Tükrük Bezi Hastalıkları
Özet
Tükrük bezleri; parotis, submandibuler ve sublingual olmak üzere üç çift majör bez ile yüzlerce minör bezden oluşur ve günlük ortalama 1-1.5 litre salgı üretir. Bu bezler anatomi, embriyoloji, histoloji ve fizyoloji açısından farklılıklar gösterir; örneğin parotis en büyük bez olup seröz salgı yaparken, submandibuler mikst, sublingual ise müköz karakterde salgı üretir. Tükrük bezi patolojilerinin tanısında sialografi, ultrasonografi, bilgisayarlı tomografi, MR, sintigrafi, ince iğne aspirasyon sitolojisi ve sialoendoskopi gibi yöntemlerden yararlanılır. Bezlerin hastalık yelpazesi oldukça geniştir; viral (en sık kabakulak) ve akut bakteriyel enfeksiyonlar, neonatal ve kronik siyaloadenitler, Sjögren sendromu ve sarkoidoz gibi granülomatöz/otoimmün süreçler ile siyalolitiazis (taş), ranula ve mukus kistleri gibi reaktif ve obstrüktif lezyonlar sıkça görülür. Tümörlerin %80’i benign (en sık pleomorfik adenom ve Warthin tümörü) ve çoğunlukla parotis yerleşimlidir. Malign neoplaziler arasında ise en sık mukoepidermoid karsinom, adenoid kistik karsinom ve asinik hücreli karsinom ile karşılaşılır. Bu hastalıkların ayırıcı tanısında doğru klinik, radyolojik ve histopatolojik değerlendirme, uygun tedavi stratejisinin belirlenmesinde kritik bir rol oynamaktadır.
The salivary glands consist of three pairs of major glands—parotid, submandibular, and sublingual—and over a hundred minor glands, producing an average of 1-1.5 liters of secretion daily. These glands exhibit distinct anatomical, embryological, histological, and physiological characteristics; the parotid is the largest gland producing serous secretion, whereas the submandibular gland is mixed, and the sublingual gland is predominantly mucous. Diagnostic modalities for salivary gland pathologies include sialography, ultrasonography, computed tomography, MRI, scintigraphy, fine-needle aspiration cytology, and sialoendoscopy. The spectrum of salivary gland diseases is highly broad, encompassing viral (most commonly mumps) and acute bacterial infections, neonatal and chronic sialadenitis, granulomatous or autoimmune processes such as Sjögren's syndrome and sarcoidosis, as well as reactive and obstructive lesions like sialolithiasis (calculi), ranula, and mucus retention cysts. Approximately 80% of salivary gland tumors are benign (most frequently pleomorphic adenoma and Warthin's tumor) and mainly located in the parotid gland. Among malignant neoplams, mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma are the most frequently encountered types. Accurate clinical, radiological, and histopathological evaluation is essential for the differential diagnosis and formulation of effective treatment strategies.
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