title: T- and T/natural killer-cell lymphomas of the salivary gland: a clinicopathologic, immunohistochemical and molecular study of six cases.
abstract: Primary salivary gland lymphomas are almost always of B lineage, with most being represented by low grade B-cell lymphoma of mucosa-associated lymphoid tissue. This study characterizes the rare non-B-cell lymphomas of the salivary gland based on an analysis of six cases. All patients were men, with a mean age of 53.5 years. They presented with submandibular or parotid mass, which on histological examination showed extensive interstitial infiltration by small, medium-sized, or large lymphoid cells. There was prominent invasion and expansion of the ducts and acini in five cases. Angioinvasion was evident in two cases. Three cases were of T lineage and were CD56 negative; one of these cases expressed CD30. Three cases showed an immunophenotype of CD2+ CD3(f)- CD3(p)+ CD56+, consistent with T/natural killer (NK) cell lymphoma. In situ hybridization for Epstein-Barr virus (EBV)-encoded early nuclear RNA (EBER) showed positive reaction exclusively in the three CD56+ cases. Clonal T-cell populations were shown in two CD56-negative cases by polymerase chain reaction on paraffin sections using primers for the T-cell-receptor (TCR) gamma-chain gene, but not in the other four cases (the three CD56+ cases and one CD56- case). Four patients (two CD56+ and two CD56-) died within 3 years, and two were disease free at 4 and 1.5 years, respectively. This study shows that salivary gland T- or T/NK-cell lymphomas cannot be reliably distinguished from B-cell lymphomas on morphological grounds alone, because both can show prominent lymphoepithelial lesions. It appears that T/NK-cell lymphomas, which are often extranodal in localization and strongly associated with Epstein-Barr virus (EBV), show a predilection to involve the salivary glands as well.
authors.affiliation: Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
authors.forename: J K
authors.initials: JK
authors.lastname: Chan
authors.forename: W Y
authors.initials: WY
authors.lastname: Tsang
authors.forename: P K
authors.initials: PK
authors.lastname: Hui
authors.forename: C S
authors.initials: CS
authors.lastname: Ng
authors.forename: V C
authors.initials: VC
authors.lastname: Sin
authors.forename: S M
authors.initials: SM
authors.lastname: Khan
authors.forename: L L
authors.initials: LL
authors.lastname: Siu
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D007694:Killer Cells, Natural / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin; D016399:Lymphoma, T-Cell / Q000737:chemistry / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012468:Salivary Gland Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D015703:Antigens, CD