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Benign Lymphoepithelial Lesions of HIV
H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Benign lymphoepithelial lesions (BLEL)-HIV
            • Synonyms

              • AIDS-related parotid cysts (ARPC)
                • Patient need only be HIV-positive to manifest BLEL
                  • May not have full-blown AIDS with BLEL
                  • Avoid ARPC synonym
            • Definitions

              • Multifocal mixed cystic and solid intraparotid masses found in HIV-infected patients
              • 3-tiered classification
                • Persistent generalized parotid gland lymphadenopathy: Solid lesions
                • Benign lymphoepithelial lesions: Mixed solid and cystic lesions
                • Benign lymphoepithelial cysts: Cystic lesions

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              • Immunohistochemistry

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Sujatha D et al: Parotid lymphoepithelial cysts in human immunodeficiency virus: a review. J Laryngol Otol. 127(11):1046-9, 2013
                                              2. Kreisel FH et al: Cystic lymphoid hyperplasia of the parotid gland in HIV-positive and HIV-negative patients: quantitative immunopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 109(4):567-74, 2010
                                              3. Wu L et al: Lymphoepithelial cyst of the parotid gland: its possible histopathogenesis based on clinicopathologic analysis of 64 cases. Hum Pathol. 40(5):683-92, 2009
                                              4. Marsot-Dupuch K et al: Head and neck lesions in the immunocompromised host. Eur Radiol. 14 Suppl 3:E155-67, 2004
                                              5. Mandel L: Ultrasound findings in HIV-positive patients with parotid gland swellings. J Oral Maxillofac Surg. 59(3): 283-6, 2001
                                              6. Uccini S et al: The benign cystic lymphoepithelial lesion of the parotid gland is a viral reservoir in HIV type 1-infected patients. AIDS Res Hum Retroviruses. 15(15): 1339-44, 1999
                                              7. Chetty R: HIV-associated lymphoepithelial cysts and lesions: morphological and immunohistochemical study of the lymphoid cells. Histopathology. 33(3): 222-9, 1998
                                              8. Craven DE et al: Response of lymphoepithelial parotid cysts to antiretroviral treatment in HIV-infected adults. Ann Intern Med. 128(6): 455-9, 1998
                                              9. Kooper DP et al: Management of benign lymphoepithelial lesions of the parotid gland in human immunodeficiency virus-positive patients. Eur Arch Otorhinolaryngol. 255(8): 427-9, 1998
                                              10. Maiorano E et al: Lymphoepithelial cysts of salivary glands: an immunohistochemical study of HIV-related and HIV-unrelated lesions. Hum Pathol. 29(3): 260-5, 1998
                                              11. Martinoli C et al: Benign lymphoepithelial parotid lesions in HIV-positive patients: spectrum of findings at gray-scale and Doppler sonography. AJR Am J Roentgenol. 165(4): 975-9, 1995
                                              12. Som PM et al: Nodal inclusion cysts of the parotid gland and parapharyngeal space: a discussion of lymphoepithelial, AIDS-related parotid, and branchial cysts, cystic Warthin's tumors, and cysts in Sjogren's syndrome. Laryngoscope. 105(10): 1122-8, 1995
                                              13. Kirshenbaum KJ et al: Benign lymphoepithelial parotid tumors in AIDS patients: CT and MR findings in nine cases. AJNR Am J Neuroradiol. 12(2):271-4, 1991
                                              14. Holliday RA et al: Benign lymphoepithelial parotid cysts and hyperplastic cervical adenopathy in AIDS-risk patients: a new CT appearance. Radiology. 168(2):439-41, 1988
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Benign lymphoepithelial lesions (BLEL)-HIV
                                                        • Synonyms

                                                          • AIDS-related parotid cysts (ARPC)
                                                            • Patient need only be HIV-positive to manifest BLEL
                                                              • May not have full-blown AIDS with BLEL
                                                              • Avoid ARPC synonym
                                                        • Definitions

                                                          • Multifocal mixed cystic and solid intraparotid masses found in HIV-infected patients
                                                          • 3-tiered classification
                                                            • Persistent generalized parotid gland lymphadenopathy: Solid lesions
                                                            • Benign lymphoepithelial lesions: Mixed solid and cystic lesions
                                                            • Benign lymphoepithelial cysts: Cystic lesions

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          • Immunohistochemistry

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Sujatha D et al: Parotid lymphoepithelial cysts in human immunodeficiency virus: a review. J Laryngol Otol. 127(11):1046-9, 2013
                                                                                          2. Kreisel FH et al: Cystic lymphoid hyperplasia of the parotid gland in HIV-positive and HIV-negative patients: quantitative immunopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 109(4):567-74, 2010
                                                                                          3. Wu L et al: Lymphoepithelial cyst of the parotid gland: its possible histopathogenesis based on clinicopathologic analysis of 64 cases. Hum Pathol. 40(5):683-92, 2009
                                                                                          4. Marsot-Dupuch K et al: Head and neck lesions in the immunocompromised host. Eur Radiol. 14 Suppl 3:E155-67, 2004
                                                                                          5. Mandel L: Ultrasound findings in HIV-positive patients with parotid gland swellings. J Oral Maxillofac Surg. 59(3): 283-6, 2001
                                                                                          6. Uccini S et al: The benign cystic lymphoepithelial lesion of the parotid gland is a viral reservoir in HIV type 1-infected patients. AIDS Res Hum Retroviruses. 15(15): 1339-44, 1999
                                                                                          7. Chetty R: HIV-associated lymphoepithelial cysts and lesions: morphological and immunohistochemical study of the lymphoid cells. Histopathology. 33(3): 222-9, 1998
                                                                                          8. Craven DE et al: Response of lymphoepithelial parotid cysts to antiretroviral treatment in HIV-infected adults. Ann Intern Med. 128(6): 455-9, 1998
                                                                                          9. Kooper DP et al: Management of benign lymphoepithelial lesions of the parotid gland in human immunodeficiency virus-positive patients. Eur Arch Otorhinolaryngol. 255(8): 427-9, 1998
                                                                                          10. Maiorano E et al: Lymphoepithelial cysts of salivary glands: an immunohistochemical study of HIV-related and HIV-unrelated lesions. Hum Pathol. 29(3): 260-5, 1998
                                                                                          11. Martinoli C et al: Benign lymphoepithelial parotid lesions in HIV-positive patients: spectrum of findings at gray-scale and Doppler sonography. AJR Am J Roentgenol. 165(4): 975-9, 1995
                                                                                          12. Som PM et al: Nodal inclusion cysts of the parotid gland and parapharyngeal space: a discussion of lymphoepithelial, AIDS-related parotid, and branchial cysts, cystic Warthin's tumors, and cysts in Sjogren's syndrome. Laryngoscope. 105(10): 1122-8, 1995
                                                                                          13. Kirshenbaum KJ et al: Benign lymphoepithelial parotid tumors in AIDS patients: CT and MR findings in nine cases. AJNR Am J Neuroradiol. 12(2):271-4, 1991
                                                                                          14. Holliday RA et al: Benign lymphoepithelial parotid cysts and hyperplastic cervical adenopathy in AIDS-risk patients: a new CT appearance. Radiology. 168(2):439-41, 1988