Xanthogranulomatous sialadenitis clinically mimicking a malignancy: case report and review of the literature

Abstract

The lesion measured 2.5 × 1.5 × 1.5 cm. Microscopic examination revealed sheets of foamy macrophages centrally admixed with neutrophils, eosinophils, lymphocytes, plasma cells and scattered giant cells indicating a xanthogranulomatous reaction. As a conclusion xanthogranulomatous tissue reaction can mimic neoplasms.

Primary Necrobiotic Xanthogranulomatous Sialadenitis with Submandibular Gland Localization without Skin Involvement

“…The most characteristic findings are extensive necrosis and inflammation with foamy macrophages and giant cells. These features are similar to the findings of previously reported cases of xanthogranulomatous sialadenitis [2,3,5,7-9]. Although there was a lack of detailed information about degree of necrosis, infiltration of foamy cells, and amount of giant cells accumulation, we hypothesize that there is an overlap of xanthogranulomatous sialadenitis and salivary NXG.…”

“…Although there was a lack of detailed information about degree of necrosis, infiltration of foamy cells, and amount of giant cells accumulation, we hypothesize that there is an overlap of xanthogranulomatous sialadenitis and salivary NXG. Reports of xanthogranulomatous sialadenitis are rare, and only six cases have been reported to date [2,3,5,7-9]. When excluding the secondary changes of preexisting salivary gland lesions, including Warthin tumor, pleomorphic adenoma, and sialolithiasis, only three cases of xanthogranulomatous inflammation were identified in the literature [2,3,5].…”

“…Necrobiotic xanthogranuloma (NXG) is a histiocytic disease, commonly found in the subcutaneous tissue of the periorbital area [1]. To the best of our knowledge, only one case of NXG and three cases of primary xanthogranulomatous sialadenitis have been reported [2-5]. NXG is considered a systemic disease that may involve the skin and extracutaneous sites, including the lung, myocardium, larynx, pharynx, intestines, and even ovaries [6].…”

Xanthogranulomatöses Reaktionsmuster in Speicheldrüsen

“…Während sich für die Suchbe griffe "xanthogranulomatous sialadenitis" und "xanthogranulomatous + parotid" lediglich 7 Fallberichte in der PubMed Datenbank ergeben [5,6,10,13,18,27,28], trifft man für andere Lokalisationen wie Gallenblase oder Niere auf größere Fall serien von bis zu 74 Fällen pro Studie [16,29]. Dies deutet auf eine große Seltenheit xanthogranulomatöser Veränderungen in den Speicheldrüsen hin.…”

“…Der infarzierte WarthinTumor stellt die häufigste Ursache einer sekundären xan thogranulomatösen Reaktion dar [5,6,10,13,18,27,28]. In unserer noch nicht pub lizierten Serie entstanden xanthogranulo matöse Speicheldrüsenveränderungen auf dem Boden metaplastischer/infarzierter WarthinTumoren in 12 Fällen (50%) und in der Folge einer rupturierten duktalen Zyste in 8 Fällen (33%).…”