Benign lymphoepithelial cyst in an adolescent female mimicking lymphoma: A diagnostic dilemma in a retrovirus negative patient

Authors

  • Somshankar Chowdhury MD Pathology Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029
  • Sufian Zaheer MD Pathology Associate Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029
  • Preeti Sharma MD Pathology Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029
  • Ashish Kumar Mandal MD, PhD Pathology Director Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

Keywords:

lymphoepithelial cyst, parotid, lymphoma, HIV

Abstract

Cystic lesions of the parotid gland are uncommon and may masqueradeneoplasms clinically. Benign lympho-epithelial cysts (BLEC) comprise the most common causes of the parotid gland swelling in human immunodeficiency virus (HIV)-positive patients. It is, however, less common amongst those not infected with HIV. We present a case of a12 years old female who presented with a swelling over left parotid region since one year.Local examination revealed a soft, cystic and non-tender swelling in the left parotid region measuring 5x4x3 cm. Serological investigations for viral markers were non-reactive.A differential diagnosis of granulomatous parotitis versus benign lymphoepithelial lesion was rendered on radiological investigations and superficial parotidectomy was planned. On histopathological examination, a cyst lined by cuboidal to low columnar lining was seen, underlying which, was dense lympho-plasmacytic infiltrate present in diffuse sheets. On immunohistochemistry, this lymphoid population was found to be reactive in nature (positive for kappa and lambda), thus excluding lymphoma. This case is being presented due to its rarity in HIV negative individuals and the histopathological diagnostic dilemma it presented with, mimicking a lymphoma.

 

DOI: 10.21276/APALM.1163

Author Biographies

Somshankar Chowdhury, MD Pathology Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

MD Pathology

Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

Sufian Zaheer, MD Pathology Associate Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

MD Pathology

Associate Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

Preeti Sharma, MD Pathology Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

MD Pathology

Senior Resident, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

Ashish Kumar Mandal, MD, PhD Pathology Director Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

MD, PhD Pathology

Director Professor, Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi-110029

References

1. Altman K and Bailey MW. Parotid cyst: a case report. Int J Oral Maxillofac Surg 1994;23:165-166.
2. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. 3rd ed. St Louis: Mosby;2008.
3. Terry JH, Loree TR, Thomas MD, Marti JR. Major salivary gland lymphoepithelial lesions and the acquired immunodeficiency syndrome. Am J Surg 1991;162:324-329.
4. Bernier JL, Bhaskar SN. Lymphoepithelial lesions of salivary glands. Histogenesis and classification based on 186 cases. Cancer 1958;11:1156-1179.
5. Ihrler S, Zietz C, Riederer A, Diebold J, Löhrs U. HIV-related parotid lymphoepithelial cysts. Immunohistochemistry and 3-D reconstruction of surgical and autopsy material with special reference to formal pathogenesis. Virchows Arch 1996;429:139-147.
6. Maiorano E, Favia G, Viale G. Lymphoepithelial cysts of salivary glands: an immunohistochemical study of HIV-related and HIV unrelated lesions. HUM PATHOL 1998;29:260-265.
7. Chetty R. HIV-associated lymphoepithelial cysts and lesions:morphological and immunohistochemical study of the lymphoid cells. Histopathology 1998;33:222-229.
8. Dave SP, Pernas FG, Roy S. The benign lymphoepithelial cyst and a classification system for lymphocytic parotid gland enlargement in the pediatric HIV population. Laryngoscope 2007;117(1):106-113.
9. Kooper DP, Leemans CR, Hulshof MC,et al. Management of benign lymphoepithelial lesions of the parotid gland in human immunodeficiency virus-positive patients. Eur Arch Otorhinolaryngol 1998;255(8):427-429.
10. Rahman S, Shaari R, Hassan R. Parotid lymphoepithelial cyst: A case report. Archives of Orofacial Sciences 2006;1:71-75.
11. Ahamed AS, Kannan VS, Velaven K,et al. Lymphoepithelial cyst of the submandibular gland. J Pharm Bioallied Sci 2014;6:185–187.
12. Camilleri AC, Lloyd RE. Lymphoepithelial cyst of the parotid gland. Br J Oral Maxillofac Surg 1990;28:329-332.

Downloads

Published

25-08-2017

How to Cite

1.
Chowdhury S, Zaheer S, Sharma P, Mandal AK. Benign lymphoepithelial cyst in an adolescent female mimicking lymphoma: A diagnostic dilemma in a retrovirus negative patient. Ann of Pathol and Lab Med [Internet]. 2017 Aug. 25 [cited 2024 Nov. 19];4(4):C98-101. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1163

Issue

Section

Case Report