[Immunopathologic reactions in chronic sialadenitis of the submandibular gland (so-called Küttner tumor)].

The aim of this study was to investigate immunological aspects of the inflammatory reaction in the submandibular gland during chronic sialadenitis. Specimens of 54 patients registered at the Institute of Pathology at the University of Hamburg were stained according to the indirect immunoperoxidase method. The distribution patterns of Ig-secreting plasma cells (IgA, IgG, IgM) and of the enzymes lactoferrin, lysozyme, and secretory component were analysed. The formation of lymph follicles was also examined. The results were as follows: Stage 1 of the chronic sialadenitis starts as a simple inflammation with an increase of IgA-secreting plasma cells around the ducts. During stage 2 the unspecific, humoral part of the immune system is stimulated. The production of lactoferrin and lysozyme is enhanced. The titer of IgA rises due to activation of the local, specific immune system. The simultaneous rise of the IgG titer is probably caused by production at different sites. During the course of stage 3--4, the cells involved in the local, unspecific immune system are destroyed. The number of IgG secreting plasma cells also decreases. The formation of lymph follicles and the infiltration of the gland by lymphocytes is interpreted as a transition to the cellular immune response. Stage 4 of the Küttner tumor shows similarities to the autoimmune disease of Sjögren's syndrome.