Salivary Gland - Benign lymphoepithelial cysts

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Salivary glands

Non-neoplastic tumors and tumor-like conditions

Benign lymphoepithelial cysts

Reviewers: Fatima Aly, M.D. (see Reviewers page)
Revised: 1 February 2013, last major update August 2011
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Often older women with Sjogren’s syndrome and autoantibodies
● Probably derives from salivary gland epithelium inclusion within a lymph node or from epithelium which induces a reactive lymphoid hyperplasia
● Parotid gland or upper cervical lymph nodes
● May be related to branchial cleft cyst, multilocular thymic cyst, Warthin’s tumor

Gross description
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● Usually unilocular but may be multilocular

Micro description
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● Cyst lined by glandular or squamous epithelium and surrounded by prominent lymphoid follicles with CD4+ cells, which may penetrate cyst lining

Differential diagnosis
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● Benign lymphoepithelial lesion, keratinous cyst (no associated lymphoid infiltrate), Warthin’s tumor (2 layers of oncocytic cells), low grade mucoepidermoid carcinoma (complex hyperplastic epithelium with mucinous cells), true branchial cleft cyst (presence of accompanying sinus tract or stalk)

HIV associated lymphoepithelial cyst
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● Resembles benign lymphoepithelial cyst
● Common in young individuals with HIV and usually involves the parotid gland
● Cyst epithelium derives from striated ducts
● Lymphocytes are polyclonal, CD8+
● Usually doesn’t progress to lymphoma
● In children, lesions may be monoclonal and resemble MALT but don’t progress to MALT lymphoma

Micro description
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● Lymphocytes may have clear cytoplasm and penetrate epithelium

Micro images
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Figure E

End of Salivary Glands > Non-neoplastic tumors and tumor-like conditions > Benign lymphoepithelial cysts

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