首次报告--颞下颌关节韧带内和颞下颌关节韧带附近的腮腺组织瘤

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2024-07-22 DOI:10.1016/j.oooo.2024.07.006

Scotty Bolding DDS , S. Bryan Whitaker DDS , R. Constance Wiener DMD, PhD , Jerry E. Bouquot DDS, MSD

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引用次数: 0

摘要

报告颞下颌关节韧带和关节囊异位唾液腺的首例病例。偶然发现九名患有慢性颞下颌关节疾病的受试者在受损的颞下颌关节韧带和囊内或附近有异位唾液腺（绒毛膜瘤）。现总结 12 例颞下颌关节病的临床病理特征。9 名受试者的年龄在 22-64 岁之间（平均 = 43.0），其中 6 人为女性。显微镜检查发现，除 1 个样本外，所有样本的韧带几乎全部被致密的无血管纤维瘢痕组织取代。3 个样本的基质中存在慢性炎症细胞。韧带和/或韧带囊内嵌或附近共有 33 个大小不等的分叶状独立唾液结构。其中一半位于同一关节中；13 个位于单个受试者的双侧关节中，其中一个颞下颌关节中有 8 个小腺叶。所有腺体均由组织学上正常的浆液性尖头组成，只有一个腺体显示出局灶性的粘液性尖头小叶，另一个腺体仅由粘液性尖头组成。连续切片显示与腮腺没有联系。一些绒毛膜瘤出现了脂肪浸润（7 例）和肿瘤细胞增多（7 例）的老化现象。此外，12 个颞下颌关节样本中有 3 个包含耳前淋巴结，其中 1 个关节有 3 个淋巴结，1 个受检者为双侧受累。在已确定的 5 个淋巴结中，除一个外，其余均为增生性淋巴结，并伴有非特异性炎性组织细胞增生症。我们首次报告了颞下颌关节软组织内的独立唾液腺绒毛膜瘤（33 个）（12 个），其中一个关节包含 8 个此类绒毛膜瘤。除一个粘液腺外，其余均为正常浆液组织。此外，四分之一的颞下颌关节手术样本中含有增生的耳前淋巴结。

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First report on parotid tissue choristomas within and adjacent to TMJ ligaments

Objective

To report the first examples of ectopic salivary glands of TMJ ligaments & capsules.

Methods and Materials

Nine subjects with chronic TMJ disorders were found incidentally to have ectopic salivary glands (choristomas) within or near damaged TMJ ligaments and capsules. Clinicopathologic characteristics of 12 TMJs are summarized.

Results

The 9 subjects were ages 22-64 years (average = 43.0); 6 were female. Microscopic examination revealed major, almost complete ligament replacement by dense, avascular fibrous scar tissue in all but 1 sample. Chronic inflammatory cells were present in the stroma of 3 samples. A total of 33 lobular, independent salivary structures of variable sizes were embedded in or near ligaments and/or capsules. Half were multiple in the same joint; 13 were bilaterally located in the joints of a single subject, with 8 small glandular lobules in one TMJ. All glands consisted of histologically normal serous acini except 1 which showed a focal lobule of mucus acini and another comprised only of mucus acini. Serial sections showed no connection to parotid glands. Some choristomas showed the aging phenomena of fatty infiltrates (n = 7) and oncocytosis (n = 7). Additionally, 3 of the 12 TMJ samples contained preauricular lymph nodes, with 3 nodes in 1 joint and bilateral involvement in 1 subject. Of the 5 identified nodes, all but one was hyperplastic, with nonspecific inflammatory histiocytosis.

Conclusions

We report, for the first time, independent salivary gland choristomas (n = 33) within the soft tissues of the TMJ (n = 12), with one joint containing 8 such choristomas. All consisted of normal serous tissue except one, a mucus gland. Additionally, a fourth of TMJ surgical samples contained hyperplastic preauricular lymph nodes.

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.