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Non-Neoplastic Salivary Gland Diseases
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Stephen R. Porter, Stefano Fedele, Valeria Mercadante
Multicystic lymphoepithelial lesions, sometimes termed cystic lymphoid hyperplasia (CLH) or benign lymphoepithelial lesion (BLEL) or benign lymphoepithelial cysts (BLEC), may also occur. The exact cause of the lesions is not known but it has been suggested that they are due to ductal ectasia of entrapped salivary gland inclusions arising within lymph nodes.21, 22 Cystic change can also arise following intra-glandular ductal obstruction by hyperplastic lymphoid tissue. It is estimated that swellings associated with CLH arise in up to 6% of adults and 10% of children infected with HIV. Transformation to non-Hodgkin lymphoma is a rare complication of CLH.
Salivary Glands
Published in Wojciech Gorczyca, Atlas of Differential Diagnosis in Neoplastic Hematopathology, 2014
Benign lymphoepithelial lesion in the salivary gland (LESA) usually develops in the background of Sjögren’s syndrome and is characterized by chronic inflammation, which gradually replaces the normal salivary tissue. It is usually seen in the parotid. In advanced disease, there are prominent lymphoepithelial clusters comprising ductal epithelium and B cells (Figure 43.4). Lymphoepithelial lesions are often accompanied by reactive lymphoid follicles. B cells in the lymphoepithelial lesions have a monocytoid appearance. Aberrant phenotype of B cells, monotypic plasma cells, presence of atypical B cells, which form distinct clusters (broad sheets of monocytoid B cells outside of the lymphoepithelial lesions), and prominent colonization of germinal centers by atypical lymphocytes help to diagnose lymphoma. Flow cytometric analysis is often helpful in the diagnosis of MALT lymphoma. Since LESA may show clonal IGH rearrangement, demonstration of clonality by polymerase chain reaction (PCR) is not equivocal with the diagnosis of MALT lymphoma in the parotid gland.
Malignancy rates of salivary gland tumors in Greenlandic Inuit comparable to non-endemic populations; epidemiological mapping of salivary gland tumors 1990–2019
Published in Acta Oncologica, 2023
Carl Frederik Haugaard, Simon Andreasen, Patrick R. G. Eriksen, Caroline Olsen, Katalin Kiss, Kristine Bjørndal, Marie Westergaard-Nielsen, Preben Homøe
We included 203 patients in the cohort, see Supplementary Figure 1. A total of 160 benign tumors in 155 (76%) patients and 48 malignant tumors in 48 (24%) patients were found. After review of histological specimens, one (0.5%) diagnosis was changed from benign to malignant, benign lymphoepithelial lesion to LEC. One (0.5%) benign tumor was excluded upon revision; the diagnosis was changed from pleomorphic adenoma (PA) to mucocele. Fifteen (31%) malignant diagnoses were changed, mostly ‘undifferentiated carcinoma’ to LEC with 10 (21%) cases. All other tumors had been revised in a previous study [4]. For tumor type, lesion site, histological type, male: female ratio, and age range see Table 1. The most common malignant and benign tumors were LEC 31/48 (65%) and PA 116/155 (75%), respectively. The most common place of origin for malignant tumors was the parotid gland (71%) and the submandibular gland (15%) (Table 1). The same applied for benign tumors with 79% in the parotid gland and 14% in the submandibular gland (Table 1). The proportion of malignant tumors in the parotid, submandibular, minor salivary, and sublingual salivary glands was 22%, 24%, 40% and 50%, respectively (Table 1). Overall, 76% of all tumors were benign. Regional metastases were observed in 12 patients, all LEC, constituting 25% of all salivary gland carcinomas and 39% of all LEC. The proportion of patients with LEC and regional metastases in the parotid and submandibular gland was 40% and 33%, respectively (Supplementary Table 1). All but one LECs were strongly EBV positive even in 30 years old formalin-fixed paraffin-embedded material; 30/31 specimens (Figure 1). The median follow-up in patients with salivary gland carcinoma was 1.6 years (interquartile range 0.90–3.96 years).