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Case Reports
. 2015 Jan 19;2(2):20150119.
doi: 10.1259/bjrcr.20150119. eCollection 2016.

Lymphoepithelial cyst as a herald of HIV seropositivity in a patient with known history of neurocysticercosis and suspected parotid cysticercosis

Alan Alexander  1 , Kyle Hunter  1 , Daniel Wasdahl  2 , Michael Markovic  1
Affiliations
Case Reports

Lymphoepithelial cyst as a herald of HIV seropositivity in a patient with known history of neurocysticercosis and suspected parotid cysticercosis

Alan Alexander et al. BJR Case Rep. .

Abstract

Among those with acquired immune deficiency syndrome, salivary gland pathology and other less common signs of human immunodeficiency virus (HIV) seropositivity are emerging. Generally speaking, lymphoepithelial lesions of the parotid gland are uncommon with a reported incidence of 0.6%, but they are beginning to overtake other oral lesions such as candidiasis as predominant oral manifestations of clinical HIV infection. Here, we describe a patient with a known history of neurocysticercosis with presumed extracranial cysticercosis as demonstrated by the clinical manifestation of bilateral parotid gland swelling and a ring-enhancing, hypodense lesion of the left parotid gland on CT. He was found to have a lymphoepithelial cyst arising in a lobe of the left parotid gland per pathological evaluation after left superficial parotidectomy, and this served as the initial sign of HIV positivity, which was confirmed by serological studies.

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Figures

Figure 1.
Figure 1.
(a) Axial contrast-enhanced CT scan of the neck demonstrating bilateral parotid gland masses. Dominant ring-enhancing hypodense lesion of the left parotid gland measures 3.0 × 2.9 cm. (b) Coronally reconstructed CT scan with a prominent left cystic parotid mass and a smaller dense lesion of the right parotid gland. Few enlarged level 2 lymph nodes are noted bilaterally, ranging from 1.0 to 2.4 cm. Numerous non-pathologically enlarged jugular chain lymph nodes are visualized. (c) CT scan of the neck in sagittal reconstruction revealing a hypodense lesion with rim enhancement within the left superficial parotid gland.
Figure 2.
Figure 2.
Gross specimen of left superficial parotidectomy with a 2.9 × 2.5 × 2.2cm cystic space containing clear yellow fluid. The wall of the cyst averages between 1.0 and 2.0 mm in thickness but is focally thickened up to 5.0 mm.
Figure 3.
Figure 3.
(a) Low power (40×) view of keratin stain showing lymphoepithelial complexes (brown islands) in the lymphoid tissue lining the cyst, confirming the diagnosis. (b) High power (400×) view of squamous lining of cyst on haematoxylin and eosin staining (large pink cells). (c) High power (400×) view showing keratin AE1/3 staining of squamous epithelial lining of lymphoepithelial cyst.
See this image and copyright information in PMC

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