Fine needle aspiration cytologic findings in a benign lymphoepithelial lesion with microcalcifications. A case report

Area of Science:

• Otolaryngology and Head and Neck Pathology
• Cytopathology and Surgical Pathology
• Salivary Gland Neoplastic and Non-Neoplastic Diseases

Background:

• Benign lymphoepithelial lesion (BLL) is a rare, non-neoplastic condition affecting salivary glands, primarily the parotid gland.
• Distinguishing BLL from neoplastic salivary gland lesions can be challenging, necessitating accurate diagnostic methods.
• Fine needle aspiration (FNA) cytology is a key diagnostic tool for salivary gland pathologies, but its utility in non-neoplastic lesions requires careful evaluation.

Observation:

• Aspiration cytology of a parotid gland lesion revealed a polymorphous lymphoid infiltrate, histiocytes, myoepithelial cells, ductal epithelial cells, and numerous bluish, calcified bodies.
• The cytologic findings suggested a benign nonneoplastic process, specifically chronic sialadenitis with microlithiasis.
• Clinical suspicion for neoplasia contrasted with the cytological interpretation.

Findings:

• Histologic examination confirmed the diagnosis of benign lymphoepithelial lesion (BLL) with the unexpected presence of microcalcifications.
• The cytologic diagnosis of benign nonneoplastic lesion, consistent with chronic sialadenitis and microlithiasis, was accurate in identifying the non-neoplastic nature of the lesion.
• The study highlights the presence of microcalcifications as a potential, albeit unexpected, feature in BLL.

Implications:

• Fine needle aspiration cytology can effectively diagnose benign nonneoplastic salivary gland lesions like BLL, even with atypical features such as microcalcifications.
• Cytologic findings, when correlated with clinical presentation, aid in differentiating benign conditions from potentially malignant salivary gland tumors.
• Understanding the cytologic spectrum of BLL, including microcalcifications, improves diagnostic accuracy and guides appropriate patient management, avoiding unnecessary surgical interventions for benign conditions.