Sebaceous Lymphadenoma of Parotid: Imaging, Cytological, and Histological Findings in Detail

Shekarkhar, Golsa; Soleimanpour, Hossein; Jafari, Seyed Hamed; Zamani, Fatemeh

doi:10.1155/2018/2915907

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…In some cases, sebaceous lymphadenomas will form a well-developed capsule but this capsule is often incomplete or on occasion completely absent.Even when the tumor is unencapsulated, it is invariably well circumscribed and pushes against but does not infiltrate the adjacent parenchyma. The cytologic findings observed in our three cases are similar to those previously described [9][10][11][12][13][15][16][17]. These reports uniformly document a mixed lymphoid background, which may include plasma cells and tangible body macrophages.…”

supporting

confidence: 89%

“…Even when the tumor is unencapsulated, it is invariably well circumscribed and pushes against but does not infiltrate the adjacent parenchyma. The cytologic findings observed in our three cases are similar to those previously described . These reports uniformly document a mixed lymphoid background, which may include plasma cells and tangible body macrophages.…”

Section: Discussionmentioning

confidence: 99%

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Cytologic features of sebaceous, lymphadenoma, and sebaceous lymphadenocarcinoma: Differential diagnostic considerations

Vazmitsel

Esebua

Layfield

2020

Diagnostic Cytopathology

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Background Sebaceous lymphadenomas and sebaceous lymphadenocarcinomas are uncommon neoplasms occurring predominately within the parotid gland. Cytomorphology of these neoplasms is rarely reported. Occasional reports have discussed the cytomorphological features of these neoplasms but criteria distinguishing sebaceous lymphadenomas from lymphadenocarcinomas have not been described. Methods The senior authors' consultation files and records of the University of Missouri were searched for all cases with a diagnosis of sebaceous adenoma, lymphadenoma, lymphadenocarcinoma, and adenocarcinoma. Slides from these cases were reviewed by the authors for cytologic features characteristic of these neoplasms. These features were compared with other salivary gland lesions in the differential diagnosis and for utility in separating benign from malignant sebaceous neoplasms. Results Three sebaceous lymphadenomas and one sebaceous lymphadenocarcinoma were found. Smears contained large numbers of mature lymphocytes dispersed in a watery or bloody background. Scattered among the lymphoid cells were small nests of epithelial cells characterized by a finely to coarsely vacuolated cytoplasm. The majority of cells contained bland nuclei with finely granular chromatin and conspicuous nucleoli. A second population of small basaloid cells was present. The single sebaceous lymphadenocarcinoma had a similar cytomorphology. Conclusions Sebaceous lymphadenomas can be distinguished from other neoplasms within the differential diagnosis due to their prominent lymphoid background and population of epithelial cells with a finely to coarsely vacuolated cytoplasm. The nuclei are bland but have conspicuous nucleoli. Based on our small series, cytomorphologic features are inadequate to definitively separate sebaceous lymphadenomas from lymphadenocarcinomas.

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supporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Cytologic features of sebaceous, lymphadenoma, and sebaceous lymphadenocarcinoma: Differential diagnostic considerations

Vazmitsel

Esebua

Layfield

2020

Diagnostic Cytopathology

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“…Most importantly, however, given the rarity of this neoplasm LAD may be overlooked when considering the cytologic differential diagnosis of salivary gland lesions. In addition, the available cytomorphologic data in the literature on salivary LAD are limited and prior studies have primarily been single case reports 16‐22 . Herein, we discuss a multi‐institutional case series of sebaceous and nonsebaceous LAD describing their cytomorphologic features on FNA, differential diagnosis, and highlight potential pitfalls.…”

Section: Introductionmentioning

confidence: 96%

Cytomorphology and diagnostic pitfalls of sebaceous and nonsebaceous salivary gland lymphadenoma: A multi‐institutional study

Viswanathan

Maleki

Pantanowitz

et al. 2020

Diagnostic Cytopathology

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Background Salivary gland lymphadenoma (LAD) is a rare benign neoplasm comprising sebaceous (SLAD) and nonsebaceous (NSLAD) types. Despite established histologic criteria, limited data on cytomorphology, tumor heterogeneity, and overlap with other entities make the diagnosis of LAD by fine needle aspiration (FNA) challenging. We describe a multi‐institutional cohort of 14 LADs with cytology, clinical, radiologic, and histopathologic data. Methods Our cohort included nine SLAD and five NSLAD with corresponding histopathology. Mean patient age and M:F ratio were 60.4 years (range 45‐86 years) and 1:2 for SLADs and 57.4 years (range 42‐80 years) and 1:1.5 for NSLADs, respectively. One NSLAD patient had a germline predisposition for Cowden syndrome. Glass slides and whole slide images of air‐dried Diff‐Quik (DQ), alcohol‐stained Papanicolaou smears (Pap) and cellblocks were reviewed for key cytomorphologic findings. Results FNAs from SLAD and NSLADs demonstrated vacuolated and basaloid epithelial clusters within a lymphoid background. Vacuolated cells from SLAD showed sebaceous cells with microvesicular cytoplasm indenting a central nucleus. Vacuolated cells from NSLAD were columnar with eccentric nuclei, corresponding to abluminal glandular cells. SLADs were classified using the Milan System for Reporting Salivary Gland Cytopathology as nondiagnostic (11.1%), nonneoplastic (44.4%), atypia of uncertain significance (AUS) (22.2%), and salivary gland neoplasm of uncertain malignant potential (SUMP) (22.2%). NSLADs were classified as AUS (40%), SUMP (40%) and Benign Neoplasm (20%). Conclusion Although rare, knowing the cytologic features of salivary LAD is important to avoid diagnostic pitfalls. Vacuolated cells can be prominent in both SLAD and NSLAD aspirates. Diagnostic issues arise from insufficient sampling of all tumor components leading to marked variation in diagnostic classification of LAD.

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“…It is a disease of the 5th or 6th decade and more common in males, probably because of more preponderance of sebaceous glands in males [8]. Although the disease occurs in old age, it is argued that sebaceous differentiation pace up post-puberty under influence of probably androgen similar to what happens to cutaneous sebaceous glands [9].…”

Section: Discussionmentioning

confidence: 99%

Sebaceous Lymphadenoma of Parotid: Case Report of a Rare Entity

Kanitkar

Chandra

Puntambekar

2021

Indian J Surg Oncol

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Sebaceous differentiation can be normally seen in salivary glands. An entity first described by Hamperi. Sebaceous components are present in several salivary gland tumors like Warthin's tumor and mucoepidermoid tumor. But, if the sebaceous component predominates, it is known as a sebaceous adenoma. If lymphatic stroma in the background is prominent, it qualifies as sebaceous lymphadenoma. The term was coined and properly described by McGavran et al., differentiating it from similar appearing tumors like Warthin's tumor, sebaceous adenoma, and mucoepidermoid tumor. Clinicians, as well as pathologists, need to be aware of this entity as it is known to undergo malignant degeneration. Since it is a benign entity, the most common symptom is painless parotid swelling. The patient in this case also presented with painless parotid swelling and underwent preoperative FNAC and MRI. But, the diagnosis was made after surgical excision. The patient recovered well after surgery and is being followed. Since this disease is known for malignant degeneration and recurrence careful diagnosis is required. Histopathological picture may be confused with other common entities like Warthin also known as papillary cystadenoma lymphomatosum since both have sebaceous and lymphoid components. McGavran differentiated between both entities. Sebaceous lymphadenoma can convert to sebaceous adenocarcinoma and is thus important to know the correct diagnosis, even if it is postoperative since recurrence may be associated with malignant changes. Sometimes, the picture may be confused with lymphoma and in that case, immunotyping can come as a rescue for diagnosis. The authors of this report intend to report this rare entity and emphasize the need for clinicians and pathologists being aware of it and keeping it as a differential while dealing with a similar parotid tumor.

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Sebaceous Lymphadenoma of Parotid: Imaging, Cytological, and Histological Findings in Detail

Cited by 5 publications

References 6 publications

Cytologic features of sebaceous, lymphadenoma, and sebaceous lymphadenocarcinoma: Differential diagnostic considerations

Cytologic features of sebaceous, lymphadenoma, and sebaceous lymphadenocarcinoma: Differential diagnostic considerations

Cytomorphology and diagnostic pitfalls of sebaceous and nonsebaceous salivary gland lymphadenoma: A multi‐institutional study

Sebaceous Lymphadenoma of Parotid: Case Report of a Rare Entity

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