Journal
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
Volume 43, Issue 10, Pages 1276-1281Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2014.06.014
Keywords
IgG4-related dacryoadenitis and sialoadenitis; Mikulicz's disease; IgG4-related disease; labial salivary gland biopsy; submandibular gland biopsy
Categories
Funding
- Ministry of Education, Culture, Sports, Science, and Technology of Japan [26293430]
- Takeda Science Foundation
- Grants-in-Aid for Scientific Research [26293430, 26670869] Funding Source: KAKEN
Ask authors/readers for more resources
IgG4-related dacryoadenitis and sialoadenitis (IgG4-DS) is characterized by serum IgG4 elevation and the infiltration of IgG4-positive plasma cells in glandular tissues. For definitive diagnosis of IgG4-DS, biopsies of local lesions are recommended to exclude Sjogren's syndrome (SS), malignant tumours, and similar disorders. In this study, we examined the diagnostic utility of submandibular gland (SMG) and labial salivary gland (LSG) biopsies in IgG4-DS. Fourteen patients presenting with swelling of the SMG (eight females and six males) underwent both SMG and LSG biopsies. The sensitivity, specificity, and accuracy of SMG biopsies were all 100.0%. In contrast, those of LSG biopsies were 69.2%, 100.0%, and 71.4%, respectively. Thirty-three out of 61 LSG biopsies (54.1%) from all 14 patients were positive for the diagnostic criteria of IgG4-DS (IgG4-positive/IgG-positive plasma cells >0.4). None of the patients experienced complications such as facial nerve palsy, sialocele, or hyposalivation. The IgG4/IgG ratio showed no significant correlation between the LSG and SMG. The final diagnosis was IgG4-DS in 13 patients and marginal zone B-cell lymphoma (MZL) in one. These results suggest that incisional biopsy of the SMG is useful and appropriate for the definitive diagnosis of IgG4-DS, while diagnosis by LSG biopsy alone requires more caution.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available