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Doctoral Thesis
DOI
https://doi.org/10.11606/T.25.2010.tde-02062011-094632
Document
Author
Full name
Renata Bianco Consolaro
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2010
Supervisor
Committee
Sant'Ana, Eduardo (President)
Araujo, Ney Soares de
Capelozza, Ana Lucia Alvares
Crivelini, Marcelo Macedo
Francischone, Leda Aparecida
Title in Portuguese
Análise morfológica microscópica de Mucoceles na mucosa bucal e inter-relação com sua etiopatogenia
Keywords in Portuguese
Doenças das glândulas salivares
Glândulas salivares
Mucocele
Abstract in Portuguese
Avaliamos o perfil dos portadores de Mucoceles bucais e estudamos microscopicamente suas características para correlacioná-las com as possíveis etiopatogenias, especialmente as obstruções ductais promovidas por proliferações epiteliais hiperplásicas e neoplásicas como o papiloma intraductal, Papiloma Ductal Invertido e Sialadenoma Papilífero. Realizamos o levantamento das informações registradas de 987 casos clínicos e suas respectivas peças cirúrgicas foram re-analisadas microscopicamente em cortes teciduais corados em HE. Os dados foram registrados e tabulados para comparações e correlações. A faixa etária mais comprometida foi a segunda e terceira décadas (399 e 345 casos) e o local mais afetado foi o lábio inferior (707 casos). A distribuição entre os gêneros foi praticamente igual. Em 262 casos os pacientes relacionaram a lesão com o traumatismo prévio. Dos 987 casos, 77 (7,8%) foram diagnosticados como Cisto de Retenção Mucosa e (910) como cisto por extrasamento mucoso. Os Cistos de Retenção Mucosa aconteceram predominantemente pacientes acima da quinta década de vida. Algumas situações simultâneas foram identificadas com frequência nas glândulas salivares associadas às Mucoceles, como a Sialadenite Crônica Inespecífica, Sialadenite Crônica Esclerosente ou Tumor de Kuttner, Oncocitose e Sialolitíase. Foram diagnosticados ainda, 21 Papilomas Intraductais, 6 Papilomas Ductais Invertidos e 3 Sialadenomas Papilíferos, além de 27 Proliferações Epiteliais Intraductais de diagnóstico não determinado. Concluímos que: a) além dos traumatismos, na etiopatogenia das Mucoceles bucais deve-se considerar a presença dos Papilomas Ductais como uma importante possibilidade a ser analisada especificamente nas observações microscópicas das peças cirúrgicas enviadas para análise histopatológica, considerando-se a sua natureza neoplásica. b) a Sialolitíase e a Oncocitose devem ser consideradas como causas obstrutivas ductais de Mucoceles bucais em suas análises clínicas e microscópicas. c) as causas obstrutivas parciais e totais podem estar associadas à etiopatogenia das Mucoceles bucais do tipo Cisto por Extravasamento Mucoso, especialmente quando ocorrem próximo ou no interior do corpo glandular. A retenção de muco pode promover a ruptura dos delicados ductos proximais e dos ácinos, promovendo o derramamento de muco no tecido conjuntivo do estroma glandular, iniciando-se o processo no interior da mesma. Quando mais próximas da mucosa bucal, as causas obstrutivas podem não romper o ducto pela sua estrutura epitelial e conjuntiva ser mais espessa e resistente, gerando Cistos de Retenção Mucosa com revestimento epitelial.
Title in English
Microscopic morphological analysis of Mucoceles in the oral mucosa and its interrelationship with etiopathogenesis
Keywords in English
Mucocele
Salivary gland diseases
Salivary glands
Abstract in English
This study evaluated the profile of individuals with oral Mucoceles and investigated their microscopic characteristics with a view to correlate them to the possible etiopathogenesis, especially ductal obstructions caused by hyperplastic and neoplastic epithelial proliferations such as Intraductal Papilloma, Inverted Ductal Papilloma and Sialoadenoma Papilliferum. The study surveyed the records of 987 clinical cases and respective specimens, which were microscopically reanalyzed on tissue sections stained with hematoxylin and eosin. Data were recorded and tabulated for comparisons and correlations. The most affected age range was the second and third decades of life (399 and 345 cases), and the lower lip was the most affected site (707 cases). The distribution between genders was nearly equal. In 262 cases the patients related the lesion to a previous trauma. Among the 987 cases, 77 (7.8%) were diagnosed as mucus retention cyst and (910) as mucus extravasation cyst. The Mucus Retention Cysts affected mainly patients above the fifth decade of life. Simultaneous disorders were often identified in salivary glands associated to the Mucoceles, such as Nonspecific Chronic Sialadenitis, Chronic Sclerosing Sialadenitis or Kuttner Tumor, Oncocytosis and Sialolithiasis. There were also diagnoses of 21 Intraductal Papillomas, 6 Inverted Ductal Papillomas and 3 cases of Sialoadenoma papilliferum, besides 27 Intraductal Epithelial Proliferations of undetermined diagnosis. It was concluded that: a) in addition to trauma, the etiopathogenesis of oral Mucoceles should consider the presence of Ductal Papillomas as an important possibility to be specifically analyzed on the microscopic analysis of specimens submitted to histopathological analysis, considering its neoplastic nature. b) Sialolithiasis and Oncocytosis should be considered as causes of ductal obstruction of oral Mucoceles in the clinical and microscopic analyses. c) the partial and total causes of obstruction may be associated to the etiopathogenesis of oral Mucoceles involving Mucus Extravasation Cysts, especially when they occur close to or inside the gland body. The mucus retention may cause the rupture of fragile proximal ducts and acini, causing the outflow of mucus in the connective tissue of the gland stroma, giving rise to the process inside it. When closer to the oral mucosa, the obstructive causes may not disrupt the duct because its epithelial and connective structure is thicker and more resistant, giving rise to Mucus Retention Cysts with epithelial lining.
 
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Publishing Date
2011-06-02
 
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