Konofaos et al. Journal of Medical Case Reports 2011, 5:380 http://www.jmedicalcasereports.com/content/5/1/380 patients, and progression free survival at three years was reported as 91.9%. As far as chemotherapy in patients with MALT-type lymphoma is concerned, although there is limited experience [40], clinical trials of systemic therapies are strongly advised. Regional and distant relapses are not common in gas- tric MALT lymphomas, but extragastric MALT lympho- mas tend to be more aggressive and may recur in the regional or distant lymph nodes and in other organs [30,41]. According to Wenzel et al, patients with MALT-lymphoma of the head and neck are at a rela- tively high risk for early dissemination and subsequent distant recurrence when only local therapies are applied. In the current case, there was no lymph node or other organ involvement. Conclusion Salivary gland MALT lymphoma should be considered in the differential diagnosis of cystic or bilateral salivary gland lesions. After histopathological confirmation of a suspicious parotid gland lesion as a parotid gland MALT lymphoma, careful follow-up is needed with attention either to the remaining parotid gland or to other major salivary glands and organs in the head and neck region. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Abbreviations Section MALT: mucosa associated lymphoid tissue; BLL: benign lymphoepithelial lesion Authors’ contributions PKo prepared the manuscript and reviewed it for publication. ES performed the review of the literature. PKa collected the patients’ data. GK supervised the general management and follow-up of the patient and the writing of the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 7 November 2010 Accepted: 15 August 2011 Published: 15 August 2011 References 1. Wolvius EB, Van der Valk P, Van der Wal JE, et al: Primary non-Hodgkin’s lymphoma of the salivary glands. An analysis of 22 cases. J Oral Path Med 1996, 25:177-181. 2. Isaacson PG, Norton AJ: Extranodal lymphomas. New York, NY: Churchill Livingstone; 1994. 3. Azzopardi JG, Evans DJ: Malignant lymphoma of parotid associated with Mikulicz disease (benign lymphoepithelial lesion). J Clin Path 1971, 24:744-752. Page 4 of 5 4. Batsakis JG, Bernacki EG, Rice DH, Stebler MF: Malignancy and the benign lymphoepithelial lesion. Laryngoscope 1975, 85:389-399. 5. Isaacson P, Wright DH: Malignant lymphoma of mucosaassociated lymphoid tissue: A distinctive type of B-cell lymphoma. Cancer 1983, 52:1410-1416. 6. 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 2010. 7. Balm AJ, Delaere P, Hilgers FJ, et al: Primary lymphoma of mucosa- associated lymphoid tissue (MALT) in the parotid gland. Clin Otolaryngol 1993, 18:528-532. 8. Gleeson MJ, Bennett MH, Cawson RA: Lymphomas of the salivary glands. Cancer 1986, 58:699-704. 9. Hyman GA, Wolff M: Malignant lymphomas of the salivary glands. Review of the literature and report of 33 new cases, including four cases associated with the lymphoepithelial lesion. Am J Clin Pathol 1976, 65:421-438. 10. Mehle ME, Kraus DH, Wood BG, et al: Lymphoma of the parotid glands. Laryngoscope 1993, 103:17-21. 11. Schusterman MA, Granick MS, Erickson ER, et al: Lymphoma presenting as a salivary gland mass. Head and Neck Surg 1988, 10:411-415. 12. Ciccone E, Truini M, Grossi CE: Lymphoid complement of the human salivary glands: function and pathology. Eur J Morphol 1998, 36(suppl):252-256. 13. Diss TC, Wothersoon AC, Speight P, et al: B-cell monoclonality, Epstein Barr Virus, and t (14;18) in myoepithelial sialadenitis and low-grade B- cell MALT lymphoma of the parotid gland. Am J Surg Pathol 1995, 19(5):531-536. 14. Amft N, Bowman SJ: Chemokines and cell trafficking in Sjögren’s syndrome. Scand J Immunol 2001, 54:62-69. 15. Marioni G, Marchese-Ragona R, Marino F, et al: MALT-type lymphoma and Warthin’s tumour presenting in the same parotid gland. Acta Otolaryngol 2004, 124(3):318-323. 16. Hiltbrand JB, McGuirt WF, Matthews BL: Primary malignant lymphoma of the parotid gland - Two case reports. Otolaryngol Head Neck Surg 1990, 102:77-81. 17. Barnes L, Myers EN, Prokopakis EP: Primary malignant lymphoma of the parotid gland. Arch Otolaryngol Head Neck Surg 1998, 124:573-577. 18. Nichols RD, Rebuck JW, Sullivan JC: Lymphoma and the parotid gland. Laryngoscope 1982, 92:365-369. 19. Rosenstiel DB, Carrol WR, Listinsky CM: MALT lymphoma presenting as a cystic salivary gland mass. Head Neck 2001, 23:254-258. 20. Kojima M, Shimizu K, Nishikawa M, et al: Primary salivary gland lymphoma among Japanese: A clinicopathological study of 30 cases. Leuk Lymphoma 2007, 48:1793-1798. 21. Kalpadakis C, Pangalis GA, Vassilakopoulos TP, et al: Non-gastric extra-nodal marginal zone lymphomas: A single centre experience on 76 patients. Leuk Lymphoma 2008, 49:2308-2315. 22. Tagnon BB, Theate I, Weynand B, et al: Long-standing mucosa-associated lymphoid tissue lymphoma of the parotid gland: CT and MR imaging findings. AJR Am J Roentgenol 2002, 178(6):1563-1565. 23. Corr P, Vaithilingum M, Thejpal R, et al: Parotid MALT lymphoma in HIV infected children. J Ultrasound Med 1997, 16:615-617. 24. Kirshenbaum KJ, Nadimpalli SR, Friedman M, Kirshenbaum GL, Cavallino RP: Benign lymphoepithelial parotid tumors in AIDS patients: CT and MR findings in nine case. AJNR 1991, 12:271-274. 25. Stewart A, Blenkinsopp PT, Henry K: Bilateral parotid MALT lymphoma and Sjögren’s syndrome. Br J Oral Maxillofac Surg 1994, 32:318-322. 26. Elstrom R, Guan L, Baker G, et al: Utility of FDG-PET scanning in lymphoma by WHO classification. Blood 2003, 101:3875-3876. 27. Hoffmann M, Kletter K, Becherer A, Jager U, Chott A, Raderer M: 18F- fluorodeoxyglucose positron emission tomography (18F-FDG-PET) for staging and follow-up of marginal zone B-cell lymphoma. Oncology 2003, 64:336-340. 28. Perry C, Herishanu Y, Metzer U, Bairey O, Ruchlemer R, Trejo L, Naparstek E, Sapir EE, Polliack A: Diagnostic accuracy of PET/CT in patients with extranodal marginal zone MALT lymphoma. Eur J Haematol 2007, 79(3):205-209.