Role of microliths in the aetiology of chronic submandibular sialadenitis: a clinicopathological investigation of 154 cases

Aims: Confusion about the aetiology and pathogenesis of chronic submandibular sialadenitis led to the present investigation of 154 cases in which many clinical and histological features were analysed. Methods and results: By far the greatest number of histological factors, namely liths, atrophy, fib...

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Bibliographic Details
Published in:Histopathology 1997-09, Vol.31 (3), p.237-251
Main Authors: HARRISON, J.D., EPIVATIANOS, A., BHATIA, S.N.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Atrophy - pathology
Biological and medical sciences
calculi
Fibrosis - pathology
Humans
Inflammation - pathology
Medical sciences
microlithiasis
Middle Aged
Non tumoral diseases
Otorhinolaryngology. Stomatology
Salivary Gland Calculi - pathology
Sex Factors
sialadenitis
Sialadenitis - etiology
Sialadenitis - pathology
submandibular gland
Submandibular Gland - pathology
Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
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Summary:Aims: Confusion about the aetiology and pathogenesis of chronic submandibular sialadenitis led to the present investigation of 154 cases in which many clinical and histological features were analysed. Methods and results: By far the greatest number of histological factors, namely liths, atrophy, fibrosis, parenchymal inflammation, lymphoid germinal centres, mucous and ciliary metaplasia, salivary extravasation and glycosaminoglycan accumulation, was related to the degree of inflammation, which appears to be of the greatest importance in the aetiology and pathogenesis. Inflammation, atrophy and fibrosis were related to duration of symptoms, which supports the concept of a chronological progression through increasingly severe histological changes. Conclusions: Inflammation possibly arises from ascending infection in a normal gland and exerts an obstructive and destructive effect on the parenchyma with the development of the related histological changes and a vicious circle involving further ascending infection. Normal glands contain microliths that possibly by localized obstruction cause atrophic foci that are reservoirs for ascending infection. Microliths and liths were unrelated: microliths were related to age as in normal glands whereas liths were related to duration of symptoms and appeared to be secondary to the sialadenitis. Many glands showed minimal changes, which raises the possibility of conservative treatment.
ISSN:0309-0167
1365-2559
DOI:10.1046/j.1365-2559.1997.2530856.x