Reappraisal of "Benign" Lymphoepithelial Sialadenitis for Evidence of Extranodal Marginal Zone B-Cell Lymphoma
Uniformed Services University of the Health Sciences Bethesda United States
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Introduction. Since the earliest descriptions of lymphoid lesions in the salivary glands, there has been debate regarding the differentiation of reactive and neoplastic lesions, benign and malignant processes and the significance of molecular features such as light chain restriction or immunoglobulin Ig heavy chain gene rearrangement. Lymphoepithelial sialadenitis LESA, formerly known as benign lymphoepithelial lesion BLEL, is a reactive process characterized by the infiltration of lymphocytes into the salivary gland. Extranodal marginal zone B-cell lymphoma EMZBCL is a malignant lymphoproliferative disease thought to arise in mucosa-associated lymphoid tissue MALT acquired in the development of LESA. Differentiating between these lesions is challenging due to their morphologic similarities, although modern molecular and immunohistochemical IHC staining techniques may provide mechanisms to reliably distinguish them. Objective. The aim of this study was to evaluate archival historic cases of BLEL for morphologic features, immunohistochemical profile, evidence of monoclonality and the presence of cytogenetic alterations previously identified in EMZBCL. Methods. Twenty cases of BLEL involving major salivary glands 18 parotid and 2 submandibular were retrieved from the Joint Pathology Center Tissue Repository and evaluated for morphologic, immunophenotypic, molecular and cytogenetic abnormalities associated with EMZBCL.
- Medicine and Medical Research