- Mikulicz syndrome redirects here.
Benign lymphoepithelial lesion |
Classification and external resources |
Specialty |
gastroenterology |
ICD-10 |
K11.8 |
ICD-9-CM |
527.1 |
DiseasesDB |
8218 |
MeSH |
D008882 |
Benign lymphoepithelial lesion is a type of benign enlargement of the parotid and/or lacrimal glands. This pathologic state is sometimes, but not always, associated with Sjögren's syndrome.
Contents
- 1 Eponym
- 2 Locations
- 3 Characteristic
- 4 Histology
- 5 Treatment
- 6 See also
- 7 References
- 8 Further reading
- 9 External links
Eponym
Historically, bilateral parotid and lacrimal gland enlargement was characterized by the term Mikulicz's disease if the enlargement appeared apart from other diseases. If it was secondary to another disease, such as tuberculosis, sarcoidosis, lymphoma, and Sjögren's syndrome, the term used was Mikulicz's syndrome. Both names derive from Jan Mikulicz-Radecki, the Polish surgeon best known for describing these conditions.[1][2]
Today, the terms "Mikulicz's disease" and "Mikulicz's syndrome" are viewed as ambiguous and outdated by some sources.[3]
Locations
In 80% of cases, the parotid gland is affected. Lacrimal glands are also affected.
Characteristic
Benign lymphoepithelial lesion is most likely to occur in adults around 50 years of age. There is a predilection for gender with 60–80% being female. The gland affected has a diffuse swelling. The swelling can be asymptomatic, but mild pain can also be associated. There is a preponderance of this disease in those who suffer from HIV infection.
Most cases of benign lymphoepithelial lesions appear in conjunction with Sjögren's syndrome. When Sjögren's syndrome is present, the swelling is usually bilateral. Otherwise, the affected glands are usually only on one side of the body.
In many cases, a biopsy is needed to distinguish benign lymphoepithelial lesions from sialadenosis (sialosis).
Histology
Section from salivary gland showing dense lymphoid infiltrate around and within ductal epithelium-Lympho epithelial lesion (H&E,100X)
There is a marked lymphoplasmacytic infiltration. Lymphoid follicles surround solid epithelial nests, giving rise to the 'epimyoepithelial islands', that are mainly composed of ductal cells with occasional myoepithelial cells. Excess hyaline basement membrane material is deposited between cells, and there is also acinar atrophy and destruction.
Treatment
Treatment usually consists of observation unless the patient has concern, there is pain, drainage, or other symptoms related to the lesion. Surgical removal of the affected gland would be recommended in those cases. Another treatment option would be aspiration, which can be repeated multiple times. This is commonly performed in those who are debilitated or in those whose benefit from surgery would be outweighed by the risks. Prognosis is usually good; rarely this condition may devolve into lymphoma, or could actually represent 'occult' lymphoma from the outset.
See also
References
- ^ synd/2087 at Who Named It? - "Mikulicz's disease"
- ^ synd/2088 at Who Named It? - "Mikulicz's syndrome"
- ^ Ihrler S, Harrison J (2005). "Mikulicz's disease and Mikulicz's syndrome: analysis of the original case report of 1892 in the light of current knowledge identifies a MALT lymphoma.". Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100 (3): 334–9. doi:10.1016/j.tripleo.2005.01.016. PMID 16122662.
- Bibliography
- Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.
- Regezi, Joseph A. Oral Pathology: Clinical Pathologic Correlations. 4th ed. 2002.
Further reading
- Kahn, LB (Jan 1979). "Benign lymphoepithelial lesion (Mikulicz's disease) of the salivary gland: an ultrastructural study.". Human pathology 10 (1): 99–104. doi:10.1016/S0046-8177(79)80077-5. PMID 428999.
- Lee S, Tsirbas A, McCann J, Goldberg R (2006). "Mikulicz's disease: a new perspective and literature review.". Eur J Ophthalmol 16 (2): 199–203. PMID 16703534.
- Tsubota, K; Fujita, H; Tsuzaka, K; Takeuchi, T (Jun 2000). "Mikulicz's disease and Sjögren's syndrome.". Investigative Ophthalmology & Visual Science 41 (7): 1666–73. PMID 10845583.
- Azzopardi, JG; Evans, DJ (Nov 1971). "Malignant lymphoma of parotid associated with Mikulicz disease (benign lymphoepithelial lesion)" (PDF). J Clin Pathol. 24 (8): 744–752. doi:10.1136/jcp.24.8.744. PMC 477147. PMID 4943296.
- Yamamoto, M; Harada, S; Ohara, M; Suzuki, C; Naishiro, Y; Yamamoto, H; Takahashi, H; Imai, K (Feb 2005). "Clinical and pathological differences between Mikulicz's disease and Sjögren's syndrome.". Rheumatology (Oxford, England) 44 (2): 227–34. doi:10.1093/rheumatology/keh447. PMID 15509627.
- Delaney, William E.; Balogh, Károly. "Carcinoma of the parotid gland associated with benign lymphoepithelial lesion (Mikulicz's disease) in Sjögren's syndrome". Cancer 19 (6): 853–860. doi:10.1002/1097-0142(196606)19:6<853::AID-CNCR2820190617>3.0.CO;2-N.
External links
- Mikulicz syndrome on The National Organization for Rare Disorders (NORD)
- Benign lymphoepithelial lesions on Radiopedia
Oral and maxillofacial pathology (K00–K06, K11–K14, 520–525, 527–529)
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Lips
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- Cheilitis
- Actinic
- Angular
- Plasma cell
- Cleft lip
- Congenital lip pit
- Eclabium
- Herpes labialis
- Macrocheilia
- Microcheilia
- Nasolabial cyst
- Sun poisoning
- Trumpeter's wart
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Tongue
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- Ankyloglossia
- Black hairy tongue
- Caviar tongue
- Crenated tongue
- Cunnilingus tongue
- Fissured tongue
- Foliate papillitis
- Glossitis
- Geographic tongue
- Median rhomboid glossitis
- Transient lingual papillitis
- Glossoptosis
- Hypoglossia
- Lingual thyroid
- Macroglossia
- Microglossia
- Rhabdomyoma
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Palate
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- Bednar's aphthae
- Cleft palate
- High-arched palate
- Palatal cysts of the newborn
- Inflammatory papillary hyperplasia
- Stomatitis nicotina
- Torus palatinus
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Oral mucosa - Lining of mouth
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- Amalgam tattoo
- Angina bullosa haemorrhagica
- Behçet syndrome
- Bohn's nodules
- Burning mouth syndrome
- Candidiasis
- Condyloma acuminatum
- Darier's disease
- Epulis fissuratum
- Erythema multiforme
- Erythroplakia
- Fibroma
- Focal epithelial hyperplasia
- Fordyce spots
- Hairy leukoplakia
- Hand, foot and mouth disease
- Hereditary benign intraepithelial dyskeratosis
- Herpangina
- Herpes zoster
- Intraoral dental sinus
- Leukoedema
- Leukoplakia
- Lichen planus
- Linea alba
- Lupus erythematosus
- Melanocytic nevus
- Melanocytic oral lesion
- Molluscum contagiosum
- Morsicatio buccarum
- Oral cancer
- Benign: Squamous cell papilloma
- Keratoacanthoma
- Malignant: Adenosquamous carcinoma
- Basaloid squamous carcinoma
- Mucosal melanoma
- Spindle cell carcinoma
- Squamous cell carcinoma
- Verrucous carcinoma
- Oral florid papillomatosis
- Oral melanosis
- Pemphigoid
- Pemphigus
- Plasmoacanthoma
- Stomatitis
- Aphthous
- Denture-related
- Herpetic
- Smokeless tobacco keratosis
- Submucous fibrosis
- Ulceration
- Verruca vulgaris
- Verruciform xanthoma
- White sponge nevus
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Teeth (pulp, dentin, enamel)
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- Amelogenesis imperfecta
- Ankylosis
- Anodontia
- Caries
- Concrescence
- Delayed eruption
- Dens evaginatus
- Dentin dysplasia
- Dentin hypersensitivity
- Dentinogenesis imperfecta
- Dilaceration
- Ectopic enamel
- Enamel hypocalcification
- Enamel hypoplasia
- Enamel pearl
- Fluorosis
- Fusion
- Gemination
- Hyperdontia
- Hypodontia
- Impaction
- Macrodontia
- Meth mouth
- Microdontia
- Odontogenic tumors
- Keratocystic odontogenic tumour
- Odontoma
- Open contact
- Premature eruption
- Pulp calcification
- Pulp necrosis
- Pulp polyp
- Pulpitis
- Regional odontodysplasia
- Resorption
- Supernumerary root
- Taurodontism
- Trauma
- Avulsion
- Cracked tooth syndrome
- Vertical root fracture
- Occlusal
- Tooth loss
- Tooth wear
- Abrasion
- Abfraction
- Acid erosion
- Attrition
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Periodontium (gingiva, Periodontal ligament, cementum, alveolus) - Gums and tooth-supporting structures
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- Cementoblastoma
- Cementoma
- Eruption cyst
- Epulis
- Pyogenic granuloma
- Congenital epulis
- Gingival enlargement
- Gingival cyst of the adult
- Gingival cyst of the newborn
- Gingivitis
- Desquamative
- Granulomatous
- Plasma cell
- Hereditary gingival fibromatosis
- Hypercementosis
- Hypocementosis
- Linear gingival erythema
- Necrotizing periodontal diseases
- Acute necrotizing ulcerative gingivitis
- Pericoronitis
- Peri-implantitis
- Periodontal abscess
- Periodontal trauma
- Periodontitis
- Aggressive
- As a manifestation of systemic disease
- Chronic
- Perio-endo lesion
- Teething
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Periapaical, mandibular and maxillary hard tissues - Bones of jaws
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- Agnathia
- Alveolar osteitis
- Cherubism
- Idiopathic osteosclerosis
- Mandibular fracture
- Microgenia
- Micrognathia
- Intraosseous cysts
- Odontogenic: periapical
- Dentigerous
- Buccal bifurcation
- Lateral periodontal
- Globulomaxillary
- Calcifying odontogenic
- Glandular odontogenic
- Non-odontogenic: Nasopalatine duct
- Median mandibular
- Median palatal
- Traumatic bone
- Osteomyelitis
- Osteonecrosis
- Bisphosphonate-associated
- Neuralgia-inducing cavitational osteonecrosis
- Osteoradionecrosis
- Osteoporotic bone marrow defect
- Paget's disease of bone
- Periapical abscess
- Periapical periodontitis
- Stafne defect
- Torus mandibularis
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Temporomandibular joints, muscles of mastication and malocclusions - Jaw joints, chewing muscles and bite abnormalities
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- Bruxism
- Condylar resorption
- Mandibular dislocation
- Malocclusion
- Crossbite
- Open bite
- Overbite
- Overjet
- Prognathia
- Retrognathia
- Temporomandibular joint dysfunction
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Salivary glands
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- Benign lymphoepithelial lesion
- Ectopic salivary gland tissue
- Frey's syndrome
- HIV salivary gland disease
- Necrotizing sialometaplasia
- Mucocele
- Pneumoparotitis
- Salivary duct stricture
- Salivary gland aplasia
- Salivary gland atresia
- Salivary gland diverticulum
- Salivary gland fistula
- Salivary gland hyperplasia
- Salivary gland hypoplasia
- Salivary gland neoplasms
- Benign: Basal cell adenoma
- Canalicular adenoma
- Ductal papilloma
- Monomorphic adenoma
- Myoepithelioma
- Oncocytoma
- Papillary cystadenoma lymphomatosum
- Pleomorphic adenoma
- Sebaceous adenoma
- Malignant: Acinic cell carcinoma
- Adenocarcinoma
- Adenoid cystic carcinoma
- Carcinoma ex pleomorphic adenoma
- Lymphoma
- Mucoepidermoid carcinoma
- Sclerosing polycystic adenosis
- Sialadenitis
- Parotitis
- Chronic sclerosing sialadenitis
- Sialectasis
- Sialocele
- Sialodochitis
- Sialosis
- Sialolithiasis
- Sjögren's syndrome
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Orofacial soft tissues - Soft tissues around the mouth
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- Actinomycosis
- Angioedema
- Basal cell carcinoma
- Cutaneous sinus of dental origin
- Cystic hygroma
- Gnathophyma
- Ludwig's angina
- Macrostomia
- Melkersson–Rosenthal syndrome
- Microstomia
- Noma
- Oral Crohn's disease
- Orofacial granulomatosis
- Perioral dermatitis
- Pyostomatitis vegetans
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Other
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- Eagle syndrome
- Hemifacial hypertrophy
- Facial hemiatrophy
- Oral manifestations of systemic disease
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Index of the mouth
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Description |
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Disease |
- Congenital
- face and neck
- cleft
- digestive system
- Neoplasms and cancer
- Other
- Symptoms and signs
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Treatment |
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