Abstract
Pathological diagnosis is important for the definite diagnosis of immunoglobulin G4-related
sialadenitis (IgG4-RS). Core needle biopsy (CNB) is a scarless technique; however
the pathological heterogeneity of IgG4-RS (a particular feature of this disease) could
be the potential cause of the inferior diagnostic capability of submandibular gland
CNB (SMG-CNB) for IgG4-RS. The aim of this study was to explore technical improvements
in SMG-CNB and improve its diagnostic power in IgG4-RS diagnosis. Eighteen patients
clinically suspected for IgG4-RS were enrolled and underwent both SMG-CNB and SMG
surgical biopsy. A navigation system (Brainlab) was employed during SMG-CNB to obtain
representative samples and avoid blood vessel injury. Histopathological and immunopathological
findings for the SMG-CNB samples were in good concordance with SMG surgical biopsy.
There was no statistically significant difference between SMG-CNB and SMG surgical
biopsy in IgG-positive cell count (132.4 ± 59.3 vs 132.2 ± 47.5, P = 0.99), IgG4-positive cell count (102.2 ± 39.7 vs 97.2 ± 27.6, P = 0.67), or IgG4-positive/IgG-positive cell count ratio (78.6% ± 0.1% vs 75.2% ± 0.1%,
P = 0.29). A moderate or strong significant correlation was found between SMG-CNB and
SMG surgical biopsy for these cell counts and ratio (all P < 0.01). The diagnostic consistency of SMG-CNB and SMG surgical biopsy was 100%.
The Brainlab navigation system may assist in collecting representative SMG-CNB samples
from typical pathological lesions. Tissues obtained from SMG-CNB are sufficient for
the pathological diagnosis of IgG4-RS. Standardized SMG-CNB is expected to replace
SMG surgical biopsy for IgG4-RS diagnosis.
Keywords
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Article info
Publication history
Published online: January 20, 2023
Accepted:
January 13,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
