Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken

Chievitz’s Organ

  • Jacqueline E. van der WalEmail author
Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-28845-1_669-1

Synonyms

Anatomy

A normal anatomical structure, considered of neuroepithelial origin, first described in 1885 by JH Chievitz, a Danish anatomist.

Located bilateral, within the soft tissue overlying the angle of the mandible in the buccotemporal space.

A small fusiform structure, interposed between the fascia buccotemporalis and pterygoid muscles.

Innervated by branches of the buccal nerve.

It is believed to represent an anlage of the parotid gland.

Function

  • Mechanosensor in the lateral wall of the oral cavity involved in deglutition, sucking, mastication, and speech

  • Abundant enzyme activity similar to that found in ductal cells of salivary glands (alkaline phosphatase and carbonic anhydrase activity)

  • Neurosecretory function (presence of intracellular neurosecretory granules)

  • Might be influenced by buccal nerve and pituitary gland

Size and Weight

0.7–1.7 cm in length and 0.1–0.2 cm in width.

Macroscopy

Grossly not visible. By dissecting microscope, it appears to be a flat, white solid strand of tissue resembling a nerve.

Microscopy

Epithelial islands embedded in organized connective tissue stroma rich in nerves (Figs. 1 and 2).
Fig. 1

Microscopical view of Chievitz’s organ showing epithelial islands within organized connective tissue (hematoxylin and eosin) (Courtesy of Prof. Dr. P.J. Slootweg, Department of Pathology, UMC St. Radboud, Nijmegen, The Netherlands)

Fig. 2

Detail of Fig. 1

The circumscribed, multilobulated epithelial nests rest on a basement membrane and are located both around and within nerves. The epithelial cells resemble nonkeratinizing squamous epithelial cells or columnar–glandular-like cells with clear cytoplasm. The clear central cells stain positive within the periodic acid-Schiff (PAS) reaction. The outer, smaller cells may have a basaloid appearance.

The epithelial nests are surrounded by an organized connective tissue, divided into three layers: stratum fibrosum internum (thin, dense collagen, few elastic fibers), stratum nervosum (middle layer, loose connective tissue rich in myelinated and nonmyelinated nerve fibers), and stratum fibrosum externum (envelops the entire organ, connected to fascia buccotemporalis). Within the connective tissue layers, mast cells, lymphocytes, and melanin-containing cells are present.

Immunohistochemistry

Central epithelial cells cytokeratin positive (CK19, CK10, CK14); outer, more basaloid cells negative.

Positive for vimentin and EMA (weakly).

Negative for S-100, GFAP (glial fibrillary protein), and neuroendocrine markers (chromogranin, synaptophysin, neuron-specific enolase).

Differential Diagnosis

  • Squamous cell carcinoma

  • Mucoepidermoid carcinoma

  • Perineural invasion by squamous cell carcinoma or other carcinomas

References and Further Reading

  1. Chievitz, J. H. (1885). Beitrage zur Entwicklungsgeschichte der Speicheldrusen. Virchows Archiv für Pathologische Anatomie und Physiologie und für Klinische Medizin, 9, 401–436.Google Scholar
  2. Danforth, R. A., & Baughman, R. A. (1979). Chievitz’s organ: A potential pitfall in oral cancer diagnosis. Oral Surgery, Oral Medicine, and Oral Pathology, 48, 231–236.CrossRefPubMedGoogle Scholar
  3. Ide, F., Mishima, K., & Saito, I. (2003). Juxtaoral organ of Chievitz presenting clinically as a tumor. Journal of Clinical Pathology, 56, 789–790.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Pantanowisz, L. (2004). Immunophenotype of the juxtaoral organ. International Journal of Oral and Maxillofacial Surgery, 33, 113.CrossRefGoogle Scholar
  5. Pantanowitz, L., & Balogh, K. (2003). Significance of the juxtaoral organ (of Chievitz). Head & Neck, 25, 400–405.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PathologyThe Netherlands Cancer Institute, Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands