나이에 따른 한국인 정상 이하선의 전산화단층촬영값의 차이

박창서,김기덕,이은숙,정호걸 大韓口腔顎顔面 放射線學會 1999 Imaging Science in Dentistry Vol.29 No.2

Purpose : To determine normal CT number range of parotid gland by analyzing the change by age increase and the difference among individuals and between both sexes in CT number of normal parotid gland. Materials & Methods : 134 subjects who took the CT scan between the period of Jan. 1996 and Dec. 1997 at Yonsei University, Dental Hospital were selected. Criteria for selection were that the patients must be within the normal range clinically and radiologically, and the entire parotid gland on the axial view must be shown. Among the axial views, the one showing the greatest parotid gland size was selected and its CT number was recorded. Also, CT numbers from both masseter muscle were recorded as its control. Results : There was statistically significant correlation between CT number of right and left of parotid glands and masseter muscles. With the increase of age, there is a significant decrease in the CT number of parotid gland(p<0.05). There was no statistically significant difference in CT number between sexes except the 7th decade and beyond age group of parotid gland(p>0.05). Conclusion : As age increases, CT number of parotid gland has a tendency to decrease, and there is no significant difference in the CT numbers between left and right parotid gland. Therefore in the CT scan of patients suspected of having a salivary gland disease of the parotid gland, to consider normal range of the age-dependent CT numbers of parotid gland and compare the CT numbers of the right and left parotid gland might be useful in diagnosing the disease.(J Korean Oral Maxillofac Radiol 1999;29:451-458)

주 타액선 종양에 대한 10년 간의 경험

공일규(Il gyu Kong),장동엽(Dong Yeop Chang),정은정(Eun-Jung Jung),정영호(Young Ho Jung),하정훈(J. Hun Hah),성명훈(Myung-Whun Sung),김광현(Kwang Hyun Kim) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.2

Background and Objectives :This study reports our clinicopathological experiences of major salivary gland tumors. Materials and Methods :This study included 302 patients with major salivary gland tumors who had got the diagnosis from January 1995 through December 2004. Medical records were reviewed retrospectively. Results :We found 244 benign and 58 malignant major salivary gland tumors. Among 267 parotid tumors, the most common benign parotid tumor was pleomorphic adenoma. Mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma were three most common parotid malignancies. Among 33 submandibular gland tumors, 20 cases were benign and 13 were malignant. There were one benign and one malignant su-blingual gland tumors. The duration of symptom of submandibular gland tumors was longer than that of parotid tumors. Most patients presented with asymptomatic mass. Seventy-one percent of salivary gland malignancies underwent postoperative radiation therapy. Five-year disease free survival rate of parotid malignant tumors seemed to be higher than that of submandibular one, although there was no statistical significance. Conclusion :Malignancy rate of each salivary gland followed old axiom that it is inversely related with the size of gland. Submandibular gland tumor tends to be delayed to reach diagnosis. Clinicians must be alert about this finding because submandibular gland tumors are known to have poorer prognosis than parotid tumors.

원발성 이하선 편평상피세포암종

임지훈(Ji Hoon Lim),이상욱(Sang Wook Lee),이창걸(Chang Gcol Lee),박원(Won Park),박정수(Cheong Soo Park),김귀언(Gwi Eon Kim),양우익(Wook Ick Yang),서창옥(Chang Ok Suh),금기창(Ki Chang Keum) 대한두경부종양학회 1997 대한두경부 종양학회지 Vol.13 No.2

Squamous cell carcinoma originating in the parotid gland has rare occurrence. The primary squamous cell carcinoma of the parotid gland comprise about 0.3% and 9.8% of all parotid malignant tumor. We investigated the clinical behavior and treatment outcome of patients with primary squamous cell carcinoma of the parotid gland. We reviewed all cases of possible primary squamous cell carcinoma of the parotid gland treated at Yonsei Cancer Center, Seoul, Korea, from 1981 through 1995. A total of 128 had primary parotid malignancy. Metastatic squamous cell carcinoma and mucoepidermoid carcinoma were excluded in this study. Ten cases of primary squamous cell carcinoma of the parotid gland were identified. 6 cases of them are men & 4 cases are women. The age of patients ranged from 31 to 68 years with median age of 55 years. On physical examination, 5 cases had palpated cervical neck node and 6 cases had facial nerve palsy. Staging was done according to the current guidelines established by the American Joint Committee on Cancer (1992). Two cases were stage I, 1 in stage III, and 7 in stage IV. Six cases were performed operation and postoperative radiation therapy. Four cases were treated by curative radiation therapy, dose of more than 65 Gy on parotid gland region. The 5 year actual survival rate and the 5 year disease free survival rate were 30.8%, and 40.0%. Initial complete response rate was 70% for all patients. Local failure were occurred 3 of 7 patients with local controlled cases, failure sites were primary site, ipsilateral cervical neck node, contralateral supraclavicular node. Most recurrences developed within 1 year of initial treatment. Distant metastasis was appeared 2 of 3 patients who did not achieved local control. Primary squamous cell carcinoma of the parotid gland occured infrequently. A retrospective study at the Yonsei Cancer Center indicates incidence of 7.8%. At diagnosis, advanced stage, neck node presentation, facial nerve paralysis were associated with a poor prognosis. These results may suggested that radical surgical excision may be treatment of choice and that planned postoperative radiotherapy may be bendicial for reducing locoregional recurrence rates.

이하선 천엽에 발생한 지방종의 치험례

김정한(Jung-Han Kim),김철훈(Chul-Hoon Kim),김민구(Min-Gu Kim),송진우(Jin-Woo Song),정유진(Eu-Gene Jung),김복주(Bok-Joo Kim) 대한구강악안면외과학회 2010 대한구강악안면외과학회지 Vol.36 No.5

A lipoma is a benign tumor of matured adipose tissue that usually occurs at the shoulder, back, and abdomen. 13% of lipomas occur in the head and neck area. However, the incidence of lipoma in the parotid gland is very low, approximately 2.5%. A conservational surgical excision is recommended in cases of lipoma of the parotid gland, with only 1-2% of lipomas recurring. We report a case of a lipoma in the parotid gland that was removed by conservational surgical excision. The lesion was exposed by the pre-auricular approach and the tissue was detached. After the parotid gland envelop was exposed, a yellowish mass is observed that was easy to remove due to capsulation. Most authors recommend a surgical excision of the superficial lobe of the parotid gland as the treatment for a lipoma in the parotid gland. However, enucleation only may be a sufficient treatment when a lipoma occurs in the superficial lobe or around the parotid gland. A patidectomy is not needed when a lipoma is located at the superficial lobe of the parotid gland, and a conservational surgical excision is suitable. Therefore, a clinical diagnosis is important for reducing the damage to the facial nerve.

Comparative Morphological Study on Parotid and Submandibular Salivary Glands in Ovariectomized Rats

정문진,Myoung-Hwa Lee,임도선,Myeongju Jeong,Soon-Jeong Jeong 한국치위생과학회 2022 치위생과학회지 Vol.22 No.2

Background: Estrogen deficiency affects the structure and function of the salivary glands in women, leading to a decrease in salivary secretion and a change in the composition of saliva. Previous studies on changes in the salivary glands that cause estrogen deficiency have reported only partial results for the parotid and submandibular glands, and there are few comparative morphological studies of histological changes between the parotid and submandibular glands in ovariectomized rats (OVX) leading to estrogen deficiency. This study aimed to analyze the histopathological and histochemical changes in the parotid and submandibular salivary glands causing estrogen deficiency by using OVX, and to discuss the mechanism on these changes.Methods: The parotid and submandibular glands from sacrificed control and OVX groups were fixed with cold 4% paraformaldehyde in phosphate buffer (pH 7.2). The tissues were dehydrated using a series of graded ethyl alcohol and embedded in paraffin. For histopathological analysis, sections cut to a thickness of 6 to 7 µm were stained with hematoxylin and eosin (H&E). For histochemical analysis, Periodic acid-Schiff (PAS), Alcian blue (AB, pH 2.5), and PAS+AB (pH 2.5 and pH 1) staining was performed.Results: Histopathological analysis of OVX tissue showed that the parotid and submandibular salivary glands were broadly and clearly separated and divided into lobes. In OVX, acinar and ductal cells with condensed polymorphic or pyknotic nucleus, which are presumed to be characteristic of apoptotic cells, and degenerated cells with lipid deposition in cytoplasmic granules and ruptured membranes were increased. Histochemical analysis of OVX, confirmed an increase in the number and acidification of acinar secretory granules.Conclusion: Histopathological and histochemical changes and the effects of estrogen deficiency are more evident in the submandibular salivary gland than in the parotid gland.

이하선에 생긴 지방종 증례

김형준,권호,임영민,정성노 대한두개안면성형외과학회 2007 Archives of Craniofacial Surgery Vol.8 No.1

Purpose: Lipomas are common soft tissue neoplasms but are rarely found in the parotid gland. They constitute 1-3% of all parotid tumors, and are often not considered in the initial differential diagnosis of parotid gland tumors. Methods: Our experience is a case of 70-year-old male who had a slow growing, nontender parotid mass for 1 year. CT scan showed a well encapsulated mass with fat density in the superficial lobe of left parotid gland. Lumpectomy including fatty mass and adjacent gland tissue was performed, preserving branches of facial nerve. Results: Frozen section showed lipomatous lesion without malignancy, so, further treatment such as superficial parotidectomy was not needed. Conclusion: Though lipoma of parotid gland is rare, lipoma should be included in the initial differential diagnosis of parotid gland tumors and lumpectomy would be enough to treat lipoma if frozen section excluded the possibility of malignancy.

이하선 주위 림프절 전이를 동반한 안와 주위 암종의 수술적 치료

최은창,김철호,임영창,손은진 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.3

Background and Objectives:Malignant orbital tumors represent a diverse group of neoplasms such as malignant salivary tumors, squamous cell carcinoma, sarcoma, melanoma etc. A number of orbital tumors have a potential for lymphatic metas-blished. The purpose of this study was to review lymphatic spread of malignant orbital tumors and its surgical treatment of orbital cancer when metastasized to the parotid gland. Materials and Methods:Five orbital cancer patients with lymph node metastasis of parotid gland were evaluated retrospectively. They had been treated by resection of primary tumor, par-otidectomy, neck dissection and postoperative radiotherapy (except one case) from 1994 to 2000. Histopathology revealed Results:There were no complications postoperatively. Four cases had metastasis to intraglandular lymph nodes in the parotid gland and only one case had metastasis to preauricular lymph node. Two cases had metastasis to preglandular lymph nodes and prevascular lymph nodes in the level I lymph node. Thre were NED (no evidence of disease), rhabdomyosarcoma case was DOD (died of disease) due to recurrence in submental area and breast and malignant melanoma case was AWD (alive with disease). Conclusion:Most orbital cancers with lymph nodes of the parotid gland have metastasis to intraglandular lymph nodes, but some of them does to extraglandular lymph nodes also. The examination of the parotid gland and the cervical lymph node must be considered in orbital cancers that have a potential for lymphatic metastasis. The results of this study indicates the need to include deep lobe and extraglandular lymph node of parotid gland for surgical removal of disease. (Korean J Otolaryngol 2002;45:273-8)

흰쥐 침샘에서 Carbonic Anhydrase 동위효소 Ⅳ와 Ⅸ의 분포에 관한 면역조직화학적 연구

조태영,이송은,남광일,정채용,안규윤,배춘상,김백윤,박성식 대한해부학회 2009 Anatomy & Cell Biology Vol.42 No.4

This study presents distribution of carbonic anhydrase (CA) isozymes Ⅳ and Ⅸ, membrane associated forms, and CA Ⅰ and Ⅱ, cytoplasmic forms, in rat parotid and submandibular glands using Western blot analysis and immunohistochemical staining. Western blot analysis demonstrated that CAs Ⅰ, Ⅱand Ⅸ were found to be abundantly expressed, but CA Ⅳ was weakly expressed in parotid gland. Submandibular gland expressed abundant CAs Ⅰ and Ⅱ, weak CA Ⅸ, and undetectable level of CA Ⅳ. In hematoxylin-eosin staining, parotid gland was entirely composed of serous acini and their ducts while submandibular gland was mixed population of serous and mucous lobules. Most of lobules (submandibular gland proper type) contained mostly serous acini and their ducts with granular convoluted duct. Some lobules (sublingual gland type) contained mostly mucous acini with serous demilune and their ducts without granular convoluted duct. In parotid gland, CAs Ⅳ and Ⅸ were immunolocalized in duct cells and not in serous acinar cells. Immunoreactivity for CAs Ⅰ and Ⅱ was also detectable in duct cells. Serous acinar cells were positive for CA Ⅱ, and negative for CA Ⅰ. In submandibular gland, CAs Ⅳ and Ⅸ were immunolocalized in duct cells but not in acinar cells of both types of lobules. Immunoreactivity for CAs Ⅰand Ⅱ was also detectable in duct cells of both types of lobules. Cells of serous acini and serous demilune were positive for CA Ⅱ, and negative for CA Ⅰ. Mucous cells were negative for both CAs Ⅰ and Ⅱ. These results demonstrate the distribution of CA isoenzymes in parotid and submandibular glands of the rat, and suggest CAs Ⅳ and Ⅸ as well as CAs Ⅰ and Ⅱ are related to electrolytes metabolism of saliva in duct cells. 침샘에서 carbonic anhydrase (CA) 동위효소의 발현 여부를 관찰하고자 흰쥐 귀밑샘과 턱밑샘을 대상으로 CAs Ⅰ, Ⅱ, Ⅳ 및 Ⅸ 동위효소에 대한 항체를 사용하여 면역조직화학 염색을 시행하였고, 이들 조직에서 각각의 CA 동위효소 단백발현을 Western blot 분석을 시행하여 확인하였다. Western blot 분석 결과 귀밑샘은 CAs Ⅰ, Ⅱ와 Ⅸ는 강하게 발현되었고 CA Ⅳ는 미약하게 발현되었다. 턱밑샘에서는 CAs Ⅰ과 Ⅱ는 강하게 발현되었으나 Ca Ⅸ는 미약하게 발현되었고 CA Ⅳ는 발현되지 않았다. H-E 염색에서 귀밑샘은 장액샘꽈리와 도관으로 구성되어 있었으며 턱밑샘은 샘의 대부분을 차지하는 고유턱밑샘형 소엽과 점액샘꽈리와 장액반달로 구성된 혀밑샘형 소엽으로 되어 있었다. 면역조직화학 염색에서 귀밑샘은 CA Ⅳ, Ⅸ 및 Ⅰ의 반응은 사이관, 줄무늬관 및 소엽사이관 같은 도관세포에서 양성을 보이고 샘꽈리세포에서는 음성이었다. CA Ⅱ 반응은 도관세포와 샘꽈리세포에서 양성이었다. 턱밑샘의 고유턱밑샘형 소엽에서 CA Ⅳ, Ⅸ 및 Ⅰ의 반응은 도관세포에서는 양성반응을 보였으나 샘꽈리세포에서는 음성이었다. CA Ⅱ 반응은 도관세포와 장액샘꽈리세포에서 모두 양성이었다. 턱밑샘의 혀밑샘형 소엽에서 CAs Ⅳ, Ⅸ 및 Ⅰ 반응은 도관세포에서는 양성을 보였으나 샘꽈리세포에서는 음성이었다. CA Ⅱ 반응은 도관세포와 장액반달세포에서 양성이었으나 점액샘꽈리세포에서는 음성이었다. 이상의 관찰로 흰쥐 귀밑샘과 턱밑샘에 분포하는 CA 동위효소의 분포를 확인하였으며, 침 도관세포에서의 전해질 대사는 CAs Ⅰ과 Ⅱ뿐 아니라 CAs Ⅳ와 Ⅸ도 관여할 것으로 추측되었다.

흰쥐 침샘에서 Carbonic Anhydrase 동위효소 IV와 IX의 분포에 관한 면역조직화학적 연구

조태영(Tae Young Cho),이송은(Song Eun Lee),남광일(Kwang Il Nam),정채용(Chaeyong Jung),안규윤(Kyu Youn Ahn),배춘상(Choon Sang Bae),김백윤(Baik Yoon Kim),박성식(Sung Sik Park) 대한해부학회 2009 Anatomy & Cell Biology Vol.42 No.4

침샘에서 carbonic anhydrase(CA) 동위효소의 발현 여부를 관찰하고자 흰쥐 귀밑샘과 턱밑샘을 대상으로 CAs I, II, IV 및 IX 동위효소에 대한 항체를 사용하여 면역조직화학 염색을 시행하였고, 이들 조직에서 각각의 CA 동위효소 단백발현을 Western blot 분석을 시행하여 확인하였다. Western blot 분석 결과 귀밑샘은 CAs I, II와 IX는 강하게 발현되었고 CA IV는 미약하게 발현되었다. 턱밑샘에서는 CAs I과 II는 강하게 발현되었으나 Cs IX는 미약하게 발현하게 발현되었고 CA IV는 발현되지 않았다. H-E 염색에서 귀밑샘은 장액샘꽈리와 도관으로 구성되어 있었으며 턱밑샘은 샘의 대부분을 차지하는 고유턱밑샘형소엽과 점액샘꽈리와 장액반달로 구성된 혀밑샘형 소엽으로 되어 있었다. 면역조직화학 염색에서 귀밑샘은 CA IV, IX 및 I의 반응은 사이관, 줄무늬관 및 소엽사이관 같은 도관세포에서 양성을 보이고 샘꽈리세포에서는 음성이었다. CA II 반응은 도관세포와 샘꽈리세포에서 양성이었다. 턱밑샘의 고유턱밑샘형 소엽에서 CA IV, IX 및 I의 반응은 도관세포에서는 양성 반응을 보였으나 샘꽈리세포에서는 음성이었다. CA II 반응은 도과세포와 장액샘꽈리세포에서 모두 양성이었다. 턱밑샘의 혀밑샘형 소엽에서 CAs IV, IX 및 I 반응은 도관세포에서는 양성을 보였으나 샘꽈리세포에서는 음성이었다. CA II 반응은 도과세포와 장액반달세포에서 양성이었으나 점액샘꽈리세포에서는 음성이었다. 이상의 관찰로 흰쥐 귀밑샘과 턱밑샘에 분포하는 CA 동위 효소의 분포를 확인하였으며, 침 도관세포에서의 전해질 대사는 CAs I과 II뿐 아니라 CAs IV와 IX도 관여할 것으로 추측되었다. This study presents distribution of carbonic anhydrase(CA) isozymes IV and IX, membrane associated forms, and CA I and II, cytoplasmic forms, in rat parotid and submandibular glands using Western blot analysis and immunohistochemical staining. Western blot analysis demonstrated that CAs I, II and IX were found to be abundantly expressed, but CA IV was weakly expressed in parotid gland. Submandibular gland expressed abundant CAs I and II, weak CA IX, and undetectable level of CA IV. In hematoxylin-eosin staining, parotid gland was entirely composed of serous acini and their ducts while submandibular gland was mixed population of serous and mucous lobules. Most of lobules (submandibular gland proper type) contained mostly serous acini and their ducts with granular convoluted duct. Some lobules (sublingual gland type) contained mostly mucous acini with serous demilune and their ducts without granular convoluted duct. In parotid gland, CAs IV and IX were immunolocalized in duct cells and not in serous acinar cells. Immunoreactivity for CAs I and II was also detectavle in duct cells. Serous acinar cells were positive for CA II, and negative for CA I. In submandibular gland, CAs IV and IX were immunolocalized in duct cells but not in acinar cells of both types of lobules. Immunoreactivity for CAs I and II was also detectable in duct cells of both types of lobules. Cells of serous acini and serous demilune were positive for CA II, and negative for CA I. Mucous cells were negative for both CAs I and II. These results demonstrate the distribution of CA isoenzymes in parotid and submandibular glands of the rat, and suggest CAs IV and IX as well as CAs I and II are related to electrolytes metabolism of saliva in duct cells.

원발성 이하선 비호지킨 림프종 : 증례보고

조건,서인석,탁경석,박영규,고응열,성하민,신미경 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.2

Purpose: Primary malignant lymphomas of the salivary glands are uncommon, representing only 1.7%to 3.1% of all salivary neoplasms and 0.6% to 5% of all tumors and tumor-like lesions of the parotid gland. Lymphomas of the parotid glands are usually manifestations of a systemic disease process but primary lymphomas of the parotid glands are rare. Most of these lesions are classified as extranodal non-Hodgkin's lymphoma. We report the clinicopathological features of primary malignant lymphoma of the parotid gland based on an analysis of our cases. Methods: The subject was a 48-year-old male patient with a malignant lymphoma originating in the parotid gland, which had been slowly increasing in size over previous 6 months. The diagnosis was established by MRI and a superficial lobectomy. After diagnosis, the patient was referred to an oncologist for staging and medical treatment. Results: The stage was IIIA. The patient was treated with chemotherapy following surgery with rituximab and CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). The tumor was controlled successfully by chemotherapy. The patient was followed up for 1 year with no relapse. Conclusion: A case of primary non-Hodgkin's lymphoma of the parotid gland was treated with a superficial parotidectomy and chemotherapy. The disease was well controlled after a 1 year follow-up. (J Korean Cleft Palate Craniofac Assoc 11: 99, 2010)