- Serum and histological IgG4-negative type 1 autoimmune pancreatitis. [Journal Article]
- CJClin J Gastroenterol 2018 Nov 10
- A 66-year-old man who was on oral medication for type 2 diabetes experienced a rapid decline in glycemic control (increase in glycosylated hemoglobin level from 7.7 to 10.2% over 3 months). Abdominal...
A 66-year-old man who was on oral medication for type 2 diabetes experienced a rapid decline in glycemic control (increase in glycosylated hemoglobin level from 7.7 to 10.2% over 3 months). Abdominal ultrasonography revealed a 20-mm hypoechoic mass in the pancreatic tail. Serum tumor marker carbohydrate antigen 19-9 and DUPAN2 levels were within the respective normal ranges; serum IgG4 level was also normal at 21.8 mg/dL. Abdominal contrast computed tomography revealed a 26-mm tumor in the pancreatic tail. Magnetic resonance cholangiopancreatography revealed disruption of the main pancreatic duct and dilation of the caudal pancreatic duct. Endoscopic ultrasonography revealed a near-round-shaped hypoechoic mass with interspersed hyperechoic areas. Endoscopic ultrasonography-guided fine needle aspiration was performed using a 22-G needle, but no malignant findings were observed. There were no signs of sialadenitis, retroperitoneal fibrosis, nephropathy, or other conditions associated with IgG4-related diseases. Distal pancreatectomy was performed; a 23-mm white mass was resected from the pancreatic tail. A histopathological examination showed advanced inflammatory cell infiltration mainly involving lymphocytes/plasma cells along with storiform fibrosis and obliterative phlebitis. No more than five IgG4-positive cells were observed per high-power field. These were level 1 pathological findings, and a definitive diagnosis of type 1 autoimmune pancreatitis (AIP) was made according to the International Consensus Diagnostic Criteria. Type 1 AIP associated with normal serum IgG4 levels and absence of IgG4-positive cells on histological examination is a rare clinical entity, which is very difficult to distinguish from pancreatic cancer. Here we report such a case and present a review of the relevant literature.
- Salivary calculi microbiota: new insights into microbial networks and pathogens reservoir. [Journal Article]
- MIMicrobes Infect 2018 Oct 29
- Sialolithiasis represents the most common disorders of salivary glands in middle-aged patients. It has been hypothesized that the retrograde migration of bacteria from the oral cavity to gland ducts ...
Sialolithiasis represents the most common disorders of salivary glands in middle-aged patients. It has been hypothesized that the retrograde migration of bacteria from the oral cavity to gland ducts may facilitate the formation of stones. Thus, in the present study, a microbiome characterization of salivary calculi was performed to evaluate the abundance and the potential correlations between microorganisms constituting the salivary calculi microbiota. Our data supported the presence of a core microbiota of sialoliths constituted principally by Streptococcus spp., Fusobacterium spp. and Eikenella spp., along with the presence of important pathogens commonly involved in infective sialoadenitis.
- Sialendoscopy for Definitive Management of a Submandibular Abscess following Radiotherapy for Oropharyngeal Squamous Cell Carcinoma. [Case Reports]
- OJORL J Otorhinolaryngol Relat Spec 2018 Oct 31; :1-4
- CONCLUSIONS: Sialendoscopy should thus, in select patients, be considered as an initial intervention for patients with intraparenchymal salivary gland abscesses in which prior therapy creates an increased risk of complication from an open transcervical approach.
- The synergistic effect of NOD2 and TLR4 on the activation of autophagy in human submandibular gland inflammation. [Journal Article]
- JOJ Oral Pathol Med 2018 Oct 26
- CONCLUSIONS: TLR4 and NOD2 have unique expression sites in salivary glands, and they may synergistically activate autophagy in salivary glands under conditions of inflammation. This article is protected by copyright. All rights reserved.
- Interleukin 5-producing ST2+ memory Th2 cells in IgG4-related dacryoadenitis and sialadenitis. [Journal Article]
- MRMod Rheumatol 2018 Oct 25; :1-5
- CONCLUSIONS: We demonstrated that there is an increase of interleukin-5 producing ST2+ memory Th2 cells in the involved tissues in IgG4-DS. This subset of cells is considered to be an important player in inducing the inflammatory Th2 environment characteristic of IgG4-DS.
- Abundant a proliferation-inducing ligand (APRIL)-producing macrophages contribute to plasma cell accumulation in immunoglobulin G4-related disease. [Journal Article]
- NDNephrol Dial Transplant 2018 Oct 15
- CONCLUSIONS: Abundant infiltration into tissue lesions of APRIL-producing M2 macrophages and retention of secreted APRIL in plasma-cell-rich areas support a role for APRIL in the pathogenesis of plasma cell-rich lesions in IgG4-RD.
- Intraductal Pneumatic Lithotripsy after Extended Transoral Duct Surgery in Submandibular Sialolithiasis. [Journal Article]
- OHOtolaryngol Head Neck Surg 2018 Oct 09; :194599818802224
- Objective Persistent, residual, or recurrent stones after transoral duct surgery are always associated with hilar to intraparenchymal and/or multiple sialolithiasis, causing difficulties in the treat...
Objective Persistent, residual, or recurrent stones after transoral duct surgery are always associated with hilar to intraparenchymal and/or multiple sialolithiasis, causing difficulties in the treatment. This study was performed to assess the value of intraductal lithotripsy in the treatment of persistent, residual, or recurrent sialolithiasis after extended duct surgery in the submandibular gland. Study Design Retrospective study covering February 2015 to June 2018. Study Setting Tertiary referral center for salivary gland diseases. Subjects and Methods After extended ductal surgery, 39 patients presenting with persistent, residual, or recurrent stones were treated. Four patients had persistent stones; 16 had residual stones; and 19 presented with recurrent stones. Among these patients, 50 stones were treated with intraductal pneumatic lithotripsy. Fragmentation rate, stone-free rate, and symptom-free rate after treatment with intraductal lithotripsy were outcome measures. Results Of the 39 patients, 97.4% became stone-free, and all were symptom-free. Ninety-eight percent of the stones were completely fragmented. For 23.1% of the patients, >1 stone was treated with intraductal lithotripsy. All patients with persistent stones, 93.7% of those with residual stones, and all with recurrent stones became stone-free and symptom-free. No severe complications developed. Conclusions This study shows that patients presenting with difficult and/or multiple sialolithiasis after extended transoral submandibular duct surgery can be treated with success rates >97%. For multiple sialolithiasis in particular, a multimodal treatment approach with interventional sialendoscopy and intraductal lithotripsy as a central element is a prerequisite for success, as this enables the most difficult part to be performed with high success rates.
- Mitochondrial disorder mimicking rheumatoid disease. [Journal Article]
- ZRZ Rheumatol 2018 Oct 05
- CONCLUSIONS: Seronegative and non-destructive polyarthralgia and unexplained cutaneous features mimicking cutaneous lupus should be considered as a phenotypic feature of a multisystem MID (mitochondrial multiorgan disorder syndrome, MIMODS). Mitochondrial metabolic defects may trigger secondary immune reactions. Core clinical features of a non-specific MID with infantile onset include symptomatic myopathy, endocrine abnormalities, cardiac conduction defects, dysmorphism, hyperlipidemia, anemia, and nephrolithiasis.
- Efficiency of Ultrasonography in Swellings of Orofacial Region. [Journal Article]
- NJNiger J Surg 2018 Jul-Dec; 24(2):82-89
- CONCLUSIONS: USG was found to be a reliable diagnostic modality in the diagnosis of orofacial swellings.
New Search Next
- Histopathology of salivary glands. [Journal Article]
- RReumatismo 2018 Oct 03; 70(3):146-154
- Salivary gland (SG) biopsy is a technique broadly applied for the diagnosis of primary Sjögren's syndrome (pSS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and IgG4-related disease The most ...
Salivary gland (SG) biopsy is a technique broadly applied for the diagnosis of primary Sjögren's syndrome (pSS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and IgG4-related disease The most peculiar feature of pSS on biopsy is focal lymphocytic sialadenitis. In the past, several histological scores have been reported in the literature to describe glandular involvement during pSS. However, the variability among centres in reporting glandular scores is one of the rationales behind the development of standardised consensus guidance. SGs as well as lacrimal glands are involved in up to 50% of patients with IgG4-related disease with 3 histopathological hallmarks such as dense lymphoplasmacytic infiltration, storiform fibrosis and obliterative phlebitis. SGs can be also affected by amyloidosis with MSG biopsy being more sensitive than that of rectal mucosa or subcutaneous fat. SG involvement is a rare manifestation during sarcoidosis, and the presence of non-caseating granulomas needs to be differentiated from granulomas of other etiology. This review article provides an overview of normal and pathological SGs in the context of rheumatic diseases, identifying key elements in the tissue as diagnostic and prognostic biomarkers, useful in the current clinical practice.