Primary lymphoma of the parotid gland.Primary lymphoma of the salivary glands is a rare entity. When it does occur, it reportedly arises in the parotid gland in 80% of cases and in the submandibular gland in 20%. (1-4) Only isolated reports describe a primary lymphoma in the sublingual gland and minor salivary glands. (1) Salivary gland lymphomas are classified as MALT (mucosa-associated lymphoid tissue The mucosa-associated lymphoid tissue (MALT) (also called mucosa-associated lymphatic tissue) is the diffuse system of small concentrations of lymphoid tissue found in various sites of the body such as the gastrointestinal tract, thyroid, breast, lung, salivary glands, eye, and ) lymphomas in the classification schema. (2-4) A 72-year-old white man came to our ENT clinic with a 3-month history of a slowly enlarging left parotid parotid /pa·rot·id/ (pah-rot´id) near the ear. pa·rot·id adj. 1. Situated near the ear. 2. Of or relating to a parotid gland. n. A parotid gland. mass. Fine-needle aspiration biopsy was nondiagnostic. The patient underwent magnetic resonance imaging magnetic resonance imaging (MRI), noninvasive diagnostic technique that uses nuclear magnetic resonance to produce cross-sectional images of organs and other internal body structures. (MRI), but because of his chronic renal insufficiency, intravenous contrast computed tomography could not be performed. MRI detected a well-marginated mass in the tail of the left parotid gland (figure 1). The differential diagnosis included pleomorphic adenoma, Warthin's tumor, metastatic disease, adenoid cystic carcinoma adenoid cystic carcinoma n. A carcinoma characterized by large epithelial masses containing round glandlike spaces or cysts, frequently containing mucus, that are bordered by layers of epithelial cells. Also called cylindromatous carcinoma. , and mucoepidermoid carcinoma. During surgical excision of the mass, no evidence of left facial nerve involvement was noted. The systemic work-up included a bone marrow biopsy Bone marrow biopsy A procedure in which cellular material is removed from the pelvis or breastbone and examined under a microscope to look for the presence of abnormal blood cells characteristic of specific forms of leukemia and lymphoma. examination for staging, and it revealed no evidence of a lymphoma. However, the histologic characteristics of the mass were consistent with a malignant lymphoma (figure 2). Immunohistochemical stains were positive for CD20, CD79a, CD10, and Bcl-2, supporting the diagnosis of malignant lymphoma. [FIGURE 1-2 OMITTED] References (1.) Som PM, Curtin HD.Neck. In: Som PM, Curtin HD, eds. Head and Neck Imaging. 4th ed. Vol. 2. St. Louis: Mosby, 2003:2109-13. (2.) Sato K, Kawana M, Sato Y, Takahashi S. Malignant lymphoma in the head and neck associated with benign lymphoepithelial lesion benign lymphoepithelial lesion Mikulicz disease A lesion of the salivary and lacrimal glands, clinically related to Sjögren syndrome, which may be autoimmune in nature. Cf 'Eskimoma.'. of the parotid gland. Auris Nasus Larynx 2002;29:209-14. (3.) Liang R, Loke SL. Non-Hodgkin's lymphomas involving the parotid gland. Clin Oncol (R Coil Radiol) 1991;3:81-3. (4.) Harnsberger HR, Hudgins PA, Wiggins RH III, et al. Non-Hodgkin lymphoma, parotid. In: Harnsberger HR, Hudgins PA, Wiggins RH III, et al, eds. Diagnostic Imaging: Head and Neck. 1st ed. Salt Lake City: Amirsys, 2004; sect III:7, 32-5. Andres Eraso, MD; Giovanni Lorusso, MD; Enrique Palacios, MD, FACR FACR abbr. Fellow of the American College of Radiologists |
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