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Lymphoid lesions of the parotid
1Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland 21224, USA.
Insights
Fine-needle aspiration (FNA) of parotid gland lymphoid lesions, aided by flow cytometry, can definitively diagnose conditions. This avoids surgery for reactive and malignant lymphomas, improving patient care.
Area of Science:
- Cytopathology
- Oncology
- Immunology
Background:
- Lymphoid lesions of the parotid gland are rare compared to epithelial tumors, leading to limited fine-needle aspiration (FNA) experience.
- Accurate diagnosis of parotid lymphoid lesions is crucial for appropriate patient management and avoiding unnecessary surgical procedures.
Purpose of the Study:
- To evaluate the diagnostic utility of FNA with ancillary studies for parotid gland lymphoid lesions.
- To determine if FNA and immunophenotypic analysis can obviate the need for surgery in diagnosing these conditions.
Main Methods:
- Retrospective review of 391 parotid gland FNAs performed between 1990 and 1998.
- Analysis of cytology, histology, and flow cytometry data for 76 identified lymphoid lesions.
- Classification of lymphoid lesions into reactive, lymphoepithelial cysts, malignant lymphomas, atypical lymphoid population, and Sjogren's disease.
Main Results:
- Out of 391 FNAs, 76 lymphoid lesions were identified.
- Diagnoses included: reactive lesions (n=35), lymphoepithelial cysts (n=27), malignant lymphomas (n=12), atypical lymphoid population (n=1), and Sjogren's disease (n=1).
- FNA combined with flow cytometry and immunophenotyping demonstrated high diagnostic accuracy.
Conclusions:
- Fine-needle aspiration (FNA) with adjunctive tests like flow cytometry and immunophenotyping is effective for diagnosing parotid gland lymphoid lesions.
- These methods can differentiate between reactive and malignant lymphoid conditions, potentially avoiding surgical intervention.
- Cytologic diagnosis of parotid lymphoid lesions is feasible and aids in clinical decision-making.
Abstract:
Lymphoid lesions of the parotid gland are much less common than their epithelial counterparts, and thus cytologic experience on fine-needle aspiration (FNA) is limited. FNA of lymphoid lesions with ancillary aids (flow cytometry and immunophenotypic studies) can make a definitive diagnosis. All FNAs of the parotid gland performed at the Johns Hopkins Hospital in an 8-yr span (1990-1998) were reviewed retrospectively. In all, 391 cases were done, of which 76 cases of lymphoid lesions were identified. The relevant cytology, histology, and flow cytometry were analyzed. Of the 76 lymphoid lesions, results included reactive lesions (n = 35), lymphoepithelial cysts (n = 27), malignant lymphomas (n = 12), an atypical lymphoid population (n = 1), and Sjogren's disease (n = 1). We conclude that both reactive and malignant lymphoid lesions of the parotid can be diagnosed on FNA with adjunctive tests such as flow cytometry and immunophenotyping, obviating the need for surgery. Diagn. Cytopathol. 1999;21:170-173.