Salivary glands
Nonneoplastic tumors/tumor-like conditions
Lymphoepithelial cyst
Topic Completed: 1 October 2015
Minor changes: 30 October 2020
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PubMed Search: Benign lymphoepithelial cysts salivary
Table of Contents
Definition / general | Radiology images | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology images | Differential diagnosis | Additional referencesCite this page: Tanakchi S, Aly FZ. Lymphoepithelial cyst. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/salivaryglandsb9lymphoepithelialcyst.html. Accessed January 17th, 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
Images hosted on other servers:
CT: enlarged salivary glands
Case reports
- 28 year old HIV+ man with benign lymphoepithelial cysts of parotid and submandibular glands (J Oral Maxillofac Pathol 2015;19:107)
- 32 year old HIV+ woman with benign lymphoepithelial cysts of parotid (HIV AIDS (Auckl) 2012;4:81)
Treatment
- 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
Images hosted on other servers:
HIV+ patient
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
Images hosted on other servers:
Minor salivary
gland did not
show lymphocytic
infiltration
Cytology images
Images hosted on other servers:
FNAC: salivary gland acinar and ductal cells
Differential diagnosis
- Branchial cleft cyst: accompanying sinus tract or stalk
- Extranodal marginal zone lymphoma: monoclonal with centrocytic or monocytoid appearance
- Retention cyst: mucinous cystic contents
- Warthin tumor: double layer of oncocytic epithelium
Additional references
