Abstract
Küttner tumor/chronic sclerosing sialadenitis is a fibroinflammatory process that characteristically involves the submandibular gland of patients with IgG4-related disease. Histologic examination is often important to make the diagnosis because of its nonspecific clinical and radiologic findings. Microscopically, Küttner tumor should be distinguished from other entities such as extranodal marginal zone lymphoma, Sjögren’s syndrome, and lymphoepithelial sialadenitis. The lesion is histologically well-demarcated with lobular architecture, extensive fibrosis, marked lymphoplasmacytic inflammation, formation of lymphoid follicles, acinar atrophy, and obliterative phlebitis, without the presence of lymphoepithelial lesions. The IgG4-to-IgG positive plasma cell ratio of >40 % is also an important feature to support the diagnosis of Küttner tumor. Moreover, flow cytometry is helpful to exclude a lymphoproliferative process. Clinicians and pathologists should consider the diagnosis of Küttner tumor in patients with elevated serum IgG4 level. Timely and accurate diagnosis is important for appropriate management.
Similar content being viewed by others
References
Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med. 2012;366:539–51.
Kuttner H. Uber entzundiche tumoren der submaaxillar-.speichel-druse. Bruns Beitr Klin Chir. 1986;15:815–34.
Kitagawa S, Zen Y, Harada K, et al. Abundant IgG4-positive plasma cell infiltration characterizes chronic sclerosing sialadenitis (Küttner tumor). Am J Surg Pathol. 2005;29:783–91.
Geyer JT, Ferry JA, Harris NL, et al. Chronic sclerosing sialadenitis (Küttner tumor) is an IgG4-associated disease. Am J Surg Pathol. 2010;34:202–10.
Deshpande V, Zen Y, Chan JKC, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol. 2012;25:1181–92.
Rapidis AD, Stavrianos S, Lagogiannis G, Faratzis G. Tumor of the submandibular gland: clinicopathologic analysis of 23 patients. J Oral Maxillofac Surg. 2004;62:1203–8.
Ochoa ER, Harris NL, Pilch BZ. Marginal zone B-cell lymphoma of the salivary gland arising in chronic sclerosing sialadenitis (Küttner tumor). Am J Surg Pathol. 2001;25:1546–50.
Ihrler S, Baretton GB, Menauer F, et al. Sjogren’s syndrome and MALT lymphomas of salivary glands: a DNA-cytometric and interphase-cytogenetic study. Mod Pathol. 2000;13:4–12.
Culver EL, Hunt A, Crewe E, et al. Immunoglobulin G4 related chronic sclerosing sialadenitis. J Laryngol Otol. 2015;129:226–31.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
No conflict of interest to disclose.
Rights and permissions
About this article
Cite this article
Putra, J., Ornstein, D.L. Küttner Tumor: IgG4-Related Disease of the Submandibular Gland. Head and Neck Pathol 10, 530–532 (2016). https://doi.org/10.1007/s12105-016-0729-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12105-016-0729-2