Lymphoepithelial carcinoma of the salivary gland: morphologic patterns and imaging features on CT and MRI

AJNR Am J Neuroradiol. 2014 Sep;35(9):1813-9. doi: 10.3174/ajnr.A3940. Epub 2014 May 15.

Abstract

Background and purpose: Lymphoepithelial carcinoma is a rare salivary gland lesion. We retrospectively reviewed CT and MR imaging features of salivary gland lymphoepithelial carcinoma to determine their imaging features and morphologic patterns.

Materials and methods: The clinical data, CT, and MR imaging findings of 28 patients with histologically proved lymphoepithelial carcinoma of the salivary gland were retrospectively reviewed. Morphologic patterns of the lesions were categorized into 3 types on the basis of margin and shape.

Results: There were 17 men and 11 women with a mean age of 39.3 years; 96.4% of patients were positive for Epstein-Barr virus both on histologic staining and Epstein-Barr virus serology. Tumors were parotid in 18 patients, submandibular in 8 patients, sublingual in 1 patient, and palatal in 1 patient. Most tumors (57.1%) manifested as a partially or ill-defined mass with a lobulated or plaque-like shape. Homogeneous enhancement was found in 16 patients, while heterogeneous enhancement was found in 12, including 4 patients with intratumoral necrosis. Invasion into adjacent structures was found in 5 patients; 60.7% of patients exhibited abnormal lymph nodes, with nodal necrosis in 3 patients.

Conclusions: The characteristic lobulated or plaque-like shape, with a partially or ill-defined margin, of a salivary gland mass associated with ipsilateral lymphadenopathy may suggest a preoperative diagnosis of lymphoepithelial carcinoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma, Squamous Cell / pathology*
  • Female
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Lymph Nodes / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Parotid Gland / pathology
  • Retrospective Studies
  • Salivary Gland Neoplasms / pathology*
  • Squamous Cell Carcinoma of Head and Neck
  • Tomography, X-Ray Computed