- Describe what you see in the salivary gland.
On cross sections, a small yellow-tan stone is present. Microscopically, the parenchyma shows extensive chronic inflammation and fibrosis (scarring). The scarring is characterized by an increased amount of collagenous tissue around the ducts and acini. There is extensive atrophy of acini. Mucus (with a few neutrophils) is present in the larger duct lumens. The chronic inflammatory infiltrate consists of lymphocytes, with fewer plasma cells and macrophages.
- What was the role of the salivary duct lithiasis?
Obstruction is often a contributing factor to the development of inflammation, as normal flow of lumenal contents is blocked. Infection is also more likely to occur in such a setting. In this case, obstruction with chronic inflammation led to the scarring and atrophy. In older persons, the secretions are more likely to become inspissated and cause duct blockage.
- What is the diagnosis?
Chronic sialadenitis.
