臨床的に多形性腺腫を疑わしめた Necrotizing sialometaplasia の1症例

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One day early in May, 1988, a 31-year-old man noticed a burning pain at the right hard palate, and the lesion became a swelling with spontaneous pain by the middle of that month. On May 20, the swelling of the patient received an abscess incision by a dentist, but the suppuration did not come out.<BR>The patient was referred the Department of Oral and Maxillofacial Surgery 11, Matsumoto Dental College on May 30. The swelling was 15×20mm in size with well demarcation and an incision wound in the center. No abnormality was observed in the radiograph. Under the clinical diagnosis of pleomorphic adenoma, the lesion was extracted on June 1, and was examined histopathologically.<BR>Salivary glands showed necrosis in large area keeping their lobular structures, and adjacent epithelial components, consisting of both acinar and ductal cells, became squamous metaplasia and grew large by forming cell nests. These cells showed no atypism but keratinization. The lesion, therefore, was diagnosed as necrotizing sialometaplasia.<BR>No abnormality nor recurrence was seen 4 months after the operation.<BR>Our case clinically resembles a pleomorphic adeoma in appenarance. So differentiation of necrotizing sialometaplasia from pleomorphic adenoma was discussed in this article.
社団法人日本口腔外科学会の論文