Lymphadenoma of parotid gland: Two additional cases and a literature review

Dardick, Irving; Thomas, Meera

doi:10.1016/j.tripleo.2007.08.035

Cited by 26 publications

(34 citation statements)

References 8 publications

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“…4,6,9,11 The non-sebaceous LAD tend to have more focal keratinization, less peripheral palisading, generally lack the production of basement membrane material and have a small or non-existent myoepithelial component as compared with basal cell adenomas. 6,[12][13][14]16 The prominent reactive mixed B-and T-cell proliferation with germinal centers is identical to follicular hyperplasia of reactive lymph nodes, and is a defining feature of LAD. We frequently noted a granulomatous reaction in sebaceous LAD, likely secondary to ruptured cyst contents.…”

Section: Discussionmentioning

confidence: 99%

“…2,23,24 Rarely, LAD may be associated with other benign salivary tumors as in one of our cases where a 35-year-old man had a combined sebaceous LAD and Warthin tumor, adjacent to a separate sclerosing polycystic adenosis tumor. 18 Both sebaceous and non-sebaceous LAD raise several differential diagnostic considerations, 13 most important being metastatic low-grade adenocarcinoma and adenosquamous carcinoma involving intraparotid lymph node. Nodal metastasis is not the primary presentation in low-grade adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…7 Only 11 non-sebaceous LAD are reported in the literature. 5,6,[8][9][10][11][12][13][14][15][16] We present a multicenter experience with 33 salivary LAD: 22 sebaceous and 11 non-sebaceous, in order to better define their clinicopathological characteristics, and explore their etiopathogenesis including association with malignancy, altered immune status, and viral infection.…”

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Lymphadenoma of the salivary gland: clinicopathological and immunohistochemical analysis of 33 tumors

et al. 2012

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Lymphadenomas (LADs) are rare salivary gland tumors. Their clinicopathologic characteristics and etiopathogenesis are poorly understood. We examined 33 LADs in 31 patients (17 women and 14 men) aged 11-79 years (median 65 years). There were 22 sebaceous LADs in 21 patients (9 women and 12 men) and 11 nonsebaceous LADs in 10 patients (8 women and 2 men). Two patients had synchronous double tumors. Twentysix tumors (79%) arose in parotid, three in the neck, and two each in submandibular gland and oral cavity. Extraparotid tumors were seen in 2 of 21 (10%) patients with sebaceous and 4 of 10 (40%) patients with nonsebaceous LADs. Seven of twenty-three (30%) patients had immunosuppressive therapy for unrelated diseases. The tumors were well circumscribed, encapsulated (n ¼ 28, 84%) painless masses, varying in size from 0.6 to 6 cm (median 2.2). The cut surfaces were gray-tan to yellow, homogeneous and multicystic (n ¼ 24, 72%). The epithelial cells were basaloid, squamous and glandular, forming solid nests, cords, tubules, and cysts. Sebaceous differentiation was restricted to sebaceous lymphadenoma. The epithelial cells expressed basal cell markers (p63, 34BE12, and/or CK5/6, 18/18, 100%) and the luminal glandular cells expressed CK7 (12/12, 100%). Myoepithelial cells were absent (n ¼ 10/16, 63%) or focal. The lymphoid stroma was reactive, with germinal centers in 28 (84%). There was no evidence of HPV (0/11), EBV (0/7), and HHV-8 (0/8). Malignant transformation to sebaceous and basal cell adenocarcinoma was seen in one patient each. None of the 11 patients with followup (1-8 years) recurred. In summary, sebaceous and non-sebaceous LADs are benign, encapsulated, solid and cystic tumors affecting older adults. Non-sebaceous LADs affect women and extraparotid sites more frequently than sebaceous LADs. Altered immune status may have a role in their etiopathogenesis. Multiple synchronous tumors, origin in buccal mucosa, and malignant transformation may rarely occur.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Lymphadenoma of the salivary gland: clinicopathological and immunohistochemical analysis of 33 tumors

et al. 2012

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“…Since the first description of a case designated as 'nonsebaceous lymphadenoma' (NSLA) in 1991 by Auclair et al [1], a total of 17 cases of this rare entity have been described, mostly as single case reports or small case series [2][3][4][5][6][7][8][9][10][11]. NSLA was officially recognized as a separate tumor entity by the World Health Organization's (WHO) classification in 2005 [12], distinct from the more common sebaceous lymphadenoma.…”

Section: Introductionmentioning

confidence: 99%

Nonsebaceous lymphadenoma of salivary glands: proposed development from intraparotid lymph nodes and risk of misdiagnosis

et al. 2012

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Nonsebaceous lymphadenoma (NSLA) is a rare benign salivary gland tumor composed of lymphoid and epithelial components. By definition, the epithelial component lacks sebaceous differentiation and instead displays a wide range of histological differentiation. In this study, we have collected nine cases of NSLA to characterize their histological and immunohistochemical profiles. The samples were histologically reviewed and immunohistochemical stains for CK5/6, CK7, CK14, CK18, p63, and Ki67 performed. Patients were six males and three females (mean age, 50 years). All tumors were located in the parotid gland and showed intimate intermingling of lymphoid tissue with islands or strands of epithelium with a wide spectrum of histological differentiation. The immunohistochemical profiles mirrored the epithelial differentiation; hence, areas with basaloid or lymphoepithelial differentiation strongly expressed CK5/6, CK14, and p63, while areas with ductal differentiation showed strong positivity for CK18/CK7 and CK5/6/CK14/p63 in luminal and basal cell layers, respectively. A hilus structure with salivary inclusions or D2-40 (podoplanin)-positive marginal sinus was identifiable in four and nine of the cases, respectively, supporting origin within intra-/periparotid lymph nodes. Six cases were initially misdiagnosed as other benign (n = 4) or malignant tumors (n = 2). Our study on the second largest series of NSLA reported to date provides strong evidence that NSLA belongs to the group of salivary gland tumors that pathogenetically develop from embryonic salivary gland inclusions in intra-/periparotid lymph nodes. Knowledge of the wide histological spectrum of this rare and presumably underreported tumor is important in order to avoid misdiagnosis, particularly as malignant tumor.

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“…6.11 ) [ 31 ]. Although one immunohistochemical study did not confi rm the presence of myoepithelial cells [ 173 ], another recent study demonstrated the presence of both luminal and myoepithelial cells [ 36 ]. Some may have argued that lymphadenoma may represent an adenoma arising from heterotopic salivary tissue in an intra-or periparotid lymph nodes.…”

Section: Lymphadenomamentioning

confidence: 99%