Diagnostic approach to lymphoid lesions of major salivary glands

Among lesions of the major salivary glands (parotid, submandibular, and sublingual glands), those with a prominent lymphoid component are encountered frequently in the surgical pathology laboratory and range from reactive lesions to benign and malignant neoplasms. A majority of these lymphoid lesions have a co-mingled epithelial component, which also ranges from benign to malignant. As a result, many of these lesions have similar and overlapping histopathologic features, and attention to details, sometimes subtle, is required to accurately distinguish one from another. This review will discuss these lymphoid-epithelial lesions of major salivary glands, with emphasis on features that help in the differential diagnosis. Entities discussed include lymphoepithelial sialadenitis, HIV-associated salivary gland disease, extranodal marginal zone B-cell lymphoma, lymphoepithelial carcinoma, lymphadenoma, sebaceous lymphadenocarcinoma, chronic sclerosing sialadenitis, and Warthin tumour.