Foulsham C K, Johnson G S, Snyder G G, Carpenter R J, Shafi N Q
Ann Clin Lab Sci. 1984 Jan-Feb;14(1):47-63.
A retrospective study of various benign salivary gland neoplasms was designed to study the frequency distribution and density of immunoglobulins (Igs) located within their various tissue compartments. Buffered-formalin fixed, paraffin embedded sections of Warthin's tumor, cystadenoma, oncocytoma, autoimmune thyroiditis, normal salivary gland, and reactive peripheral lymph node were obtained and processed via the peroxidase-antiperoxidase method following trypsinization to re-expose antigenic sites. The subepithelial and parafollicular zones of Warthin's tumor show an Ig density distribution (IgA greater than or equal to IgG) much greater than IgM, but the relative densities in the germinal center are (IgG = IgM) much greater than IgA. In contrast, the normal salivary gland displays almost exclusively IgA positive cells with only an occasional IgG or IgM positive cell. In general, the three salivary gland neoplasms considered all display a relatively similar frequency distribution with (IgA greater than or equal to IgG) much greater than IgM and much greater densities of all Igs than encountered in the normal salivary gland; however, the densities of IgA and IgG positive cells are greatest in Warthin's tumor. A similar frequency distribution of immunocytes in the parafollicular zone of autoimmune thyroiditis and Warthin's tumor is noted with an increased density of all Igs occurring in autoimmune thyroiditis. A significant increase in the density of IgA immunocytes is noted in the germinal centers of autoimmune thyroiditis. A comparison of Warthin's tumor with a reactive peripheral lymph node shows a marked increase in the density and frequency of IgA in the parafollicular zone in the former lesion, and significant elevations of IgG and IgM in the latter process both in the parafollicular zone and in the germinal centers. No data generated by this study support an autoimmune etiology of Warthin's tumor. Histopathologically, the oncocytoma appears to represent a pathologic entity distinctly different from papillary cystadenoma lymphomatosum. Our data tend to support the hypothesis that Warthin's tumor arises within ectopic salivary gland elements trapped within paraparotid or intraparotid lymph nodes during embryogenesis. The cystadenoma appears to represent a similar pathologic process arising in salivary gland elements independent of lymphoid tissue.
一项针对各种涎腺良性肿瘤的回顾性研究旨在探讨免疫球蛋白（Igs）在其不同组织成分中的频率分布和密度。获取了经缓冲福尔马林固定、石蜡包埋的沃辛瘤、囊腺瘤、嗜酸性细胞瘤、自身免疫性甲状腺炎、正常涎腺及反应性外周淋巴结的切片，并在胰蛋白酶消化以重新暴露抗原位点后，通过过氧化物酶-抗过氧化物酶法进行处理。沃辛瘤的上皮下和滤泡旁区显示出免疫球蛋白密度分布（IgA大于或等于IgG）远高于IgM，但生发中心的相对密度为（IgG = IgM）远高于IgA。相比之下，正常涎腺几乎仅显示IgA阳性细胞，仅有偶尔的IgG或IgM阳性细胞。总体而言，所考虑的三种涎腺肿瘤均显示出相对相似的频率分布，即（IgA大于或等于IgG）远高于IgM，且所有免疫球蛋白的密度均远高于正常涎腺；然而，IgA和IgG阳性细胞的密度在沃辛瘤中最高。自身免疫性甲状腺炎的滤泡旁区和沃辛瘤中的免疫细胞频率分布相似，自身免疫性甲状腺炎中所有免疫球蛋白的密度均增加。自身免疫性甲状腺炎的生发中心中IgA免疫细胞的密度显著增加。沃辛瘤与反应性外周淋巴结的比较显示，在前者病变的滤泡旁区IgA的密度和频率显著增加，而在后者的滤泡旁区和生发中心中IgG和IgM均显著升高。本研究产生的数据不支持沃辛瘤的自身免疫病因。组织病理学上，嗜酸性细胞瘤似乎代表一种与乳头状囊腺瘤淋巴瘤明显不同的病理实体。我们的数据倾向于支持这样的假说，即沃辛瘤起源于胚胎发育过程中被困在腮腺旁或腮腺内淋巴结中的异位涎腺成分。囊腺瘤似乎代表在独立于淋巴组织的涎腺成分中发生的类似病理过程。
