An invasive presentation of parotid lymphadenoma: A first reported case

Hideoki Uryu; Minako Fujiwara; Ryutarou Uchi; Hidetaka Yamamoto; Torahiko Nakashima

doi:10.1016/j.prp.2023.154823

An invasive presentation of parotid lymphadenoma: A first reported case

Pathol Res Pract. 2023 Oct:250:154823. doi: 10.1016/j.prp.2023.154823. Epub 2023 Sep 15.

Authors

Hideoki Uryu¹, Minako Fujiwara², Ryutarou Uchi³, Hidetaka Yamamoto⁴, Torahiko Nakashima³

Affiliations

¹ Department of Otorhinolaryngology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyouhama, Chuou-ku, Fukuoka 810-8563 Japan. Electronic address: uryu.hideoki.qm@mail.hosp.go.jp.
² Pathology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyouhama, Chuou-ku, Fukuoka 810-8563 Japan.
³ Department of Otorhinolaryngology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyouhama, Chuou-ku, Fukuoka 810-8563 Japan.
⁴ Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-chou, Kita-ku, Okayama 700-8558 Japan.

PMID: 37717469
DOI: 10.1016/j.prp.2023.154823

Abstract

Lymphadenoma, a rare benign tumor recognized in the WHO salivary gland tumor classification of 2005, poses diagnostic and treatment challenges due to its rarity and distinct histopathological characteristics. We report a unique case of lymphadenoma in a 45-year-old male patient who presented with a hard, painless tumor in the right parotid gland that had been present since he was 15 years old. Distinctively, MRI and CT imaging revealed signs of infiltration into the surrounding muscle tissues, challenging the traditional notion of lymphadenomas as tumors with clear boundaries. The histopathological examination identified the characteristic epithelial and lymphoid cell proliferation, suggestive of a lymphadenoma. However, the possibility of sebaceous differentiation due to faintly pale cells within the epithelial component was inconclusive. The tumor's invasive nature and the high risk of facial nerve paralysis associated with surgical resection led to the patient's decision against treatment. Findings from this case underline the need for caution in diagnosing lymphadenoma, given its potential to show invasive images and the risks associated with a malignant diagnosis based solely on these images. Furthermore, the observations from this case present new insights into the FDG-PET findings of lymphadenoma, contributing to the overall understanding of this rare tumor's clinical implications. Future studies are warranted to provide more clarity on this condition.

Keywords: FDG-PET; Parotid Lymphadenoma; Pseudo-invasion; Salivary gland.

Publication types

Case Reports