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Primary T cell lymphoma of salivary gland: a report of a case and review of the literature
  1. W S R Hew1,
  2. F A Carey1,
  3. N M Kernohan1,
  4. A D Heppleston2,
  5. R Jackson3,
  6. R F Jarrett4
  1. 1Department of Pathology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK
  2. 2Department of Haematology, Lincoln County Hospital, Greetwell Road, Lincoln DN33 2BA, UK
  3. 3Department of Pathology, Glasgow Royal Infirmary, Glasgow G4 0SF, UK
  4. 4LRF Virus Centre, Department of Veterinary Pathology, University of Glasgow, Glasgow, G61 1QH, UK
  1. Correspondence to:
 Dr WSR Hew, Department of Pathology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK;
 roger.w.hew{at}tuht.scot.nhs.uk

Abstract

Lymphoma of the salivary gland accounts for 5% of cases of extranodal lymphoma and 10% of malignant salivary gland tumours. Most primary salivary gland lymphomas are B marginal zone lymphomas arising on a background of sialadenitis associated with autoimmune disorders such as Sjorgen's syndrome. Primary T cell lymphoma of the salivary gland is rare. This report describes a case of primary T cell lymphoma arising in the parotid gland of an elderly white man, which was notable for its striking resemblance to a B cell extranodal marginal zone lymphoma. Immunohistochemistry and gene rearrangement studies confirmed the clonal T cell nature of the tumour. There was no molecular evidence of Epstein-Barr virus (EBV) infection of neoplastic or surroundings cells. Only 14 cases of primary T cell lymphoma of the salivary glands have been recorded in the literature, most being from the Orient and having extremely variable prognosis. Those with a T/natural killer cell phenotype are associated with EBV infection. This case highlights the fact that T cell lymphoma in the salivary gland can mimic closely the morphological features of B cell extranodal marginal zone lymphoma.

  • salivary gland
  • T cell lymphoma
  • Epstein Barr virus
  • ALK1, anaplastic lymphoma kinase antibody
  • CHOP regimen, cyclophosphamide, hydroxydaunorubicin (adriamycin), oncovin (vincristine), and prednisolone
  • EBER, Epstein-Barr virus encoded early nuclear RNA
  • EBV, Epstein-Barr virus
  • IgH, immunoglobulin heavy chain
  • MACOP regimen, methotrexate, adriamycin (doxorubicin), cyclophosphamide, oncovin (vincristine), and prednisolone
  • NHL, non-Hodgkin's lymphoma
  • NK, natural killer
  • PCR, polymerase chain reaction
  • TCR, T cell receptor
  • TdT, terminal deoxynucleotidyl transferase

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