Case 232 - Discussion

Uploaded: 2008-05-20, Updated: 2008-05-20

   

Mikulicz’s Disease (Benign Lymphoepithelial Lesion)

CLINICAL FEATURES

  • Slow growth, bilateral, symmetric enlargement of salivary and lacrimal glands.

  • M:F=1:3, 40-70 years of age.

  • Mostly associated with Sjogren’s syndrome, but may be confined to salivary gland.

  • Mostly seen in parotid gland (85%).

  • Increased incidence with HIV.

  • Initially polyclonal, may evolve into lymphoma.

GROSS FINDINGS

  • Solid gray-white areas and occasional cysts.

MICROSCOPIC FINDINGS

  • Marked lymphocytic infiltration with lymphoid follicles, parenchymal atrophy, foci of epithelial proliferation as solid epithelial nests (epimyoepithelial islands).

  • Scattered histiocytes and dendritic cells; excess hyaline basement membrane material deposited between cells.

  • Acinar atrophy and destruction, lymphoepithelial lesions, monocytoid B cells; usually no fibrosis, no involvement of large ducts.

REFERENCES

  • AFIP, tumor of the salivary glands, series 3.