MORPHOLOGICAL JUSTIFICATION OF THE SALIVARY GLAND TISSUE RESECTION BOUNDARIES DURING SURGICAL TREATMENT OF PATIENTS WITH PLEOMORPHIC ADENOMAS

Abstract

The aim is to substantiate morphologically the resection boundaries of the salivary gland tissue in the surgical treatment of patients with pleomorphic adenoma of different histological variants. Materials and methods: The study used autopsy, surgical and biopsy material, divided into 2 groups. Group 1 included autopsy material (n=6), represented by tissue fragments of the parotid salivary gland, in which macroscopic and microscopic examination did not reveal any general pathological processes. Group 2 included surgical and biopsy material from 30 patients, represented by pleomorphic adenomas with adjacent tissue of the salivary gland at a distance of 0.5 cm and 1.0 cm. Histological, morphometric and statistical research methods were used. Results: The morphological features of the salivary gland tissue which was adjacent to the pleomorphic adenoma at a distance of 1.0 cm, practically corresponded to the physiological norm. However, the tissue of the salivary gland, bordering the tumor at a distance of 0.5 cm, was characterized by pronounced changes. These changes were: violation of the ratio of the specific volumes of the parenchyma and stroma; atrophy of the terminal sections and ducts with cystic expansion of some ducts; thickening of the secretion and formation of calculi in the lumen of some ducts; atrophic and alterative changes in the epithelial lining the terminal sections and ducts; sclerosis and lipomatosis, areas with hyalinosis and dystrophic calcification in the stroma; hemodynamic disturbances in the stroma with a decrease in the number of vessels; pronounced focal or diffuse immune infiltration in the stroma in some areas with the lymphoid follicles formation. Conclusion: The comprehensive study has confirmed that removal of the tumor with the adjacent tissue of the salivary gland at a distance of 1.0 cm in patients with pleomorphic adenoma of various histological variants is the most justified from the morphological point of view.