Medizinische Universität Graz - Research portal
Selected Publication:
Anzengruber, R.
Lymphoepithelial cysts of the parotid gland: a clinicopathologic study of 26 cases demonstrating a hitherto unreported predominance of multicystic cases in an unselected, non HIV-infected population and histomorphological oberservations contributing to the etiology of sporadic cases.
[ Diplomarbeit/Master Thesis ] Graz Medical University; 2005.
- Authors Med Uni Graz:
- Advisor:
- Beham Alfred
- Altmetrics:
- Abstract:
- Lymphoepithel cysts of the parotid glands are very rare lesions, of which additional twenty-six cases are reported in detail regarding clinico-pathologiacal data and compared with the existing literature on this topic. The cysts came from an unselect population an concerned each 13 nin HIV-infected males and females. Age range was 2-81 years (mean 53, median 55.5). All cysts arose unilateral with the right parotid gland being preferred. 10 cases appeared as unicystic, 16 as multicystic lesions. Preoperative fine needle biopsy for cytodiagnostic purposes was performed in 14 cases, whereas preoperative clinical imaging including sialography, sonography, CT and MRI was applied in 12 patients. Recurrences were seen in two mulitcystic cases 2 and 12 years, and 1 year respectively after first operation. Macroscopy revealed cystic spaces of 2 to 40 mm in diameter with an either smooth or granulated inner surface, and were filled by a serous to coseous material. Cytologically, the material obtained was usually characterized by a mixture of lymphoid cells and macrophages set in an inflammatory proteinaceous background. Only in single cases epithel cells in good condition corresponding either to metaplastic of proper squamous epithelium were present. Histological examination exhibited cysts with an inner lining by a multilayered or rarely squamous epithelium, which was peripherally surrounded by lymphoid tissue with follicle- and germinal center formation. In some cases goblet or oncocytic cells appeared within the lining epithelium, and duct-like, sometimes ecstatic structures could be found within the lymphoid component. Immunohistochemistry using different CD-antibodies proved the non-neoplastic character of the lymphoid tissue with the lymphocytes mostly being of B-lineage, whereas cytokeratins highlighted the epithelial lining and its infolding to the cyst wall. Contrary to the literature this study is the first to present a predominance of a multicystic architecture of parotid lymphoepithelial cysts in an unselected, non HIV-infected population. Moreover, the histopathological findings obtained support impressively the theory that these sporadic cysts arise from heterotopic sialogenic duct like structures in intra- and periparotid lymph nodes.