Vagaries in the Labial Minor Salivary Glands Associated with Extravasation Mucoceles- A Histological and Histochemical Pilot Study of 20 cases

Extravasation mucoceles are common in the minor salivary glands (MSG) of the lower lip. The treatment with least recurrence rate is excision along with associated MSG; alterations of which are rarely studied. The present study attempts to identify the deviations noted in labial MSG. Aim: To analyze the histological and histochemical changes in labial MSG lobules close to areas of mucin spillage and correlate clinically. Materials and Methods: Twenty cases of labial extravasation mucoceles and their associated MSG were studied under hematoxylin-eosin and alcian blue stains. Results/Statistics: Left lower lip was commonly affected (70%). The ratio of superficial to deep extravasation phenomenon was 11:9 and 60% were in resorptive stage. The acini were predominantly mucous and 25% showed acinar degeneration. Intralobular ductal dilation was noted in 25% of cases. Inflammation in MSG was evident in all cases- 50% mild, 45% moderate and 5% dense. 60% showed congested blood capillaries and 20% interstitial fibrosis. Recurrence was principally seen in superficial mucoceles, was statistically significant at p=0.02%. Conclusions: Alcian blue stain adds value in detecting the mucous cells and areas of mucin presence. Left lower lip was the common site and superficial mucoceles have a tendency to recur. Recurrence was common in initial lesions and when inflammation in MSG was moderate to dense; though not statistically significant. The related MSG are to be removed to avoid recurrence, since most of them are affected, are a constant source of mucin spillage and show changes such as inflammation and congested blood capillaries predominantly.