Marginal zone B-cell lymphoma of the parotid gland associated with epithelioid granulomas. Report of a case with fine needle aspiration.

BACKGROUND

Although granulomas can occur in association with malignant neoplasms, including some subtypes of lymphoma, they have been described rarely in marginal zone B-cell lymphoma (MZCL). To our knowledge, the cytologic features of this association have not been documented. We present the cytologic findings with fine needle aspiration cytology (FNAC) of an unusual case of MZCL with concomitant granulomas.

CASE

An 82-year-old male presented with a mass in the left parotid gland. The lesion was evaluated by FNAC. The smears showed syncytial aggregates of epithelioid histiocytes intermixed with small and medium-sized lymphoid cells containing round to irregular-shaped nuclei and small nucleoli. Some of these cells had a greater amount of cytoplasm and frequently had a plasmacytoid appearance. The lesion was removed, and histopathologic study showed MZCL associated with extensive nonnecrotizing granulomas.

CONCLUSION

Granulomatous reactions can be seen in rare cases of MZCL. However, the cytologic features of the lymphoid infiltrate can suggest the possibility of MZCL in the clinical setting of FNAC performed from an extranodal location, such as the parotid gland.