[Malignant lymphomas and immunosialadenitis (author's transl]

Immune sialadenitis with or without clinical symptoms of Sjögren's syndrome represents an inflammation of the salivary duct system with considerable proliferation of the immunoactive lymphoproliferative system. By prolonged stimulation the immune system can turn into malignant lymphoma, mainly of immunocytoma or immunoblastic sarcoma type. In four out of 77 cases from the salivary gland register of the Institute of Pathology, University of Hamburg, showing myoepithelial sialadenitis, malignant lymphomas associated with chronic myoepithelial lymphadenitis were observed. According to the new "Kiel-classification" (Lennert) of malignant lymphomas two of the cases represented a diffuse germinoblastoma (lymphoblastoma Brill-Symmers), one a immunocytic lymphoma and one a immunoblastic sarcoma (reticulum cell sarcoma). From literature 16 further observations of malignant lymphoma occuring in the area of the major salivary glands in association with immune sialadenitis (Sjögren's syndrome) were collected, likewise 25 other cases with lymphomas outside of the major salivary glands and Sjögren's syndrome. It is suggested that the above average frequency of malignant lymphomas in immune sialadenitis may result from a secondary malignant transformation of immune cells due to prolonged stimulation. Local rapidly appearing tumorous alterations of the salivary glands in chronic immune sialadenitis are, therefore, always be suspicious of the development of a malignant lymphoma and demand adequate therapy.