Malignant Lymphomas of the Salivary Glands: Review of the Literature and Report of 33 New Cases, Including Four Cases Associated with the Lymphoepithelial Lesion

Hyman, George A.; Wolff, Marianne

doi:10.1093/ajcp/65.4.421

Cited by 123 publications

(49 citation statements)

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“…Several reports have demonstrated the occurrence of myoepithelial islands in biopsy specimens of the parotid glands that also contained lymphoma; therefore, the occurrence of myoepithelial islands can no longer be taken as definitive evidence for the "benign" condition of a biopsy sample (57)(58)(59). Persistent major salivary gland swelling also may result from adenoma or carcinomas (Table 2).…”

Section: Differential Diagnosis Of Enlarged Major Salivary Glandsmentioning

confidence: 99%

Sjögren's syndrome. Proposed criteria for classification

Fox¹,

Robinson²,

Curd³

et al. 1986

Arthritis & Rheumatism

617

230

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The term “Sjögren's syndrome” (SS) is frequently used to describe the occurrence of keratocon‐junctivis sicca and xerostomia in association with an autoimmune disorder. However, well‐defined criteria for the classification of SS have not been established, and this diagnosis is being applied to a wide spectrum of conditions, ranging from clear “autoimmune” disease in some patients, to sicca complaints without evidence of a systemic immune process in elderly patients. Here, we review the clinical and laboratory features of patients referred for evaluation of sicca symptoms. In particular, we emphasize the need for care in choosing the site for minor salivary gland biopsy, and we describe the histologic features that aid in the evaluation of these biopsy specimens. In an attempt to identify a population of patients whose conditions might have a common etiopathogenesis and, thus, a common treatment program, we propose the following criteria for a diagnosis of SS: 1) objective evidence of keratoconjunctivis sicca, as documented by rose bengal or fluorescein dye staining; 2) objective evidence of diminished salivary gland flow; 3) minor salivary gland biopsy, obtained through normal mucosa, with the specimen containing at least 4 evaluable salivary gland lobules, and having an average of at least 2 foci/4 mm2; 4) evidence of a systemic autoimmune process, as manifested by the presence of autoantibodies, such as rheumatoid factor and/or anti‐nuclear antibody. The diagnosis of “definite SS” would be made when all 4 criteria are met; the diagnosis of “possible SS” would be made when 3 criteria are present. Specific exclusions for this diagnosis are preexisting lymphoma, graft‐versus‐host disease, sarcoidosis, and acquired immunodeficiency disease. These proposed criteria are more restrictive than are those currently used for diagnosing SS. Future multicenter trials will be required to determine whether these criteria are generally useful. Finally, we emphasize the rheumatologist's role in selecting safe, inexpensive methods of objectively monitoring sicca complaints (i.e., kerato‐conjunctivitis sicca and parotid salivary flow) and in evaluating the results of minor salivary gland biopsy.

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Section: Differential Diagnosis Of Enlarged Major Salivary Glandsmentioning

confidence: 99%

Sjögren's syndrome. Proposed criteria for classification

Fox¹,

Robinson²,

Curd³

et al. 1986

Arthritis & Rheumatism

617

230

View full text Add to dashboard Cite

show abstract

“…Among NHLs, salivary gland NHL accounts for 4% of NHL and 4.7% of extranodal NHL [2, 3]. The parotid gland was most frequently involved, followed by the submandibular gland, minor salivary glands and sublingual gland [1, 2, 4, 5, 6, 7]. Some studies focused on parotid NHL [8, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies focused on parotid NHL [8, 9, 10]. Although many papers were published on this subject, the majority of them used the histological classifications of Rappaport or Working Formulation, which did not include the category of mucosa-associated lymphoid tissue (MALT) lymphomas [1, 2, 4, 5, 8, 10]. MALT lymphoma is now incorporated in the Revised European-American Lymphoma (REAL) and the World Health Organization (WHO) classification systems as a new entity [11, 12]and is the most common lymphoma involving the salivary glands in a recent report [6].…”

Section: Introductionmentioning

confidence: 99%

Primary Salivary Gland Lymphoma: A Clinicopathologic Study of 23 Cases in Taiwan

et al. 2004

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Twenty-three patients with primary salivary gland lymphoma were diagnosed between 1990 and 2001. The sites of involvement were the parotid gland in 13, the submandibular gland in 9 and the minor salivary gland in 1. The sites of lymphoma involvement beyond the salivary glands were the cervical lymph nodes in 7, bone marrow in 3, the axillary lymph nodes in 3, the nasopharynx in 2, the abdominal lymph nodes in 2, the palate, the subconjunctiva, and the spleen in 1 each patient. Histologically, 19 patients had lymphomas of mucosa-associated lymphoid tissue (MALT) with myoepithelial sialadenitis in 13, 3 patients had diffuse large cell lymphomas and 1 had follicular lymphoma. Six patients were in stage I, 4 in II, 1 in III and 12 in IV. Eight of 23 patients (35%) had autoimmune diseases before or after the diagnosis of NHL and all suffered from MALT lymphoma. Four patients with parotid MALT lymphoma had primary or secondary Sjögren’s syndrome. One each patient suffered from hyperthyroidism, systemic lupus erythematosus, membranoproliferative glomerulonephritis and cryoglobulinemia, respectively. All the 6 stage I patients had achieved complete remission (CR) without relapses 17–84 months (median 44 months) after treatment. Excluding a stage IV patient with follicular lymphoma who died at 3.5 months without treatment, CR was achieved in all of the remaining 16 patients. However, a high relapse rate (9/16, 56%) was noted in stage II–IV patients. These patients tended to relapse in the original sites, but achieved CR again after chemotherapy or radiotherapy. One patient with MALT lymphoma developed histologic transformation into diffuse large lymphoma during relapse and died of refractory disease. Overall, only 2 patients succumbed. The overall survival and relapse-free survival rates at 5 years were 94.7 and 51.4%, respectively. Thus, salivary gland lymphoma proved to be an indolent disease.

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“…For this reason, it is not suspected clinically before FNAB or parotidectomy. Primary salivary gland lymphomas show parenchymal involvement of the parotid gland without lymph node differentiation [6,7]. Our case presented with slow growing, painless mass without symptom on the right parotid region.…”

Section: Discussionmentioning

confidence: 74%

Extranodal Marginal Zone Lymphoma of the Parotid Gland

Aydın

Demir

Barışık

2016

J. Maxillofac. Oral Surg.

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Non Hodgkin lymphomas correspond to 25 % of all head and neck cancers. These rare tumors only include less than 5 % of malign tumors in parotid region. Differential diagnosis of these tumors cover many malign and benign tumors of the parotid gland. Definite diagnosis depends on sufficient tissue material of parotidectomy specimen. Treatment modality is surgical removal of the lesion with or without additional radiation and chemotherapy depending on the stage of the tumor. Prognosis is better than other forms of the B-cell lymphoma. We present a 54 year old woman who suffered from progressively and slowly growing mass on parotid region, without any inflammatory disease or chronic infection, diagnosed with mucosa associated lymphoid tissue lymphoma of the parotid gland. Parotid gland was totally excised by superficial parotidectomy and there is no recurrence after 5 years postoperative period.

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Malignant Lymphomas of the Salivary Glands: Review of the Literature and Report of 33 New Cases, Including Four Cases Associated with the Lymphoepithelial Lesion

Cited by 123 publications

References 0 publications

Sjögren's syndrome. Proposed criteria for classification

Sjögren's syndrome. Proposed criteria for classification

Primary Salivary Gland Lymphoma: A Clinicopathologic Study of 23 Cases in Taiwan

Extranodal Marginal Zone Lymphoma of the Parotid Gland

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