Abundant IgG4-positive plasma cell infiltration characterizes chronic sclerosing sialadenitis (Küttner's tumor).
Chronic sclerosing sialadenitis (CSS) is a cryptogenic tumor-like condition of the salivary gland(s). While immune-mediated processes are suspected in its pathogenesis, and CSS is occasionally reported to be associated with sclerosing pancreatitis, an IgG4-related disease, the exact immunopathologic processes of CSS remain speculative. In this study, we examined the clinicopathologic findings of CSS (12 cases) in comparison with sialolithiasis (8 cases) and Sjogren's syndrome (13 cases), and tried to clarify whether CSS is an IgG4-related disease or not. Submandibular gland(s) were affected in all cases of CSS. CSS cases could be divided into two types: 5 cases were associated with sclerosing lesions in extrasalivary glandular tissue (systemic type), while only salivary gland(s) were affected in the remaining 7 cases (localized type). In the former type, which showed male predominance, bilateral salivary glands were frequently affected, and eosinophilia and elevations of gamma-globulin and IgG in serum were frequently found. Histologically, all cases of CSS showed marked lymphoplasmacytic infiltration admixed with fibrosis and the destruction of glandular lobules. Obliterative phlebitis was found in the affected salivary glands in all cases of CSS. Immunohistochemically, the proportion of IgG4/IgG-positive plasma cells was more than 45% in CSS, while it was less than 5% in controls. The resemblance of the clinicopathologic features of CSS with those of sclerosing pancreatitis suggests the participation of a similar immunopathologic process with IgG4 disturbance in CSS. The abundance of IgG4-positive plasma cells in the lesions would be useful for distinguishing CSS from other forms of sialadenitis.
Kitagawa
Satoshi
S
Department of Human Pathology, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
Zen
Yoh
Y
Harada
Kenichi
K
Sasaki
Motoko
M
Sato
Yasunori
Y
Minato
Hiroshi
H
Watanabe
Kishichiro
K
Kurumaya
Hiroshi
H
Katayanagi
Kazuyoshi
K
Masuda
Shinji
S
Niwa
Hideki
H
Tsuneyama
Koichi
K
Saito
Katsuhiko
K
Haratake
Joji
J
Takagawa
Kiyoshi
K
Nakanuma
Yasuni
Y
D000368:Aged; D015209:Cholangitis, Sclerosing; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications; D010950:Plasma Cells / Q000276:immunology*; D015494:Salivary Gland Calculi / Q000150:complications; D012598:Sclerosis / Q000473:pathology; D012793:Sialadenitis / Q000150:complications / Q000276:immunology* / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications
D007074:Immunoglobulin G