Salivary glands

Nonneoplastic tumors/tumor-like conditions

Lymphoepithelial cyst

Topic Completed: 1 October 2015

Minor changes: 6 August 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Benign lymphoepithelial cysts salivary

Sally Tanakchi, M.D.
F. Zahra Aly, M.D., Ph.D.
Page views in 2020: 9,852
Page views in 2021 to date: 11,216
Cite this page: Tanakchi S, Aly FZ. Lymphoepithelial cyst. website. Accessed December 7th, 2021.
Definition / general
  • Slow growing unilocular or multilocular lesions that appear in head and neck, including salivary glands
  • May develop in setting of:
    • HIV infection as part of diffuse infiltrative lymphocytosis syndrome (DILS) or
    • Non-HIV individuals with autoimmune disease (e.g. Sjögren 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
Radiology images

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CT: enlarged salivary glands

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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HIV+ patient

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Parotid swelling

Gross description
  • Usually unilocular but may be multilocular
Microscopic (histologic) 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
Microscopic (histologic) images

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Minor salivary
gland did not
show lymphocytic

Cytology images

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FNAC: salivary gland acinar and ductal cells

Differential diagnosis
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