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Int J Clin Exp Pathol 2013;6(11):2591-2596

Case Report
Prominent mucoid degeneration of the parotid gland in a patient with systemic lupus
erythematosus

Mitsuaki Ishida, Muneo Iwai, Keiko Yoshida, Akiko Kagotani, Keiko Hodohara, Hidetoshi Okabe

Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Department of Hematology, Shiga University of Medical
Science, Shiga, Japan

Received August 19, 2013; Accepted September 11, 2013; Epub October 15, 2013; Published November 1, 2013

Abstract: Lupus erythematosus (LE) can cause various cutaneous lesions including panniculitis (LE profundus), but salivary gland
involvement has been extremely rare in patients with LE. Herein, we report the first documented case of systemic LE with prominent mucoid
degeneration and lymphoplasmacytic infiltration in the parotid gland. A 38-year-old Japanese male with histories of autoimmune hemolytic
anemia and systemic LE presented with a swelling of the bilateral cervical region. A physical examination revealed a swelling of the bilateral
parotid gland and erythema of the right cheek. A biopsy specimen of the cheek demonstrated LE profundus with mucoid material deposition in
the dermis. A biopsy specimen of the parotid gland showed lymphoplasmacytic infiltration and prominent mucoid material deposition within the
parotid gland as well as mild lymphoplasmacytic infiltration and hyaline fat necrosis in the perisalivary tissue. Mucoid material deposition is
one of the characteristic features of LE, however, this is the first case demonstrating mucoid material deposition in the salivary gland. Moreover,
albeit extremely rare, lymphoplasmacytic infiltration within the lobules of the salivary gland has also been reported in patients with LE.
Therefore, it is important that both lymphoplasmacytic infiltration and mucoid material deposition must be included in the differential diagnostic
considerations for salivary gland tumors in patients who had been previously diagnosed as systemic or discoid LE. (IJCEP1308049).

Keywords: Systemic lupus erythematosus, lupus erythematosus profundus, mucoid degeneration, parotid gland

Address correspondence to: Dr. Mitsuaki Ishida, Department of Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga
University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan. Tel: +81-77-548-2603; Fax: +81-77-548-2407; E-mail:
mitsuaki@belle.shiga-med.ac.jp