Benign lymphoepithelial cyst of parotid gland without human immunodeficiency virus infection: A case report

Abstract

Background: Benign lymphoepithelial cyst (BLEC) of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus (HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients. The main presentation is a slow-growing, painless mass, and secondary infection may cause acute inflammatory symptoms.

Case summary: A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck. On physical examination, a mass similar in size and shape to a quail egg was found in the left parotid gland. The mass was tough, without tenderness, and easily moveable. The results of HIV tests, including antibody and nucleic acid tests and CD4+ T cell examination, were negative. Imaging examination revealed a left parotid gland mass. The patient underwent surgical treatment, and BLEC was diagnosed based on postoperative pathology. After 2 years of follow-up, the patient survived well without related discomfort.

Conclusion: The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.

Keywords: Benign lymphoepithelial cyst; Case report; Human immunodeficiency virus; Parotid gland.

Figure 1

Color ultrasound of the neck. It reveals a 2.2 cm × 2.2 cm hypoechoic mass in the left parotid gland, with a clear boundary, coarse calcification foci, and no blood flow signal.

Figure 2

Neck computed tomography. A: Plain computed tomography scan. A round cystic lesion was seen in the left parotid gland, with a maximum cross-sectional area of about 2.3 cm × 2.2 cm, uneven density, small patches with slightly high-density shadow, and clear boundary; B: Arterial phase. On enhanced scanning, the cyst wall was slightly enhanced in the arterial phase, but no obvious enhancement was observed in the cyst; C: Venous phase. The enhancement degree in the venous phase was similar to that in the arterial phase (orange arrows).

Figure 3

Histopathology of benign lymphoepithelial cyst of the parotid gland. A: The cyst wall was laminated squamous epithelium without epithelial nail process and the surface layer was mostly incomplete keratosis; B: The epithelium was surrounded by a large number of lymphoid stromata with lymphoid follicular formation and a center of occurrence (hematoxylin–eosin staining, magnification × 200).