Parmar Harshad V
Assistant Professor, Department of General Pathology, Christian Medical College , Vellore, India .
J Clin Diagn Res. 2015 Mar;9(3):ED05-6. doi: 10.7860/JCDR/2015/11291.5693. Epub 2015 Mar 1.
Lipomatous tumours of salivary glands are very uncommonly diagnosed and reported tumours. Majority of these tumours present as painless masses which grow slowly over many years. On the histological grounds, they can be subclassified into "monophasic" (lipoma component only) and "biphasic" (lipoma component+epithelial component) tumours. A handful of biphasic tumours contain oncocytic component and they have been omitted from the WHO classification of salivary gland tumours so far and this has remained a matter of persistent confusion and controversy over many years. Other rare variants of monophasic tumours include fibrolipoma, sialolipoma, angiolipoma, sialadenosis and very rarely a liposarcoma can also occur in salivary glands. Pre-operative imaging can help in picking up the fatty component of the tumours and guide in accurate classification. FNAC may not be accurate in diagnosis of these tumours. We report a case of 45-year-old gentleman presenting with submandibular gland swelling for which submandibular gland excision was done. A final diagnosis of oncocytic lipoadenoma was made. We present this rare entity to add to the few cases reported to date and hence, to increase recognisation and understanding of these rare tumours, which may help in establishing a reproducible subclassification. We have discussed the pathological aspects with review of literature of this very rare entity.
涎腺脂肪瘤性肿瘤是非常罕见被诊断和报道的肿瘤。这些肿瘤大多数表现为无痛性肿块，多年来生长缓慢。从组织学角度来看，它们可分为“单相性”（仅含脂肪瘤成分）和“双相性”（脂肪瘤成分+上皮成分）肿瘤。少数双相性肿瘤含有嗜酸性细胞成分，到目前为止它们一直被排除在世界卫生组织涎腺肿瘤分类之外，多年来这一直是一个持续存在混淆和争议的问题。单相性肿瘤的其他罕见变体包括纤维脂肪瘤、涎腺脂肪瘤、血管脂肪瘤、涎腺肿大，涎腺中也极罕见会发生脂肪肉瘤。术前影像学检查有助于发现肿瘤的脂肪成分并指导准确分类。细针穿刺抽吸活检（FNAC）对这些肿瘤的诊断可能不准确。我们报告一例45岁男性患者，因下颌下腺肿大接受了下颌下腺切除术。最终诊断为嗜酸性脂腺瘤。我们展示这个罕见病例，以补充迄今报道的少数病例，从而提高对这些罕见肿瘤的认识和理解，这可能有助于建立可重复的亚分类。我们结合该罕见实体的文献回顾讨论了其病理方面。
