Adenolymphoma
Introduction
Introduction to adenolymphoma Adenolymphoma (adenolymphoma) is also known as papillary cystadenomalymphomatosum or Warthin tumor. This disease was first reported by Albrecht and Arzt (1910) and is called papillary lymphocytic adenoma. Warthin (1929) reported 2 cases and described them in detail, so they were named. The origin of glandular lymphoma is different. Most people believe that ectopic parotid tissue from the adjacent lymph nodes is observed in the lymph nodes of the parotid gland of the embryo and in the lymph nodes near the typical adenolymphoma. A similar gland tube was found. Immunological studies have shown that the lymphoid tissue in the tumor tissue is mainly composed of T lymphocytes and a few B lymphocytes. Ultrastructural observations suggest that these lymphoid tissues are the result of a cell-mediated immune response. Therefore, it is believed that the lymphoid components in the tumor tissue are derived from normal or reactive lymph node tissues in the parotid gland, and do not participate in the formation and growth of tumors. basic knowledge The proportion of illness: 0.052% Susceptible people: no specific population Mode of infection: non-infectious Complications: bacterial infection
Cause
Cause of adenolymphoma
1. Gross morphology: The size of adenolymphoma is generally small, and the diameter is generally 3 to 4 cm. The surface of the tumor is smooth, often with mild lobes, and has a complete and thin capsule, which is round or oval, soft. Can be flattened, sometimes sac sexy, the cut surface is mostly solid, can be seen like cheese-like, gray-white, uniform texture, part of the cystic, common brown clear mucus, glue-like or milk-like substances flow out of the capsule.
2. Microscopic examination: The tumor consists of epithelial and lymphoid tissue. The epithelial component forms an irregular large gland or cystic cavity, and the nipple protrudes into the lumen. The glandular cavity contains red staining and amorphous substances, sometimes with cholesterol crystal fissures. Or a small amount of inflammatory cells, the epithelial cells are arranged in a double layer, the inner layer is a high columnar cell, and has a granular, eosinophilic cytoplasm; the outer layer of cells is cubic, polygonal or round, nuclear vacuolated, lightly stained, Visible nucleoli, glandular epithelial cells no atypical, sometimes visible epithelial cells squamous metaplasia, occasionally mucus cells, sebaceous gland cells and ciliated columnar epithelial cells, epithelial cells can also be arranged into solid mass, interstitial In addition to some fibrous connective tissue, there are many lymphocytes densely arranged into lumps of varying sizes or forming lymphoid follicles with germinal centers.
3. Biological characteristics: Glandular lymphoma grows slowly, the tumor is generally small, and there are very few patients with a diameter of more than 10cm. The local recurrence rate reported in the literature is 5.5% to 12.2%, but Evans et al believe that the so-called recurrence is not the original The lesion can grow, but has the characteristics of multifocality. There may be more than one tumor in the same parotid gland, and there are also bilateral co-occurrences, and tumor carcinogenesis is rare.
Prevention
Adenolymphoma prevention
Get rid of some bad habits in life, develop a good life, and eat some anti-cancer foods, such as broccoli and cabbage, citrus orange fruit, garlic, apricot, fig, sweet potato, bitter gourd, etc. Both have a good effect of inhibiting tumors.
Complication
Adenolymphoma complications Complications bacterial infection
Complicated with maxillofacial infections, respiratory obstruction and other diseases.
Symptom
Lymphoma symptoms Common symptoms Lymph node degeneration Slow growth Parotid painless mass
The majority of adenolymphomas occur in the parotid gland, which is unique to adenolymphoma. It is also reported to occur in the submandibular gland. However, this condition is thought to occur in the part of the parotid gland that is close to the submandibular gland, possibly related to its tissue source. In the parotid gland, the common site is the posterior surface of the parotid gland and its lower pole. The incidence of adenolymphoma is 6% of the parotid gland tumor, 8.4% to 20.7% of the parotid gland tumor, and 17% of the benign tumor of the parotid gland. ~33%, adenolymphoma can occur at any age, but 40 to 70 years old is a good age, children are rare, mainly suffering from men, accounting for 85% to 90%.
Most patients complained of slow-growing painless masses. The masses were round, oval, and smooth. In most cases, the tumors were soft and flexible, with a few cysts, clear boundaries, movable, and no adhesion to the skin. Generally, the tumor is no more than 6cm, and it is difficult to distinguish it from other salivary gland tumors. It can be seen that the tumor capsule is thin and brittle. Although it is easy to peel off, it is easy to break through and overflows with yellow or brown liquid. In a few cases, the tumor has a sense of fluctuation. Or tenderness, generally no dysfunction.
Examine
Adenosial lymphoma examination
1. Can be bilateral, or multiple tumor nodules in the ipsilateral parotid gland and nearby neck.
2. Mostly 3-4cm in diameter, round or oblong lumps, smooth or slightly lobulated, soft, can have a sense of undulation, the tumor and surrounding glandular tissue boundary is not clear.
3. The upper neck of the tumor can be molded and swollen lymph nodes.
The 4.99Tc radionuclide scan is a hot nodule.
Diagnosis
Diagnosis and diagnosis of adenolymphoma
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
According to the detailed medical history and clinical examination, and can grasp the pathogenesis and characteristics of the disease, the preoperative diagnosis is generally not difficult, but should be differentiated from other tumors of the parotid gland, cleft palate, and swollen lymph nodes.
Parotid gland angiography showed benign space-occupying lesions, with or without changes in the main duct, disordered branching catheters, distortion, irregular expansion or stenosis, and acinar filling defects were more regular.
Isotope 99m scan is specific for the diagnosis and differential diagnosis of adenolymphoma. Because adenolymphoma is composed of epithelial cells and lymphoid tissues, highly differentiated epithelial cells form a lumen-like structure and may retain their normal aggregation mechanism. Epithelial cells contain a large number of mitochondria, and the tumor can take up citrate, which is higher than normal parotid tissue, and the scan shows "hot" nodules.
