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Head and Neck Pathology

, Volume 10, Issue 4, pp 530–532 | Cite as

Küttner Tumor: IgG4-Related Disease of the Submandibular Gland

  • Juan Putra
  • Deborah L. Ornstein
Sine qua non Clinicopathologic Correlation

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.

Keywords

Küttner tumor Chronic sclerosing sialadenitis IgG4-related disease 

Notes

Compliance with Ethical Standards

Conflict of interest

No conflict of interest to disclose.

References

  1. 1.
    Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med. 2012;366:539–51.CrossRefPubMedGoogle Scholar
  2. 2.
    Kuttner H. Uber entzundiche tumoren der submaaxillar-.speichel-druse. Bruns Beitr Klin Chir. 1986;15:815–34.Google Scholar
  3. 3.
    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.CrossRefPubMedGoogle Scholar
  4. 4.
    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.CrossRefPubMedGoogle Scholar
  5. 5.
    Deshpande V, Zen Y, Chan JKC, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol. 2012;25:1181–92.CrossRefPubMedGoogle Scholar
  6. 6.
    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.CrossRefPubMedGoogle Scholar
  7. 7.
    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.CrossRefPubMedGoogle Scholar
  8. 8.
    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.CrossRefPubMedGoogle Scholar
  9. 9.
    Culver EL, Hunt A, Crewe E, et al. Immunoglobulin G4 related chronic sclerosing sialadenitis. J Laryngol Otol. 2015;129:226–31.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineDartmouth-Hitchcock Medical CenterLebanonUSA

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