Volume 61, December 2022, 152058Abstract

We are presenting a case of a 74-year-old female with a parotid gland mass. Fine-needle aspiration (FNA) of the mass demonstrated cohesive groups of epithelial cells with overall bland-appearing nuclei and abundant vacuolated cytoplasm, consistent with sebaceous cells, in a background of polymorphous lymphocytes, scattered histiocytes, and adipose tissue. Immunostains showed that the epithelial cells stain positive for p63, but negative for CD117 and DOG-1. CD3 and CD20 showed a mixture of T- and B-cells. On the PAP-stained slides, there were numerous sac-like structures, consistent with myospherules. These findings were suggestive of neoplasm with sebaceous differentiation. The main differential diagnosis included sebaceous adenoma, sebaceous lymphadenoma, and other benign lesions with sebaceous differentiation. The parotid mass was resected. Histology sections demonstrated a well-circumscribed neoplasm with multicystic epithelial component and surrounding lymphoid infiltrate, consistent with sebaceous lymphadenoma. Sebaceous lymphadenoma (SLA) is a rare benign salivary gland neoplasm that is most commonly seen in the parotid gland. Preoperative FNA diagnosis of sebaceous neoplasms is challenging. To the best of our knowledge, this is the third case of sebaceous lymphadenoma diagnosed preoperatively. In this manuscript, we detail the epidemiological characteristics and histogenesis of sebaceous salivary gland neoplasms, and the cytomorphologic differential diagnosis of SLA with key diagnostic features of each entity.

Introduction

Sebaceous lymphadenoma (SLA) is a rare benign salivary gland neoplasm that is most commonly seen in the parotid gland. Histologically, this neoplasm is characterized by proliferation of epithelial elements of the sebaceous glands in the lymphoplasmacytic background. Preoperative diagnosis of this entity in the cytology specimens is challenging due to its rarity and overlap of cytomorphologic features with other low-grade salivary gland neoplasms [1], [2], [3], [4], [5], [6], [7]. Herein, we report the cytomorphologic findings and differential diagnosis of sebaceous lymphadenoma in preoperative fine-needle aspiration (FNA) specimen with follow-up surgical pathology and review of the literature.

Section snippetsCase report

A 74-year-old female presented for the evaluation of the left parotid region mass which initially thought to be related to a tooth abscess. The patient noted that the mass was increasing in size. Otherwise, the mass was asymptomatic, without pain, overlying skin change or facial weakness. The patient denied any difficulties in masticating or swallowing, fevers, chills, night sweats, and sore throat.

The patient had ultrasound (US) and computer tomography (CT) of her neck performed. The US

Discussion

Sebaceous salivary gland neoplasms are extremely rare, accounting for less than 0.2 % of benign and malignant salivary gland tumors. Sebaceous lymphadenoma (SLA) is a subtype of sebaceous salivary gland tumors [2], [3], [4], [5]. Unlike non-sebaceous lympadenomas, SLA show slight male predominance, arguably due to generally higher concentration of sebaceous glands in men than in women [5]. SLAs typically occur in adult patients with a mean age at presentation of 59 years [2], [3], [4], [5].

References (19)T. Dreyer et al.Unusual differentiation of a combination tumor of the parotid gland. A case report

Pathol Res Pract

(1993)

H. Kurokawa et al.Sebaceous lymphadenoma in the midline of the maxilla: report of case

J Oral Maxillofac Surg

(1999)

Boyle J.L.Master SCFine needle aspiration cytology of a sebaceous lymphadenoma: a case report

Acta Cytol

(2004)

D.R. Gnepp et al.Sebaceous neoplasms of salivary gland origin. Report of 21 cases

Cancer

(1984)

R.R. Seethala et al.Lymphadenoma of the salivary gland: clinicopathological and immunohistochemical analysis of 33 tumors

Mod Pathol

(2012)

A.J. Rawson et al.Sebaceous glands and sebaceous gland-containing tumors of the parotid salivary gland; with a consideration of the histogenesis of papillary cystadenoma lymphomatosum

Surgery

(1950)

M.H. McGavran et al.Sebaceous lymphadenoma of the parotid salivary gland

Cancer

(1960)

There are more references available in the full text version of this article.

View full text

© 2022 Elsevier Inc. All rights reserved.