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Case Reports
. 2020 Nov 30;13(11):e238099.
doi: 10.1136/bcr-2020-238099.

Non-sebaceous lymphadenoma of the submandibular gland: diagnostic challenges in the head and neck cancer pathway

Graham Garside  1 , Dominic Jaikaransingh  2 , Gayani Pitiyage  3 , Enyinnaya Ofo  4
Affiliations
Case Reports

Non-sebaceous lymphadenoma of the submandibular gland: diagnostic challenges in the head and neck cancer pathway

Graham Garside et al. BMJ Case Rep. .

Abstract

Non-sebaceous lymphadenoma (NSLA) is a rare benign salivary gland tumour with lymphoid and epithelial components and without sebaceous differentiation. The large majority of the reported cases arise within the parotid gland. We present an NSLA arising from the submandibular gland. The tumour presented as a painless longstanding neck lump. Ultrasound, fine needle aspiration, MRI and positron emission tomography found features supportive of squamous cell carcinoma. The patient was treated with surgery for oropharyngeal carcinoma of unknown origin, in accordance with local and national guidelines. The final histological assessment revealed the level Ib neck lesion to be NSLA. Although a rare occurrence, these lesions may pose a diagnostic challenge in the head and neck cancer pathway.

Keywords: otolaryngology / ENT; pathology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Positron emission tomography CT showing fluorodeoxyglucose enhancement of the left submandibular gland.
Figure 2
Figure 2
Low-power view (×2) showing the well-circumscribed and well-demarcated lesion suggestive of cyst formation.
Figure 3
Figure 3
Lesion showing trabeculae of squamous epithelium.
Figure 4
Figure 4
High-power view (×10) showing part of a cystic island and benign lymphoid parenchyma.
Figure 5
Figure 5
High-power view (×20) showing lymphoepithelium forming small keratin pearls.
See this image and copyright information in PMC

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