Cystic Lymphoepithelial Lesions of the Parotid Gland In HIV-1 Infection

Abstract

The benign cystic lymphoepithelial lesion (BLL) of the parotid gland is a rare disorder affecting HIV-1-infected patients. Here we describe the clinical and histopathological features of 10 cases of BLL, who presented to our observation between November 1992 and December 1996, before the combination antiretroviral therapy was introduced.

The Benign Lymphoepithelial Cyst and a Classification System for Lymphocytic Parotid Gland Enlargement in the Pediatric HIV Population

“…Clinically, PGL is often present in conjunction with BLEC as demonstrated by patient no. 4 12,15,21,22,24,28 . The same histologic features of reactive follicular hyperplasia that are present in the lymph nodes of PGL are also seen in the setting of BLEC within the cyst walls, intraparotid lymph nodes, and surrounding cervical lymph nodes 6,10,16,20,22,24–26 .…”

“…Numerous terms have been used to describe lymphocytic parotid enlargement in the HIV population, including BLEC, BLEL, cystic BLEL, AIDS‐related lymphadenopathy, PGL, diffuse lymphocytosis syndrome, cystic lymphoid hyperplasia, and HIV‐associated salivary gland disease 4,5,7–10,12,14–16,20–26,28–30 . Histologically, this lymphocytic involvement appears to manifest in three distinct forms: 1) reactive follicular hyperplasia (PGL), 2) diffuse lymphocytic infiltration (BLEL), and 3) intraductal epithelial proliferation with cyst formation (BLEC) 7,20,28 …”

“…HIV‐associated BLEC often presents early in the course of HIV infection with slowly progressive, but asymptomatic parotid gland enlargement 1,5,10,12,14,25 . It is associated with cervical lymphadenopathy (PGL) in up to 90% of cases 12,18,20–24,26 . The cysts are usually bilateral (up to 80%), multiple (up to 90%), painless, and involve the superficial lobe 1,5,10,12,18,21–23 .…”

“…The management of parotid gland BLEC in HIV‐positive children is even less concrete, with only 12 reported cases 1,2,11,18–20 . Although the incidence appears to have decreased with the widespread use of highly active antiretroviral therapy (HAART), the treatment of parotid gland BLEC in the HIV population continues to be controversial 21,22 . We present a series of four pediatric patients with HIV‐associated BLEC and propose a three‐tiered classification system for lymphocytic parotid gland enlargement in the HIV population.…”

Squamous Cell Carcinoma of Parotid Gland Associated with Concurrent Lymphoepithelial Cysts and Lymphoepithelial Lesion: Case Report and Proposed Histogenesis

“…Lymphoepithelial cyst, a rare benign lesion of the parotid gland, is most commonly reported in patients infected with human immunodeficiency virus (HIV) [1]. Lymphoepithelial lesion, another rare lesion of the parotid gland, is frequently associated with Sjögren's syndrome and other autoimmune connective tissue disorders [2].…”