Lymphoma presenting as a salivary gland mass

Abstract

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.

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

“…NHL of the salivary gland usually presents as a painless, progressively enlarging mass [1, 2, 4, 6, 8, 9, 10]. Therefore, it was rarely suspected before biopsies or surgical removal.…”

“…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]. 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].…”

Mucosa-Associated Lymphoid Tissue Lymphoma of the Salivary Glands Occurring in Patients Affected by Sjögren’s Syndrome: Report of 6 Cases

“…Primary lymphomas of the salivary glands are uncommon diseases; they represent only 1.7–3.1% of all neoplastic disorders of the salivary gland [1, 2, 3]; the parotid is the gland most commonly involved, likely because of the frequent presence of intraglandular lymph nodes and lymphoid tissue, which are usually absent in other salivary glands [4]. Primary parotid lymphomas represent about 1% of all the lymphomas [5].…”

Primary Non-Hodgkin's Lymphoma involving Parotid Gland: A Rare Entity

“…Various literature shows that primary tumors of the parotid gland show no characteristic features in diagnostic imaging, reflecting none of their histological findings. 5 Therefore, it is difficult to differentiate benign conditions from malignant tumors, and most patients are subjected to surgical procedures before a definitive diagnosis has been made. In the present case report, we describe a case of NHL of the parotid gland.…”