Benign Lymphoepithelial Cyst of Parotid Gland: A Pathologist's Perspective

Abstract

Benign lymphoepithelial cyst (BLEC) of the salivary gland is a gradually increasing cystic lesion commonly associated with human immunodeficiency virus (HIV) infection. In rare instances, it can be seen in immunocompetent patients. Here, such a classic case of BLEC of the parotid gland in an elderly seronegative patient has been reported. Proper medical history, physical examination, radiology, and fine needle aspiration can fetch a preoperative diagnosis. However, histopathology helps to rule out other possibilities. Surgical excision is the best treatment modality with lower chances of recurrences.

Keywords: Benign; cyst; cytology; parotid.

Figure 1

(a) CECT scan showing cystic lesion in superficial lobe of left parotid, (b) and (c) Cytology smears show lymphoid cells along with occasional cystic macrophages (Giemsa, 400x)

Figure 2

(a) Cut surface showing a cystic lesion filled with mucoid brownish material, (b) and (c) Microscopy showing cyst wall containing dense lymphoid tissue underneath the squamous epithelium with the focal germinal center formation in (d) (Hematoxylin and Eosin, 400x)

Figure 3

Flow chart illustrating cystic lesions of parotid and their characteristic cytological features (Abbreviations: ACC-Acinic cell carcinoma; BLEC-Benign lymphoepithelial cyst; LGMEC-Low grade mucoepidermoid carcinoma; PA-Pleomorphic adenoma; PDP-Polycystic disease of parotid; SC-Secretory carcinoma; SCC-Squamous cell carcinoma; WT-Warthin tumor)