Linfoma MALT de glándula parótida. Revisión sistemática
Resumen Introducción y objetivo: Los linfomas de la glándula parótida son una entidad infrecuente. El objetivo de este estudio es realizar una revisión sistemática retrospectiva de la literatura sobre casos clínicos de linfomas MALT parotídeos. Se revisa su epidemiología y clínica más habitual, los métodos diagnósticos y tratamiento empleados y su pronóstico. Método: Revisión bibliográfica sistemática. Resultados: Se seleccionaron 28 estudios originales de casos o series, de los cuales 10 incluyeron más de 25 pacientes. Todos mostraron mayor incidencia en mujeres, en consonancia con su asociación con la presencia de enfermedades autoinmunes, específicamente con el síndrome de Sjögren. Los estudios evidenciaron la dificultad en el diagnóstico diferencial de otras patologías parotídeas. El tratamiento varió entre estudios, sin mostrar ninguno de ellos un claro beneficio respecto de los demás. Discusión: Se trata de un tipo de LNH relacionado principalmente con inflamación autoinmune crónica en el caso de aparición en glándulas salivales. Se presenta como una tumoración asintomática e inespecífica de crecimiento lento. Se diagnostica por su histología y se estudia su extensión mediante TC o RM en la mayoría de los casos. El tratamiento se realiza mediante parotidectomía asociada a quimioterapia y/o radioterapia. La tasa de supervivencia es >80% a los 5 años. Conclusiones: Los linfomas MALT de glándulas salivales son poco habituales y ocasionalmente se diagnostican de manera inadecuada debido a su comportamiento benigno, que mimetiza a tumores más familiares del área parotídea. Su sospecha y distinción son esenciales y no debe olvidarse en el diagnóstico diferencial de masas parotídeas.
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Liberati A, Altman DG, Tetzla J, Mulrow C,Gotzsche PC, Loannidis JP. PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009; 62:1-34.
Vázquez A, Khan MN, Sanghvi S, Patel NR, Caputo JL, Baredes S, Eloy JA. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the salivary glands: a population-based study from 1994 to 2009. Head Neck 2015;37:18-22.
Anacak Y, Miller RC, Constantinou N, Mamusa AM, Epelbaum R, Li Y, Calduch AL, Kowalczyk A, Weber DC, Kadish SP, Bese N, Poortmans P, Kamer S, Ozsahin M. Primary mucosa-associated lymphoid tissue lymphoma of the salivary glands: a multicenter Rare Cancer Network study. Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):315-20.
Troch M, Formanek M, Streubel B, Müllauer L, Chott A, Raderer M. Clinicopathological aspects of mucosa-associated lymphoid tissue (MALT) lymphoma of the parotid gland: A retrospective single-center analysis of 28 cases. Head Neck. 2011;33:763-7.
Mantsopoulos K, Koch M, Fauck V, Schinz K, Schapher M, Constantinidis J, Rösler W, Iro H. Primary parotid gland lymphoma; pitfalls in the use of ultrasound imaging by a great pretender. Int J Oral Maxillofac Surg 2021;50:573-8.
Zhang C, Xia R, Gu T, Wang L, Tian Z, Zhu L, et al. Clinicopathological aspects of primary mucosa-associated lymphoid tissue lymphoma of the salivary gland: A retrospective single-center analysis of 72 cases. J Oral Pathol Med 2021;50:723-30.
Zhu L, Wang P, Yang J, Yu Q. Non-Hodgkin lymphoma involving the parotid gland: CT and MR imaging findings. Dentomaxillofac Radiol. 2013;42(9):20130046.
Isaacson P, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983;52:1410–6.
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Joshi R, McNamara C. MALT lymphoma - Symptoms, diagnosis and treatment. BMJ Best Practice. Disponible en: https://bestpractice.bmj.com/topics/en-us/878. [Citado el 13/05/2022].
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Biasi D, Caramaschi P, Ambrosetti A, et al. Mucosa-associated lymphoid tissue lymphoma of the salivary glands occurring in patients affected by Sjogren’s syndrome: report of 6 cases. Acta Haematol. 2001;105: 83-8.
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Wierzbicka M, Bartochowska A, Kope? T, Szyfter W. Ch?oniak typu MALT ?linianki przyusznej--opis przypadku i przegl?d pi?miennictwa. Otolaryngol Pol. 2013;67:61-5.
Mada Y, Koshitsuka K, Ihara F, Ueki Y, Konno A. [A Clinical Study of a Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of Salivary Glands]. Nihon Jibiinkoka Gakkai Kaiho.2015;118:25-33.
Tachikawa M, Yoshihara T. Four cases of MALT lymphomas of parotid gland. J-Global. 2015; 28(1):95-101.
Vissink A, van der Meij EH, Spijkervet FKL. Ontstaan van. MALT-lymfomen bijhet syndroom van Sjögren [Development of MALT-lymphoma in Sjögren syndrome]. Ned Tijdschr Tandheelkd 2020;127:543-50.
Mavragani CP, Moutsopoulos HM. Sjögren syndrome. CMAJ. 2014 Oct 21;186(15):E579-86.
Fragkioudaki S, Mavragani CP, Moutsopoulos HM. Predicting the risk for lymphoma development in Sjogren syndrome: An easy tool for clinical use. Medicine (Baltimore). 2016 Jun;95(25):e3766.
Klussmann JP, Guntinas-Lichius O, Heilig B, Wagner M, Jungehülsing M, Michel O. Sjögren-Syndrom und beidseitiges MALT-Lymphom der Glandula parotis.1999;47:637-41.
Tesher MS, Esteban Y, Henderson TO, Villanueva G, Onel KB. Mucosal-associated Lymphoid Tissue (MALT) Lymphoma in association with pediatric primary Sjogren syndrome: 2 cases and review. J Pediatr Hematol Oncol 2019;41:413-6.
Povlow MR, Streiff M, Madireddi S, Jaramillo C. A Primary Parotid Mucosa-Associated Lymphoid Tissue Non-Hodgkin Lymphoma in a Patient With Sjogren Syndrome. Cureus. 2021 Jun 16;13(6):e15679.
Alvi A, Johnson JT. The neck mass: a challenging differential diagnosis. Postgrad Med 1995;97:87–9.
Dong Y, Wen F, Shi A, Guan HW, Ge Y, Jiang Y. Value of multidetector computed tomography in the diagnosis of mucosa-associated lymphoid tissue-lymphomas in the parotid gland: A case report and review of the literature. Oncol Lett 2014;7:781-6.
Xu PC, Zhou XY, Zhou C, Xuan XL, Peng ZL. [Analysis of the clinical features of mucosa-associated lymphoid tissue lymphoma of the parotid gland]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017;31:61-4.
Vaíllo A, Gutiérrez-Martín A, Ballestín C, Ruiz-Liso JM. Marginal zone B-cell lymphoma of the parotid gland associated with epithelioid granulomas. Report of a case with fine needle aspiration. Acta Cytol 2004;48:420-4.
Som PM, Brandwein MS, Silvers A. Nodal inclusion cysts of the parotid gland and parapharyngeal space: a discussion of lymphoepithelial, AIDS-related parotid, and branchial cysts, cystic Warthin’s tumors, and cysts in Sjogren’s syndrome. Laryngoscope 1995;105:1122-8.
Okura M. A case of metachronous bilateral MALT lymphoma of the parotid gland. J Oral Maxillofacial Surg. 2010,56:18-22.
Suchy BH, Wolf SR. Bilateral mucosa-associated lymphoid tissue lymphoma of the parotid gland. Arch Otolaryngol Head Neck Surg. 2000;126:224-6.
Rosenstiel DB, Carroll WR, Listinsky CM. MALT lymphoma presenting as a cystic salivary gland mass. Head Neck. 2001;23:254-8.
Toni G, Cozzolino I, Colella G, Tirino V, Mariani P, Laino L, Ronchi A, Franco R. Extranodal B-cell marginal zone lymphoma arising in the context of a lympho-epithelial cyst of the parotid gland in a patient with clonal B-cell lymphocytosis: report of the first case. Minerva Stomatol. 2020 Dec 16. https://doi.org/10.23736/S0026-4970.20.04441-6.
Ando M, Matsuzaki M, Murofushi T. Mucosa-associated lymphoid tissue lymphoma presented as diffuse swelling of the parotid gland. Am J Otolaryngol. 2005;26:285-8.
Baer AN, Grader-Beck T, Antiochos B, Birnbaum J, Fradin JM. Ultrasound-guided biopsy of suspected salivary gland lymphoma in Sjogren’s syndrome. Arthritis Care Res (Hoboken). 2021;73: 849-55.
Muntean D, Dudea S, Lenghel M, Solomon C, Iuga T, Rotar H. Mucosa-associated lymphoid tissue lymphoma of the parotid gland -a case report. Med Ultrason. 2021;23:364-6.
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Tsang, R W, Gospodarowicz, M K, Pintilie, M, Wells, W, Hodgson, D C, Sun, A, Crump, M, Patterson, B J. Localized mucosa associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol. 2003;21:4157-64.
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Fischbach W, Goebeler ME, Ruskone-Fourmestraux A, Wündisch T, Neubauer A, Raderer M, Savio A; EGILS (European Gastro-Intestinal Lymphoma Study) Group. Most patients with minimal histological residuals of gastric MALT lymphoma after successful eradication of Helicobacter pylori can be managed safely by a watch and wait strategy: experience from a large international series. Gut. 2007 Dec;56(12):1685-7.
Liberati A, Altman DG, Tetzla J, Mulrow C,Gotzsche PC, Loannidis JP. PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009; 62:1-34.
Vázquez A, Khan MN, Sanghvi S, Patel NR, Caputo JL, Baredes S, Eloy JA. Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of the salivary glands: a population-based study from 1994 to 2009. Head Neck 2015;37:18-22.
Anacak Y, Miller RC, Constantinou N, Mamusa AM, Epelbaum R, Li Y, Calduch AL, Kowalczyk A, Weber DC, Kadish SP, Bese N, Poortmans P, Kamer S, Ozsahin M. Primary mucosa-associated lymphoid tissue lymphoma of the salivary glands: a multicenter Rare Cancer Network study. Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):315-20.
Troch M, Formanek M, Streubel B, Müllauer L, Chott A, Raderer M. Clinicopathological aspects of mucosa-associated lymphoid tissue (MALT) lymphoma of the parotid gland: A retrospective single-center analysis of 28 cases. Head Neck. 2011;33:763-7.
Mantsopoulos K, Koch M, Fauck V, Schinz K, Schapher M, Constantinidis J, Rösler W, Iro H. Primary parotid gland lymphoma; pitfalls in the use of ultrasound imaging by a great pretender. Int J Oral Maxillofac Surg 2021;50:573-8.
Zhang C, Xia R, Gu T, Wang L, Tian Z, Zhu L, et al. Clinicopathological aspects of primary mucosa-associated lymphoid tissue lymphoma of the salivary gland: A retrospective single-center analysis of 72 cases. J Oral Pathol Med 2021;50:723-30.
Zhu L, Wang P, Yang J, Yu Q. Non-Hodgkin lymphoma involving the parotid gland: CT and MR imaging findings. Dentomaxillofac Radiol. 2013;42(9):20130046.
Isaacson P, Wright DH. Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983;52:1410–6.
El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ. World Health Organization Classification of Tumours of Head and Neck. International Agency for Research on Cancer (IARC). Lyon, France. Ed. 4. 2017. pp. 347.
Harris NL. Lymphoid proliferations of the salivary glands. Am J Clin Pathol 1999;111:S94-103.
Joshi R, McNamara C. MALT lymphoma - Symptoms, diagnosis and treatment. BMJ Best Practice. Disponible en: https://bestpractice.bmj.com/topics/en-us/878. [Citado el 13/05/2022].
Ribrag V, Orphanet: Linfoma MALT. Disponible en: https://www.orpha.net/consor/cgi-bin//OC_Exp.php?lng=ES&Expert=52417. [Citado el 13/05/2022].
Cohen SM, Petryk M, Varma M, Kozuch PS, Ames ED, Grossbard ML. Non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue. Oncologist. 2006 Nov-Dec;11(10):1100-17.
Vega F, Lin P, Medeiros LJ. Extranodal lymphomas of the head and neck. Ann Diagn Pathol. 2005;9:340-50.
Celedón C, Ojeda JP, Agurto M. Tumores de glándulas salivales. Experiencia de 20 años. Rev Otorrinolaringol Cir Cab Cuello 2002;62:255-64.
Boukheris H, Ron E, Dores GM, Stovall M, Smith SA, Curtis RE. Risk of radiation-related salivary gland carcinomas among survivors of Hodgkin lymphoma: a population-based analysis. Cancer 2008;113: 3153–9.
Damborenea Tajada J, García Erce JA, Castillo Fornies AC, Leache Pueyo J, Naya Gálvez MJ, Rubio Martínez A, Ortiz García A. Linfoma MALT de glándula parótida en asociación con síndrome de Sjögren. Aportación de un caso y revisión de la literatura. Acta Otorrinolaringol Esp 1998;49:595-8.
Biasi D, Caramaschi P, Ambrosetti A, et al. Mucosa-associated lymphoid tissue lymphoma of the salivary glands occurring in patients affected by Sjogren’s syndrome: report of 6 cases. Acta Haematol. 2001;105: 83-8.
Tonami H, Matoba M, Yokota H, et al. Mucosa-associated lymphoid tissue lymphoma in Sjogren’s syndrome: initial and follow-up imaging features. AJR Am J Roentgenol 2002;179(2):485-9.
Gorodetsky V.R., ????????? ?.?., Logvinenko O.A., ???????? ?.?., Ogorodnikova M.D., ??????? ?.?., ???????? ?.?., ???????? ?.?., Varlamova M.Yu., Mekheda L.V., Malakhova N.V., ??????? ?.?. Rheumatoid arthritis with Sjogren's syndrome and MALT lymphoma of the parotid gland, associatedwith multiple myeloma: Description of a case and review of literature. Rheumatology Science and Practice. 2010;48(2):103-6.
Wierzbicka M, Bartochowska A, Kope? T, Szyfter W. Ch?oniak typu MALT ?linianki przyusznej--opis przypadku i przegl?d pi?miennictwa. Otolaryngol Pol. 2013;67:61-5.
Mada Y, Koshitsuka K, Ihara F, Ueki Y, Konno A. [A Clinical Study of a Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma of Salivary Glands]. Nihon Jibiinkoka Gakkai Kaiho.2015;118:25-33.
Tachikawa M, Yoshihara T. Four cases of MALT lymphomas of parotid gland. J-Global. 2015; 28(1):95-101.
Vissink A, van der Meij EH, Spijkervet FKL. Ontstaan van. MALT-lymfomen bijhet syndroom van Sjögren [Development of MALT-lymphoma in Sjögren syndrome]. Ned Tijdschr Tandheelkd 2020;127:543-50.
Mavragani CP, Moutsopoulos HM. Sjögren syndrome. CMAJ. 2014 Oct 21;186(15):E579-86.
Fragkioudaki S, Mavragani CP, Moutsopoulos HM. Predicting the risk for lymphoma development in Sjogren syndrome: An easy tool for clinical use. Medicine (Baltimore). 2016 Jun;95(25):e3766.
Klussmann JP, Guntinas-Lichius O, Heilig B, Wagner M, Jungehülsing M, Michel O. Sjögren-Syndrom und beidseitiges MALT-Lymphom der Glandula parotis.1999;47:637-41.
Tesher MS, Esteban Y, Henderson TO, Villanueva G, Onel KB. Mucosal-associated Lymphoid Tissue (MALT) Lymphoma in association with pediatric primary Sjogren syndrome: 2 cases and review. J Pediatr Hematol Oncol 2019;41:413-6.
Povlow MR, Streiff M, Madireddi S, Jaramillo C. A Primary Parotid Mucosa-Associated Lymphoid Tissue Non-Hodgkin Lymphoma in a Patient With Sjogren Syndrome. Cureus. 2021 Jun 16;13(6):e15679.
Alvi A, Johnson JT. The neck mass: a challenging differential diagnosis. Postgrad Med 1995;97:87–9.
Dong Y, Wen F, Shi A, Guan HW, Ge Y, Jiang Y. Value of multidetector computed tomography in the diagnosis of mucosa-associated lymphoid tissue-lymphomas in the parotid gland: A case report and review of the literature. Oncol Lett 2014;7:781-6.
Xu PC, Zhou XY, Zhou C, Xuan XL, Peng ZL. [Analysis of the clinical features of mucosa-associated lymphoid tissue lymphoma of the parotid gland]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017;31:61-4.
Vaíllo A, Gutiérrez-Martín A, Ballestín C, Ruiz-Liso JM. Marginal zone B-cell lymphoma of the parotid gland associated with epithelioid granulomas. Report of a case with fine needle aspiration. Acta Cytol 2004;48:420-4.
Som PM, Brandwein MS, Silvers A. Nodal inclusion cysts of the parotid gland and parapharyngeal space: a discussion of lymphoepithelial, AIDS-related parotid, and branchial cysts, cystic Warthin’s tumors, and cysts in Sjogren’s syndrome. Laryngoscope 1995;105:1122-8.
Okura M. A case of metachronous bilateral MALT lymphoma of the parotid gland. J Oral Maxillofacial Surg. 2010,56:18-22.
Suchy BH, Wolf SR. Bilateral mucosa-associated lymphoid tissue lymphoma of the parotid gland. Arch Otolaryngol Head Neck Surg. 2000;126:224-6.
Rosenstiel DB, Carroll WR, Listinsky CM. MALT lymphoma presenting as a cystic salivary gland mass. Head Neck. 2001;23:254-8.
Toni G, Cozzolino I, Colella G, Tirino V, Mariani P, Laino L, Ronchi A, Franco R. Extranodal B-cell marginal zone lymphoma arising in the context of a lympho-epithelial cyst of the parotid gland in a patient with clonal B-cell lymphocytosis: report of the first case. Minerva Stomatol. 2020 Dec 16. https://doi.org/10.23736/S0026-4970.20.04441-6.
Ando M, Matsuzaki M, Murofushi T. Mucosa-associated lymphoid tissue lymphoma presented as diffuse swelling of the parotid gland. Am J Otolaryngol. 2005;26:285-8.
Baer AN, Grader-Beck T, Antiochos B, Birnbaum J, Fradin JM. Ultrasound-guided biopsy of suspected salivary gland lymphoma in Sjogren’s syndrome. Arthritis Care Res (Hoboken). 2021;73: 849-55.
Muntean D, Dudea S, Lenghel M, Solomon C, Iuga T, Rotar H. Mucosa-associated lymphoid tissue lymphoma of the parotid gland -a case report. Med Ultrason. 2021;23:364-6.
Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol. 1999 Dec;17(12):3835-49.
Ciccone E, Truini M, Grossi CE. Lymphoid complement of the human salivary glands: Function and pathology. Eur J Morphol 1998;36(Suppl):252–6.
Wirth A, Mikhaeel NG, Aleman BMP, Pinnix CC, Constine LS, Ricardi U, Illidge TM, Eich HT, Hoppe BS, Dabaja B, Ng AK, Kirova Y, Berthelsen AK, Dieckmann K, Yahalom J, Specht L. Involved Site Radiation Therapy in Adult Lymphomas: An Overview of International Lymphoma Radiation Oncology Group Guidelines. Int J Radiat Oncol Biol Phys. 2020 Aug 1;107(5):909-33.
Yahalom J, Illidge T, Specht L, Hoppe RT, Li YX, Tsang R, Wirth A; International Lymphoma Radiation Oncology Group. Modern radiation therapy for extranodal lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys. 2015 May 1;92(1):11-31.
Jackson AE, Mian M, Kalpadakis C, Pangalis GA, Stathis A, Porro E, Conconi A, Cortelazzo S, Gaidano G, Lopez Guillermo A, Johnson PW, Martelli M, Martinelli G, Thieblemont C, McPhail ED, Copie-Bergman C, Pileri SA, Jack A, Campo E, Mazzucchelli L, Ristow K, Habermann TM, Cavalli F, Nowakowski GS, Zucca E. Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue of the Salivary Glands: A Multicenter, International Experience of 248 Patients (IELSG 41). Oncologist. 2015 Oct;20(10):1149-53.
Tsang, R W, Gospodarowicz, M K, Pintilie, M, Wells, W, Hodgson, D C, Sun, A, Crump, M, Patterson, B J. Localized mucosa associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol. 2003;21:4157-64.
Jamal B. Treatment of parotid non-Hodgkin lymphoma: a meta-analysis. J Glob Oncol 2018; 4:1–6.
Logvinenko OA, Vasil'ev VI, Sedyshev SKh, Safonova TN, Rodionova EB, Kokosadze NV, Aleksandrova EN, Cherkasova MV, Radenska-Lopovok SG, Nasonov EL. [Rituximab therapy for systemic manifestations and MALT lymphomas of the parotid gland in Sjögren's disease: preliminary data]. Ter Arkh. 2012;84:88-96.
Pollard RP, Pijpe J, Bootsma H, Spijkervet FK, Kluin PM, Roodenburg JL,Kallenberg CG, Vissink A, van Imhoff GW. Treatment of mucosa-associated lymphoid tissue lymphoma in Sjogren’s syndrome: a retrospective clinical study. J Rheumatol. 2011;38:2198-208.
Shum JW, Emmerling M, Lubek JE, Ord RA. Parotid lymphoma: a review of clinical presentation and management. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118:e1-5.
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