Mandible & maxilla

Non-odontogenic cysts

Oral lymphoepithelial cyst


Resident / Fellow Advisory Board: Kyle Devins, M.D.
Deputy Editor-in-Chief: Kelly Magliocca, D.D.S., M.P.H.
Abberly Lott Limbach, M.D.

Last author update: 21 January 2022
Last staff update: 21 January 2022

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PubMed Search: Lymphoepithelial cyst [title] oral

Abberly Lott Limbach, M.D.
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Cite this page: Lott Limbach A. Oral lymphoepithelial cyst. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/mandiblemaxillalymphoepithelial.html. Accessed December 7th, 2022.
Definition / general
  • Lymphoepithelial cysts are uncommon benign oral cavity cysts
Essential features
  • Oral lymphoepithelial cysts are most common in the lateral tongue and floor of mouth
  • Histologic features include a squamous epithelial lined cyst filled with keratin debris and stromal lymphoid tissue
  • Treatment is conservative surgical excision with no recurrence
Terminology
  • Oral lymphoepithelial cyst
  • Intraoral lymphoepithelial cyst
  • Benign lymphoepithelial cyst
ICD coding
  • ICD-10:
    • K09.8 - other cysts of oral region, not elsewhere classified
    • K09.9 - cyst of oral region, unspecified
Epidemiology
Sites
Etiology
Clinical features
Diagnosis
  • Combination of clinical and histologic findings
Prognostic factors
  • Good prognosis
  • No recurrence after excision
Case reports
Treatment
  • Conservative surgical excision
Clinical images

Images hosted on other servers:
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Lymphoepithelial cyst in tonsil

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Lymphoepithelial cyst, floor of mouth

Gross description
  • Cystic structure, well demarcated, filled with yellowish keratin-like material
Gross images

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Lymphoepithelial cyst, floor of mouth

Microscopic (histologic) description
  • Well circumscribed cyst lined by parakeratinized stratified squamous epithelium with lymphoid stroma
    • May have connection to overlying epithelium but not always identified
    • Other cyst linings: nonkeratinized squamous epithelium, respiratory metaplasia or ciliated pseudostratified epithelium (or any combination)
    • Cyst contents: predominantly keratin debris, amorphous eosinophilic material and inflammatory cells
    • Lymphoid stroma may or may not have germinal centers
    • Rarely subgemmal neurogenous plaques have been reported near the cyst (Head Neck Pathol 2021 Jun 29 [Epub ahead of print], J Oral Pathol Med 2020;49:219)
Microscopic (histologic) images

Contributed by John Kalmar, D.M.D., Ph.D.
Floor of mouth cyst

Floor of mouth cyst

Squamous epithelial lining

Squamous epithelial lining

Lateral tongue cyst

Lateral tongue cyst

Germinal center in stroma

Germinal center in stroma

Positive stains
Sample pathology report
  • Floor of mouth, biopsy:
    • Oral lymphoepithelial cyst
Differential diagnosis
Board review style question #1

A 45 year old patient presents with a painless 0.5 cm white nodule on the left lateral tongue. A biopsy is performed and a representative image from the histology is shown above. What is the diagnosis?

  1. Fordyce granule
  2. Lymphoepithelial cyst
  3. Lymphoid aggregate
  4. Mucocele
  5. Sialolith
Board review style answer #1
B. Lymphoepithelial cyst

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Reference: Oral lymphoepithelial cyst
Board review style question #2
Which of the following is seen in the stroma surrounding the cyst lining of a lymphoepithelial cyst?

  1. Collagen
  2. Lymphoid tissue
  3. Mucin
  4. Sebaceous glands
  5. Seromucinous glands
Board review style answer #2
B. Lymphoid tissue

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Reference: Oral lymphoepithelial cyst
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