Case Of Benign Lymphoepithelial Lesion Research Articles

Primary parotid gland lymphoma: a case report.

IntroductionMucosa associated lymphoid tissue lymphomas are the most common lymphomas of the salivary glands. The benign lymphoepithelial lesion is also a lymphoproliferative disease that develops in the parotid gland. In the present case report, we describe one case of benign lymphoepithelial lesion with a subsequent low transformation to grade mucosa associated lymphoid tissue lymphoma appearing as a cystic mass in the parotid gland.Case presentationA 78-year-old Caucasian female smoker was referred to our clinic with a non-tender left facial swelling that had been present for approximately three years. The patient underwent resection of the left parotid gland with preservation of the left facial nerve through a preauricular incision. The pathology report was consistent with a low-grade marginal-zone B-cell non-Hodgkin lymphoma (mucosa associated lymphoid tissue lymphoma) following benign lymphoepithelial lesion of the gland.ConclusionsSalivary gland mucosa associated lymphoid tissue lymphoma should be considered in the differential diagnosis of cystic or bilateral salivary gland lesions. Parotidectomy is recommended in order to treat the tumor and to ensure histological diagnosis for further follow-up planning. Radiotherapy and chemotherapy should be considered in association with surgery in disseminated forms or after removal.

Non-neoplastic salivary gland lesions: a 15-year study

The spectrum of salivary gland lesions is wide and the relative incidence of neoplastic versus non-neoplastic lesions is variable in different studies. A series of non-neoplastic salivary gland lesions is reviewed to analyze their spectrum and their relative frequency. This is a retrospective study of salivary gland excisions and biopsies received in our department from January 1994 to December 2008. Routine hematoxylin and eosin-stained sections of all the salivary gland excisions and biopsies received were analyzed. Of the 393 salivary gland excisions and biopsies received, 216 cases were reported as non-neoplastic (55%) and formed our study group; 177 (45%) were neoplastic. Non-neoplastic lesions were more frequent in major salivary glands (65.7%) and submandibular gland was the most commonly involved (66.2%). Lip was the most frequent site (81.7%) for minor salivary gland lesions. Inflammation was the predominant pathological finding (49.5%), of which non-specific chronic sialadenitis constituted the majority (86.9%). Sialolithiasis was present in 22 cases (20.6%); all of these cases were of non-specific chronic sialadenitis. Cysts were second in frequency (36.6%), of which mucocele was the most common (54.5%). There were 5.6% cases of benign lympho-epithelial lesions, while normal salivary gland tissue was seen in 6.5% cases. Non-neoplastic salivary gland diseases are more common than neoplastic diseases and have a wide disease spectrum.

Benign lymphoepithelial lesion: a less than benign disease

Benign lymphoepithelial lesion: a less than benign disease The precise clinical correlate of the benign lymphoepithelial lesion is unclear. Thirty-six cases of benign lymphoepithelial lesions (BLL), reported to the British Salivary Gland Tumour Panel between 1971 and 1984, have been reviewed. Eighty per cent arose in the parotid gland and 20% were bilateral; 83% were in females and the mean age at presentation was 55.26 years. Only 50% presented with, or developed, symptoms of sicca complex, Sjogren's syndrome or related autoimmune disease. Two cases of BLL had, or went on to develop, extra salivary lymphomas and 5 cases of BLL had lymphomatous change in the initial biopsy. A further case had carcinoma within the benign lymphoepithelial lesion. None of those who developed lymphoma had sicca or Sjogren's syndrome but 3 of them had rheumatoid arthritis. The incidence of lymphomas (salivary or extra-salivary) in this series is very much higher than that reported in Sjogren's patients and amounted to 20% overall.

The Benign Lymphoepithelial Cyst and a Classification System for Lymphocytic Parotid Gland Enlargement in the Pediatric HIV Population

The objectives of this study are to present a series of parotid gland benign lymphoepithelial cysts (BLEC) in HIV-positive children and to propose a three-tiered classification system for HIV-associated lymphocytic parotid gland enlargement. The authors conducted a retrospective case series and literature review. The authors conducted a retrospective chart review of four pediatric patients with HIV-associated parotid gland BLEC who presented to a tertiary care university medical center. Four pediatric HIV-positive patients (four girls; age range, 7-17 years [mean age, 12.8 years]) were diagnosed with parotid gland BLEC. Two patients presented with acute parotitis and the others presented with asymptomatic enlargement of the parotid glands. Three patients had bilateral parotid gland BLEC. The other patient demonstrated persistent generalized lymphadenopathy (PGL) of the intraparotid and cervical lymph nodes and early BLEC limited to the left parotid gland. One patient also displayed parotid gland microcalcifications and cystic changes in the adenoids, neither of which have been described previously in the setting of HIV-associated BLEC. Computed tomography was performed on all patients, and one patient underwent fine needle aspiration to confirm the diagnosis. All patients opted for observation and antiretroviral medication therapy as long-term treatment. Based on these findings and a review of the literature, we propose a three-tiered classification system for lymphocytic parotid gland enlargement in the HIV population: 1) PGL, 2) benign lymphoepithelial lesions (BLEL), and 3) BLEC. This series equals the largest pediatric series of HIV-associated parotid gland BLEC in the English literature. One patient in our series also demonstrated PGL; there were no cases of BLEL. A classification system based on morphology is proposed to help resolve the confusion in terminology used to describe this entity. Most pediatric HIV-infected patients with parotid gland BLEC can be treated with observation and antiretroviral medication therapy. For others, who are symptomatic or more concerned about their cosmetic appearance, sclerotherapy may offer a reasonable option. Radiation therapy and surgery should be reserved for select cases.

Benign lymphoepithelial lesion of minor salivary gland: report of a case involving the palatal mucosa

The article describes a rare case of benign lymphoepithelial lesion of the palatal minor salivary gland of a 70-year-old Japanese female patient who suffered from swelling for three months. The serological findings suggested that the patient was affected by Sjögren’s syndrome, although she had no obvious clinical symptoms. CT examinations revealed the presence of a round soft tissue mass in the posterior right side of the hard palate to the soft palate with slight thinning of the bone cortex of the palate. Histologically, the surgically removed mass was composed of a diffuse infiltration of lymphoid cells in the lamina propriae to the submucosal layer. There were many scattered epi-myoepithelial islands throughout the lymphoid background. The histological finding was consistent with that of benign lymphoepithelial lesion of the major salivary gland. The frequency and incidence of benign lymphoepithelial lesions in minor salivary glands and their association with Sjögren’s syndrome were discussed based on 10 cases previously reported in the literature.

口腔領域に発症した良性リンパ上皮性疾患の２例

Benign lymphoepithelial lesions (BLEL) are an uncommon autoimmune disease. Clinically, BLEL show painless tumor formation in the major salivary glands. Pathologically, BLEL are associated with infiltration of lymphocytes into the salivary glands, followed by the formation of lymphoid follicles and myoepithelial islands.In this report, we describe two cases of BLEL. Case 1: A 48-year-old woman with a history of Sjogren's syndrome presented with a tumor at the left border of the tongue. BLEL arising in the lingual minor salivary glands is very rare. Case 2: A 50-year-old woman presented with bilateral BLEL in the submandibular glands.

良性リンパ上皮性病変の２症例 腺上皮におけるサイトケラチン発現の検討

Two cases of benign lymphoepithelial lesions (BLEL) are reported along with a discussion on the expression of cytokeratin.Case 1: A 46-year-old man was referred to our clinic with a chief complaint of swelling at the right submandibular gland. Computed tomography showed the submandibular gland as a homogeneous high density area. Gallium scintigraphy demonstrated a clear hot spot at the same region. The submandibular mass was extirpated extraorally. Pathologically, there were atrophic changes of the ducts and acini, acompanied by severe lymphoid cell infiltration.Case 2: A 55-year-old man complained of swelling of the right buccal region. Magnetic resonance imaging revealed a homogeneous mass showing low intensity in T1 weighted SE and slightly high intensity in T2 weighted SE at the right lower parotid region. Examination of a specimen of the extraorally excised mass showed severe lymphoid tissue infiltration interspersed with myoepithelial islands in the atrophic parotid gland.Immunohistochemical staining was performed to check for the expression of the cytokeratin in the atrophic salivary gland. All duct-like structures (DLSs) reacted positively against K8.13 and cytokeratin #7 and #18. On the other hand, # 8 was negative especially in small DLSs.

良性リンパ上皮性疾患の２例

We report two cases of benign lymphoepithelial lesions (BLL) of the salivary gland. BLL arose in the sublingual gland in case 1 and in the palatine gland in case 2. Neither patient complainted of xerostomia or xerophthalmia, and other salivary glands were normal.In both cases histopathologic findings of lymphocytic infiltration, ectatic ducts, myoepithelial islands and acinar atrophy were observed. Immunohistological examination revealed that the predominat population of lymphocytes around the ducts and myoepithelial islands consisted of B-cells rather than T-cells.

耳下腺の良性リンパ上皮性病変症例

A case of benign lymphoepithelial lesion (BLEL) in the parotid gland is reported. The patient was a 60-year-old female with a solitary mass of the right parotid gland, not complicated with Sjogren's syndrome. The CT scan and echogram demonstrated a well-circumscribed mass and we treated this lesion as a parotid tumor. The pathological findings in the resected tumor were atrophy of the glandular parenchyma and lymphocytic infiltration with islands of epithelial cells (epimyoepithelial islands). The histogenetic origin of the cells in the epimyoepithelial islands was investigated immunohistochemically. The majority of cells in these islands were stained with anti-cytokeratin and anti-actin antibodies. These results suggest that myoepithelial cells play an important role in the histogenesis of epimyoepithelial islands in BLEL.

Benign lymphoepithelial lesion with large cysts: case report

A case of benign lymphoepithelial lesion with two large cysts and many foci of duct dilatation is reported. Clinical features, except for absence of dry eyes, indicated the case was Sjögren's syndrome. The cysts were found in the left parotid gland of a 60-yr-old woman and were surgically removed. The size of each cyst was 20 mm in diameter and one of them was located in the lymph node. Because of the HLA-DR expression by the epithelium, the cysts are considered to have formed as a result of duct dilatation due to autoimmune response. As for one cyst, it is also possible that the pre-existing lymphoepithelial cyst might be involved in the autoimmune phenomenon because of its relation to the lymph node.

Benign lymphoepithelial lesion: a less than benign disease.

The precise clinical correlate of the benign lymphoepithelial lesion is unclear. Thirty-six cases of benign lymphoepithelial lesions (BLL), reported to the British Salivary Gland Tumour Panel between 1971 and 1984, have been reviewed. Eighty per cent arose in the parotid gland and 20% were bilateral; 83% were in females and the mean age at presentation was 55.26 years. Only 50% presented with, or developed, symptoms of sicca complex, Sjogren's syndrome or related autoimmune disease. Two cases of BLL had, or went on to develop, extra salivary lymphomas and 5 cases of BLL had lymphomatous change in the initial biopsy. A further case had carcinoma within the benign lymphoepithelial lesion. None of those who developed lymphoma had sicca or Sjogren's syndrome but 3 of them had rheumatoid arthritis. The incidence of lymphomas (salivary or extra-salivary) in this series is very much higher than that reported in Sjogren's patients and amounted to 20% overall.

A case of benign lymphoepithelial lesion of the hard palate

The benign lymphoepithelial lesion is a rare condition, most frequently affecting the parotid gland. A review of the literature brought to light 4 earlier cases with localization in the accessory salivary glands in the oral cavity. The present report presents a 5th case arising from the accessory salivary glands on the left side of the hard palate. Destruction of the underlying bone was demonstrated radiologically; the latter has not previously been described. The present report contains a survey of the literature, as well as a review of the pathogenesis, clinical aspects and treatment of the disease.