cyclin D1, demonstrating that populations of CD34- and SMA-positive stromal fibroblasts contribute to the fibrosis characteristic of CSS. In addition, our results provide a comprehensive insight into the study of CSS and its relationship with IgG4-RD.
本研究旨在描述慢性硬化性涎腺炎的组织病理学免疫组化特征，重点关注 IgG4 相关疾病。
对 17 例慢性硬化性涎腺炎病例进行组织病理学观察（炎症、纤维化、腺实质和淋巴滤泡）和免疫组化（BCL2、CD3、CD20、CD34、CD163、p63、cyclin D1、肥大细胞、SMA、S100A4、IgG 和 IgG4）评分，并研究 IgG4 相关疾病特征。同时收集了患者的人口统计学和临床资料。
男性居多（10 例男性，7 例女性），平均病变大小为 3.9cm。常见的组织病理学发现包括腺实质减少、淋巴滤泡形成和导管增生。CD3 阳性 T 淋巴细胞和 CD34 和 SMA 阳性基质成纤维细胞丰富。9 例（53%）有涎石，3 例符合 IgG4 相关疾病的标准。
下颌下腺的 CSS 表现为反应性模式，而不是 IgG4-RD，因为只有 3 例似乎与 IgG4-RD 相关。免疫组化分析显示大量 CD3 阳性 T 淋巴细胞，而不是 cyclin D1 等调节蛋白，表明 CD34 和 SMA 阳性基质成纤维细胞的群体有助于 CSS 的纤维化特征。此外，我们的研究结果为 CSS 及其与 IgG4-RD 的关系提供了全面的认识。
