Parotid mass as first symptom of a malignant lymphoma.

Abstract

Primary malignant lymphoma in the parotid gland is rare and seldom described in the literature. We studied the medical history and outcome of seven patients with a primary malignant parotid lymphoma. We looked for prognostic variables and for different behavior of these lymphomas in comparison to lymphomas in the usual sites. Between 1985 and 1995, we conducted a retrospective study of the medical histories of malignant parotid tumors operated at our hospital. There were 18 malignancies, of which 7 were primary malignant lymphomas. We classified them according to Rosenberg et al. [Blood 1994;84: 1359-1392]. Outcome and survival time were compared with malignant lymphomas in usual sites. Further we looked for possible prognostic factors. We found an unusually high percentage of primary malignant lymphomas in the parotid gland in our series: 38% of all malignancies. Histological workup showed one Hodgkin lymphoma, two marginal zone B-cell non-Hodgkin lymphomas, two lymphoplasmocytoid non-Hodgkin lymphomas, and two follicular non-Hodgkin lymphomas. The clinical course of these lymphomas is comparable to that in lymphomas in the usual sites. Primary malignant lymphomas in the parotid gland have no different behavior compared to lymphomas in usual sites. There are no prognostic variables that distinguish a malignant lymphoma in the parotid gland. The only difference is a rather difficult operation to obtain a histologic specimen.