Adenolymphoma with massive necrosis and squamous metaplasia

A 61-year-old female presented with a longstanding parotid mass with recent change in size. Histologically, the mass was composed of extensively necrotic tissue with a peripheral rim of ribbons of epithelium. In one focus, a double layer of oxyphilic epithelium overlying a lymphoid stroma in a papillary configuration was present, establishing the diagnosis of adenolymphoma (AL). The possibility of infarction and/or infection complicating AL is discussed. In any parotid gland lesion clinically presenting as a longstanding tumor with recent change clinically suggestive of infarction and/or infection, the diagnosis of AL should be considered. In the pathologic specimen with extensive necrosis, areas of preserved epithelium and stroma should be searched for carefully to confirm the diagnosis.