Salivary glands
Non-neoplastic tumors and tumor-like conditions
Benign lymphoepithelial cysts

Author: Sally Tanakchi, M.B.Ch.B. (see Authors page)
Editor: F. Zahra Aly, M.D., Ph.D.

Revised: 30 October 2015, last major update October 2015

Copyright: (c) 2002-2015,, Inc.

PubMed Search: Benign lymphoepithelial cysts [title] salivary
Definition / General
  • Slow growing unilocular or multilocular lesions that appear in head and neck, including salivary glands
  • May develop in setting of:
    1. HIV infection as part of diffuse infiltrative lymphocytosis syndrome (DILS) or
    2. Non-HIV individuals with autoimmune disease (e.g. Sjogren syndrome)
  • In non HIV patients, probably derive from salivary gland epithelium inclusion within a lymph node

  • HIV associated lymphoepithelial cyst
    • Resembles benign lymphoepithelial cyst
    • Common in young individuals with HIV and usually involves parotid gland
    • Cyst epithelium is thought to be derived from striated ducts
    • Lymphocytes are polyclonal, CD8+
    • Usually does not progress to lymphoma
    • In children, lesions may be monoclonal and resemble MALT but do not progress to MALT lymphoma
Case Reports
  • Surgical excision provides best cosmetic result, but other options are:
  • Repeated fine needle aspiration of cyst contents
  • Sclerosing therapy
  • Radiation with total dose of 24 Gy
  • HAART therapy in HIV setting
Clinical Images
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CT: enlarged salivary glands

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HIV+ patient

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Parotid swelling

Gross Description
  • Usually unilocular but may be multilocular
Micro Description
  • Dense polymorphous and polyclonal lymphoid tissue closely associated with squamous or glandular lining epithelium of cyst
  • Lymphocytes may permeate the epithelial cyst lining cells
  • Epimyoepithelial islands may be present, especially in autoimmune disease setting
  • HIV Associated: extrafollicular lymphocytes are CD8+ T cells; lymphocytes may have clear cytoplasm and penetrate epithelium
Micro Images
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FNAC: salivary gland acinar and ductal cells

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Minor salivary gland did not
show lymphocytic infiltration

HIV associated Nature image:

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Figure E

Differential Diagnosis