Konofaos et al. Journal of Medical Case Reports 2011, 5:380 http://www.jmedicalcasereports.com/content/5/1/380 a chronic parotiditis was made. The patient was given antibiotics but with little effect. Unfortunately, the mass on the left parotid continued to enlarge. After admission to our clinic, a helical CT scan was performed which revealed a solid mass with an irregular surface in the left parotid gland (Figure 1). The patient underwent resection of the left parotid gland with preservation of the left facial nerve through a preauricular incision (Figure 2). Identification of the branches of the facial nerve was made by using loupes magnification and with intraoperative electric stimula- tion of the identified branches of the facial nerve. The size of the resected tumor was 5 × 7 cm (Figure 3). The surgical specimen was sent for a histopathological examination. The pathology report was consistent with a low-grade marginal-zone B-cell non-Hodgkin lymphoma (MALT lymphoma) following BLL of the gland. According to the report, there was infiltration of the normal salivary tissue by a heterogenous mixture of lymphocytes and isolated blastic cells. Postoperative recovery was uneventful and facial nerve function was intact. CT scan of the head, neck, chest and abdomen at two and six months after the surgery revealed no evidence of lymphoma infiltration. Our patient had isolated surgical treatment without che- motherapy. By the time this report was completed, the patient had been followed for 13 months without evi- dence of recurrence. Discussion Primary lymphomas of the salivary glands are rare and account for 4.7% of lymphomas at all sites [7]. A non- Hodgkin lymphoma of a salivary gland may appear as a painless, progressively enlarging mass [8-11]. Therefore, Page 2 of 5 Figure 2 Preoperative planning of the preauricular incision - the circular dotted line represents the tumors margins. it is rarely suspected before biopsies or surgical removal. MALT lymphomas developing within the salivary glands may be related to chronic lymphoid hyperplasia. The native absence of MALT within the salivary glands necessitates the development of acquired MALT from underlying lymphoid stimulation and infiltration before MALT lymphoma can develop [12]. Low-grade MALT lymphomas of the parotid gland usually arise in a setting of BLL [13]. The main histological characteris- tic of BLL of the parotid gland is the presence of clus- tered B cells inter-digitating with ductal epithelial cells. According to Amft et al [14], BLL can be considered a ‘premalignant lesion’ due to the fact that it can contain clonal populations of B cells, although it is generally regarded as a benign lesion. The transformation from BLL to MALT lymphoma is believed to be a multi-step Figure 1 Preoperative CT scan of the tumor of the left parotid gland. Figure 3 The surgical specimen.