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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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SHORT COMMUNICATION  
Year : 2017  |  Volume : 21  |  Issue : 1  |  Page : 162-164
 

Juxtaoral organ of Chievitz: An innocuous organ to be known


1 Department of Oral Pathology and Microbiology and Forensic Odontology, School of Dental Sciences, Krishna Institute of Dental College and Hospital, Karad, Maharashtra, India
2 Department of Oral and Maxillofacial Pathology, V.S. Dental College and Hospital, Bengaluru, Karnataka, India

Date of Submission03-Feb-2017
Date of Acceptance06-Feb-2017
Date of Web Publication5-Apr-2017

Correspondence Address:
Sushma Basavaraj Bommanavar
Department of Oral Pathology and Microbiology and Forensic Odontology, School of Dental Sciences, Krishna Institute of Dental College and Hospital, Karad, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomfp.JOMFP_22_17

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   Abstract 


The Juxtaoral Organ of Chievitz is a normal anatomical structure located within the soft tissue in the buccotemporal fascia on the medial surface of the ascending ramus. This enigmatic vestigial structure is considered to be of neuroepithelial origin with no known function. As a matter of fact, JOOC is one of the most treacherous pitfalls in surgical pathology with respect to lesions in the head and neck area. Hence the basic aim of this short communication is to reveal the importance about this organ and enlighten the oral pathologist about this histopathological structure, thus preventing extensive and unnecessary investigations.


Keywords: Buccotemporal fascia, epithelial islands, Juxtaoral organ of Chievitz, normal anatomical structure, oral squamous cell carcinoma


How to cite this article:
Bommanavar SB, Hema K N, Baad R. Juxtaoral organ of Chievitz: An innocuous organ to be known. J Oral Maxillofac Pathol 2017;21:162-4

How to cite this URL:
Bommanavar SB, Hema K N, Baad R. Juxtaoral organ of Chievitz: An innocuous organ to be known. J Oral Maxillofac Pathol [serial online] 2017 [cited 2021 Jul 24];21:162-4. Available from: https://www.jomfp.in/text.asp?2017/21/1/162/203778





   Introduction Top


The Juxtaoral organ of Chievitz (JOOC) is a normal anatomical structure considered of neuroepithelial origin with no known function is located within the soft tissue in the buccotemporal fascia on the medial surface of the ascending ramus.[1],[2] JH Chievitz, a Danish anatomist, first described JOOC in 1885 while studying human embryos.[3] However, this structure is not only unique for adults but also has been reported in some other species and in reptiles.[4],[5] This enigmatic vestigial structure has been designated with various other names depending on its embryologic origin as orbital inclusions, buccopharyngeal tract, buccotemporal organ and juxtaoral organ.[6] As a matter of fact, the only practical importance of awareness of this structure lies in the potential of being misdiagnosed as perineural invasion in a patient with oral squamous cell carcinoma, which can be one of the most treacherous pitfalls in oral pathology.[7] Hence, the basic aim of this short communication is to reveal the importance about this organ and enlighten the oral pathologist about this histopathological structure, thus preventing extensive and unnecessary investigations. It also includes a concise biography on the scientist who discovered it.


   Concise Biography Of The Scientist Who Discovered This Organ Top


Johan Henrik Chievitz (1851–1901) was a Danish anatomist. He was born on October 16, 1850, in Svendborg which is a town on the island of Funen in South Central Denmark. Chievitz graduated in 1869 from Soro, which is a town in Region Sjælland on the island of Zealand in East Denmark. He got his medical degree in 1875. He practiced a short time before he was employed in 1877, in the anatomy under Professor Theodor Schmidt (1825–1880). In 1881, he won the university's gold medal for a thesis on ossification. JOOC is named for him after his description in 1885. He noted it in 10-week-old embryos during his study on the development of salivary glands.[3]


   Origin Of This Organ Top


Originally thought to be of embryonic origin, JOOC starts as an epithelial thickening of the stomodeum and invaginates into the subjacent mesenchyme. This epithelial bud then detaches from the oral epithelium and becomes innervated by a buccal nerve branch receiving vascular supply from the buccal artery. The JOOC measures between 7 mm and 15 mm in length and between 1 mm and 2 mm in diameter. If it is more than 10 mm in diameter, then clinicians are likely to suspect submucosal tumor or hyperplasia of JOOC.[8],[9]


   Histopathological Aspect Of This Organ Top


Microscopically, the epithelial component consists of circumscribed nests of nonkeratinizing squamous, columnar and occasionally, basaloid epithelial cells with a definite glandular or organoid pattern with no keratin formation.[3]

Three concentric domains of connective tissue encase the epithelial islands as shown in [Figure 1] and [Figure 2].
Figure 1: Hand drawn illustration showing epithelial component with circumscribed nests of nonkeratinized squamous, columnar and basaloid epithelial cells with a definite glandular or organoid pattern with no keratin formation within loose connective tissue stroma representative of Juxtaoral organ of Chievitz. The Juxtaoral organ of Chievitz is composed of nests of epithelial parenchyma embedded in highly organized connective tissue stroma rich in nerve bundles (Courtesy: Jerad M Gardner, MD, University of Arkansas for Medical Sciences, USA; Daifullah Al Aboud et al. 2014)

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Figure 2: Courtesy: Arvind Venkatesh, Department of Oral Pathology and Microbiology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India. Well-circumscribed epithelial sprouts present within the loose connective tissue stroma representative of juxtaoral organs of Chievetz (H and E, ×100). Inset: Cells showing paler cytoplasm and clear cell-like features (H and E, ×1000) Juxtaoral organ of Chievitz: A histopathological masquerade. Indian J Med Paediat Oncol 2015;36:193

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  • The inner layer called stratum fibrosum internum consists of dense collagen fibers that are separated from the epithelial islands by a distinct basal lamina[10],[11]
  • The middle layer, stratum nervosum, is characterized by loose connective tissue stroma, populated with myelinated and nonmyelinated fibers[10],[12]
  • The outer layer, the stratum fibrosum externum, connects to the muscle fascia of the buccotemporalis. The basement membrane around these epithelial islands demonstrates PAS positivity.[11]


Histochemically, the available CK profiles to date suggest that the epithelial nests of JOOC share the immunohistochemical phenotype of nonkeratinized stratified squamous cells.[13],[14] Mandl et al. reported CK19 immunoreactivity in the central squamous cells.[15],[16] Alkaline phosphatase activity of the epithelial component of the JOOC and a possible mechanoreceptor function due to a close approximation of JOOC to structures resembling Pacinian corpuscles have also been documented. JOOC is an innocuous variation of normal anatomy and carries no risk for malignant transformation and no recurrence after its removal.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Al Aboud D, Al Aboud K, Al Qurashi H. Juxtaoral organ of Chievitz and the scientist behind it. Oral Maxillofac Pathol J 2014;5:476-7.  Back to cited text no. 1
    
2.
Mills SE, Gaffey MJ, Frierson HF. Tumors of the Upper Aerodigestive Tract and Ear. Washington, DC: Armed Forces Institute of Pathology; 2000. p. 372-3.  Back to cited text no. 2
    
3.
Chievitz JH. Chievitz juxtaparotid organ , free from cancer. Arch Anat Physiol 1885;9:401-36.  Back to cited text no. 3
    
4.
Soucy P, Cimone G, Carpenter B. An unusual intraoral mass in a child: The organ of Chievitz. J Pediatr Surg 1990;25:1200.  Back to cited text no. 4
    
5.
Zenker W, Halzl L. Development of Chievitz's organ in man. Z Anat Entwicklungsgesch 1953;117:215-36.  Back to cited text no. 5
    
6.
Michal M, Kacerovská D, Kazakov DV, Skálová A. Pseudotumors and mimickers of malignancy of the head and neck pathology. Cesk Patol 2012;48:190-7.  Back to cited text no. 6
    
7.
Pantanowitz L, Tschen JA, Balogh K. The juxtaoral organ of Chievitz. Int J Surg Pathol 2003;11:37.  Back to cited text no. 7
    
8.
Mérida-Velasco JR, Rodríguez-Vázquez JF, de la Cuadra-Blanco C, Salmerón JI, Sánchez-Montesinos I, Mérida-Velasco JA. Morphogenesis of the juxtaoral organ in humans. J Anat 2005;206:155-63.  Back to cited text no. 8
    
9.
Kusafuka K, Kameya T. Juxtaoral organ of Chievitz, radiologically suspicious for invasion of lingual squamous cell carcinoma. Pathol Int 2007;57:754-6.  Back to cited text no. 9
    
10.
Müller E, Zenker W. Enzyme-histochemistry of the juxtaoral organ in man (“organ of Chievitz”). Histochemistry 1981;71:279-90.  Back to cited text no. 10
    
11.
Pantanowitz L, Balogh K. Significance of the juxtaoral organ (of Chievitz). Head Neck 2003;25:400-5.  Back to cited text no. 11
    
12.
Tschen JA, Fechner RE. The juxtaoral organ of Chievitz. Am J Surg Pathol 1979;3:147-50.  Back to cited text no. 12
    
13.
Vadmal MS, Rossi MB, Teichberg S, Hajdu SI. Intraoral tumor of Chievitz in a child. Pediatr Dev Pathol 1998;1:230-3.  Back to cited text no. 13
    
14.
Hültenschmidt D, Vogel J, Stoll P. Chievitz's organ (the juxtaoral organ): Morphological and immunohistochemical studies. Dtsch Zahn Mund Kieferheilkd Zentralbl 1991;79:565-70.  Back to cited text no. 14
    
15.
Mandl L, Nerlich A, Pankratz H, Hübner G. The juxta-oral organ (Chievitz organ) – A sensory organ in the bucco-temporal area? Pathologe 1993;14:205-9.  Back to cited text no. 15
    
16.
Ide F, Mishima K, Saito I. Juxtaoral organ of Chievitz presenting clinically as a tumour. J Clin Pathol 2003;56:789-90.  Back to cited text no. 16
    


    Figures

  [Figure 1], [Figure 2]



 

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   Introduction
    Concise Biograph...
   Origin Of This Organ
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