| Abstract: |
Context.-Necrotizing sialometaplasia is a benign, self- limited lesion of both major and minor salivary glands, although more commonly the latter. It can represent a diagnostic dilemma and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. A major causal relationship has been ascribed to ischemia. Bulimia, an eating disorder with increasing prevalence in our society, may also be an underlying underreported cause.Objective.-To discuss the potential pathogenesis, diagnostic pitfalls, and the application of immunohistochem- istry as an aid in the diagnosis of necrotizing sialometapla- sia.Data Sources.-This report uses a previously published case history for illustrative purposes and a review of the current literature.Conclusions.-The diagnosis of necrotizing sialometaplasia may be difficult and is reliant upon a well-oriented biopsy section and a complete clinical history. Diagnosis may be further supplemented via immunohistochemistry, demonstrating focal to absent immunoreactivity for p53, low immunoreactivity for MIB1 (Ki-67), and the presence of 4A4/p63- and calponin-positive myoepithelial cells. Interpreted in context collectively, these findings may be helpful adjuncts in the diagnosis of necrotizing sialometa- plasia; nonetheless, to date, hematoxylin-eosin staining remains the gold standard. |
| Keywords: |
immunohistochemistry; adult; clinical feature; histopathology; pathogenesis; review; case report; cigarette smoking; squamous cell carcinoma; carcinoma, squamous cell; ki 67 antigen; biological marker; biological markers; metabolism; diagnosis, differential; differential diagnosis; membrane proteins; health survey; pathology; immunoreactivity; microfilament proteins; protein p53; groups by age; membrane protein; staining; calponin; eosin; hematoxylin; nicotine; protein p63; actin binding protein; calcium binding protein; ckap4 protein, human; adenosquamous carcinoma; myoepithelium cell; salivary gland disease; sex difference; bulimia; salivary gland; salivary gland tumor; calcium-binding proteins; carcinoma, mucoepidermoid; salivary gland neoplasms; salivary glands; sialometaplasia, necrotizing
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