Abstract
Infiltration of the salivary glands by lymphocytes poses two major diagnostic problems: first, differentiating malignant lymphoma from reactive processes and second, separating autoimmune sialadenitis, which may progress to lymphoma from lesions lacking this implication. Non-autoimmune infiltrates characterize obstructive and infective diseases, several non-infective conditions and reactions to certain epithelial neoplasms. Autoimmunity plays a still poorly understood part in the pathogenesis of myoepithelial sialadenitis (MESA), a pathological entity frequently manifested as the clinical condition Sjogren's syndrome. A proportion of MESA develop malignant lymphoma of mucosa-associated lymphoid tissue (MALT) type, and recent studies have allowed the early stages in the evolution to malignancy to be recognized. If possible, MALT lymphoma should also be distinguished from nodal lymphomas presenting in intraparotid lymph nodes which are biologically different and usually carry a worse prognosis. Salivary lymphoepithelial cystic lesions are a heterologous group including Warthin's tumour, benign lymphoepithelial cyst, MESA with dilated ducts, cystic lymphoid hyperplasia of AIDS, MALT lymphoma with dilated ducts, cystic mucoepidermoid carcinoma with a lymphocytic response, and cystic metastases in intraparotid lymph nodes.
Published Version
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