Lymphoepithelial Cysts of Oral Mucosa: Two Cases in Different Regions

Abstract

Lymphoepithelial cyst of the oral cavity is a rare cystic lesion that presents as an asymptomatic, well-circumscribed, yellowish small submucosal nodule covered by normal overlying mucosa, usually located in the floor of the mouth or in the ventral or posterolateral surface of the tongue. Histopathological examination reveals a cyst lined by a stratified squamous epithelium surrounded by lymphoid tissue. In this paper, we report two cases of oral lymphoepithelial cyst, one on the anterior floor of the mouth and another on the posterior lateral tongue. In both cases, the patients were women aged approximately 50 years and the lesions were treated by local surgical excision, with no evidence of recurrence after 2 years of follow-up.

Clinicopathological and immunohistochemical features of the oral lymphoepithelial cyst: A multicenter study

“…The major histopathological description of OLEC is that of a cystic lesion lined by a parakeratinized squamous epithelium that has a flat interface with the cystic wall of fibrous connective tissue in which lymphocytic aggregates are found. The cystic lumen may contain a thick gelatinous whitish‐yellow liquid compatible with keratin, desquamated epithelial cells, and inflammatory cells . We confirm some of these features in the present study but with the following variations: a non‐keratinized epithelium predominated; epithelial hyperplasia was a common finding, blurring the clear separation between the cystic epithelium and the fibrous capsule; lymphoid follicles were not ubiquitously seen in the capsule; and many cases exhibited an evenly organized lymphocytic infiltrate.…”

“…The pathogenesis of OLEC remains an issue of debate, but two main theories are put forth. One suggests an origin from ectopic entrapped glandular epithelium in regions where lymphoid tissue is present and the other suggests either the obstruction of a tonsil crypt or traumatic epithelial implantation into deeper tissues …”

“…Ectopic lymphoid tissue may be found on the floor of the mouth, the ventral and posterolateral surfaces of the tongue, and the soft palate . Some authors suggest that these lymphoid tissues may contain ectopic foci of entrapped glandular epithelium, giving rise to OLEC . Others have suggested that OLEC develops from the obstruction of the tonsil crypt or the traumatic implantation of epithelium in deeper tissues, leading to the formation of a cyst …”

Demographic profile of oral nonodontogenic cysts in a Brazilian population

“…Some authors have hypothesized that ectopic foci of embriologic epithelium become entrapped within lymphoid tissue and may proliferate to form a cyst (15). However, other authors have suggested that oral lymphoepithelial cysts are the result of obstruction of crypts of otherwise normal oral tonsils (13,15). It is also possible that traumatic implantation of epithelial cells into deeper tissues can lead to cyst formation (13).…”

“…This condition must be differentiated from lesions that appear as submucosal papules or nodules such as lipoma and mucoceles. Sialolithiases and minor salivary gland tumors must also be included in clinical differential diagnosis (8,13,15). Histopathologically, it presents as a central cystic lesion lined with stratified squamous epitelium surrounded by lymphoid tissue similar to the histopathological findings in cervical lymphoepithelial cyst (15).…”