Papillary Cystadenoma Lymphomatosum

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Papillary cystadenoma lymphomatosum, a distinctive benign neoplasm occurring in or adjacent to the parotid gland, has been known by a variety of names including adenolymphoma, onkocytoma, onkocytic cystadenoma, orbital inclusion cystadenoma, and branchiogenic adenoma. Although this neoplasm was first mentioned by Hildebrand1 in 1895 it was not until 1910 that it was recognized as a distinct entity by Albrecht and Arzt.2 Since then many cases have been reported, the total reaching 108 in 1946.3

A review of some aspects of this neoplasm and a summary of 8 additional cases are included in this report.


Many theories as to the mode of origin of papillary cystadenoma lymphomatosum have been proposed. Hildebrand1 thought that it was of branchial cyst origin, a view that has been supported by a number of observers. Albrecht and Arzt,2 however, believed that the neoplasm arose in embryologically misplaced salivary gland tissue occurring in lymph nodes adjacent to the parotid gland. Subsequently various authors postulated that the tumor originated from evaginations of the embryonal buccal endoderm,4 ectopic tonsil,5 thymic anlage,6 undifferentiated salivary structures,7 or vestigial orbital inclusions.8 Warthin9 in describing the first case reported in the American literature (1929), believed that it began in accessory eustachian tube anlage which had assumed a neoplastic tendency. In 1931 a new theory was introduced by Hamperl10,11 who suggested that papillary cystadenoma lymphomatosum originated from onkocytes — granular eosinophilic cells appearing in the parotid glands of adults. Recently a number of observers have concluded that histogenesis from parotid ducts provides a simple. . .



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