Gareb Barzi, Perry Michael, Tadrous Paul Joseph
PhD Candidate in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, UK.
Consultant Oral and Maxillofacial Surgeon and Clinical Lead in Facial Trauma, Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, Harrow, UK.
J Oral Maxillofac Surg. 2018 Sep;76(9):1917-1924. doi: 10.1016/j.joms.2018.03.003. Epub 2018 Mar 8.
Amyloidosis in the parotid gland is rare and is usually associated with systemic amyloidosis. Localized amyloidosis in the parotid gland is extremely rare. We present a case of localized light chain amyloidosis of the parotid gland without systemic involvement. A 70-year-old woman presented with an asymptomatic swelling of the right parotid region. The findings of a physical examination, hematologic and biochemical investigations, imaging, and cytology were inconclusive. The patient underwent an extracapsular dissection of the right parotid gland. Histologic analysis showed that the tissue of the right parotid gland mostly consisted of amyloid deposition. The amyloid stained with antibodies to lambda light chains. Additional investigations showed no systemic involvement. The patient is asymptomatic 5 months after surgery. Clinicians should be aware of the possibility of localized amyloid light chain amyloidosis in the parotid gland, especially if magnetic resonance imaging, computed tomography imaging, and ultrasound findings are inconclusive, and they should recognize, evaluate, and treat it accordingly.
腮腺淀粉样变性罕见,通常与系统性淀粉样变性相关。腮腺局限性淀粉样变性极为罕见。我们报告一例无全身累及的腮腺局限性轻链淀粉样变性病例。一名70岁女性因右腮腺区无症状肿胀就诊。体格检查、血液学和生化检查、影像学及细胞学检查结果均无定论。患者接受了右腮腺囊外剥离术。组织学分析显示,右腮腺组织主要由淀粉样沉积构成。淀粉样物质用λ轻链抗体染色。进一步检查未发现全身累及。患者术后5个月无症状。临床医生应意识到腮腺局限性淀粉样轻链淀粉样变性的可能性,尤其是在磁共振成像、计算机断层扫描成像及超声检查结果无定论时,应相应地识别、评估并进行治疗。