chronic sclerosing sialadenitis

An uncommon unilateral inflammatory condition affecting the submandibular gland, which may mimic neoplasia.

Aetiology
Idiopathic, stones, microliths, infection, immune-related, linked to reduced salivary flow, increased viscosity. Long-standing obstruction causes inflammation leading to acinar atrophy and fibrosis. The most extreme manifestation of this process is the so-called Kuttner tumour—a rock-hard, tumour-like areas of end-stage fibrosis and lymphoplasmacytic inflammation, which may be accompanied by metaplasia (squamous, mucous, ciliated, oncocytic) in the ducts.

DiffDx
Lymphoma, lymphoepithelial lesion.

References in periodicals archive

Abundant IgG4-positive plasma cell infiltration characterizes chronic sclerosing sialadenitis (Kuttner's tumor).

Immunoglobulin G4-related disease complicated with vascular lesions: CT findings in 21 patients

He underwent excision of a submandibular gland, and the pathology revealed chronic sclerosing sialadenitis, with a large subset of inflammatory cells positively staining for IgG4 (Figure 2).

Thoracic Paravertebral Mass as an Infrequent Manifestation of IgG4-Related Disease

Kuttner, a German physician, who described a series of patients with a unilateral, hard, tumour-like mass of submandibular gland, which histologically showed features of chronic sclerosing sialadenitis (1).

Chronic Sclerosing Sialadenitis (Kuttner tumour): A Rare Entity Mimicking Malignancy.

Kuttner tumour--a rare clinical entity with diagnostic dilemma

In addition to the pulmonary lesions, increased numbers of IgG4-positive plasma cells were present in regional nodes and in areas of chronic sclerosing sialadenitis of 1 patient.

Update on nonneoplastic pulmonary lymphoproliferative disorders and related entities

DISCUSION: Chronic sclerosing sialadenitis or Kuttner tumor or cirrhosis of submandibular gland, although one of the common disease affecting submandibular gland, is still underrecognised, with only few publications about this entity in the literature (6,7)., This tumor was first described by Kuttner in 18968.

(1.) Ochoa, Erin Rubin MD, Harris, et al: Marginal zone B cell lymphoma of salivary gland arising in chronic sclerosing sialadenitis (Kuttner tumor).

Cirrhosis of submandibular gland (Kuttners tumor)

Chronic sclerosing sialadenitis often exclusively involves the submandibular gland, occasionally with a bilateral presentation.

Kuttner tumor (chronic sclerosing sialadenitis) of the submandibular gland: an underrecognized entity.

Epithelioid cell clusters with an extensive lymphoid background: a common cytologic architectural pattern in the diagnosis of salivary gland lesions by fine-needle aspiration biopsy