A retrospective review of 36 cases of lymphoma presenting as a salivary gland mass was conducted over a 34-year period. A significant increase in the occurrence of lymphoma was noted in proportion to other salivary gland tumors (P less than 0.01, chi 2 analysis: 1954-1972, 11 of 714 (1.5%); 1973-1979, 9 of 201 (4.5%); 1980-1987, 16 of 265 (6.0%). The mean age was 61 years, sex distribution was equal, and 75% occurred in the parotid. Only 42% presented with signs or symptoms other than a painless mass. Glandular excision was done in early stages of the disease while biopsy was done at later stages. Frozen section analysis was accurate in all but one case and was useful in determining if biopsy were adequate. All patients were definitively treated with chemotherapy and/or radiotherapy. Several instructive points are apparent. Any patient presenting with an isolated salivary gland mass can have a lymphoma. There has, in fact, been a significantly increasing proportion of salivary gland lymphoma among the various salivary gland tumors in our patient population. In contrast to other salivary gland tumors, surgery is reserved for diagnosis and not for treatment. A lymph node biopsy may be sufficient to establish a diagnosis, in which case, glandular excision is unnecessary. Most of the patients presented with an asymptomatic isolated salivary gland mass. The presence of adjacent adenopathy, a rubbery feel to the mass, and the intraoperative appearance were the most suggestive signs of lymphoma. Frozen section analysis is helpful in determining the appropriate extent of surgery and is recommended.
This is the first case report of a patient with oat cell carcinoma of the lung with scalene node metastasis who, without treatment, is alive 19 years after the original diagnosis was made by biopsy. Seven years before the publication of this report, and at the age of 66 years, he underwent coronary bypass surgery and there was no gross evidence of malignancy present.
A retrospective study is presented comparing the results of 462 frozen-section analyses of surgically extirpated salivary gland tumors with the permanent-section results. The overall agreement between frozen- and permanent-section analyses was 95.7%. A separate review of the last 47 months of this 32-year study revealed an accuracy rate of 98.8%. Frozen-section diagnosis of salivary gland tumors has been reliable and clinically valuable in our practice.
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