[Chronic myoepithelial sialadenitis - symptomatology, clinical signs, differential diagnostics]

In the differential diagnosis of mass lesions of the salivary glands, myoepithelial sialadenitis (MESA), i. e. benign lymphoepithelial lesion, carries particular importance because of its association with Sjoegren's syndrome and development of malignant lymphoma. In the present study, epidemiology and clinical findings were analysed in relation to presence of MESA, Sjoegren's syndrome and lymphoma development.

67 patients, histopathologically classified by the salivary gland registry, were analysed retrospectively in regard to their clinical presentation, especially in regard to the chronical process of inflammation as present in MESA.

MESA primarily affects women in the 5th and 6th decade and regularly the parotid gland; in 44.8 % of the cases, there is multiple organ presentation. Xerostomy (38.5 %) is usually present (in 88,9 % of all cases) before or at clinical onset of gland inflammation, whereas xerophthalmy (28.4 %) did not show such a correlation. In general, rheumatic diseases (23.9 %) precede the gland-symptoms in 77.8 % of the patients. In 31.3 % of the cases a Sjoegren's syndrome was present. 26.9 % of the patients developed a malignant Non Hodgkin's Lymphoma (88.9 % of the MALT-type).

The most important clinical relevance of MESA lies in the higher probability to develop malignant lymphoma; this requires adequate staging-procedures and proper histopathological examination of sialogenic and nodal masses, especially over the course of the disease.