Monday, April 10, 2017

Background

  • When associated with HIV, has been abbreviated as BLL-HIV (benign lymphoepithelial lesion of human immunodeficiency virus)
  • Is sufficiently commonly associated with HIV infection that the presence of a benign lymphoepithelial lesion may warrant testing for HIV
  • Look for solid and cystic structures in enlarged parotid glands with potential for cervical and tonsillar adenopathy
  • Occurs in about 3-6% of HIV positive patients (Sujatha et al. 2013), rarer with HAART therapy
  • Rarely may degenerate into B-cell lymphoma
  • Commonly bilateral with rare minor salivary gland involvement

Radiologic Findings

  • On CT:
    • Non-contrast: parotid enlargement and solid and cystic masses observed
    • Contrast: thinly rim-enhancing cysts and poorly circumscribed solid lesions; cervical and tonsillar enlargement may be noted as well
  • On MR:
    • T1 gives low signal in cysts and intermediate signal in solid components
    • T2 hyperintense cystic structures and bright lymphoid aggregates
    • On T1 post-contrast cysts become rim-enhancing and solid lesions hetergeneously enhance
1
BLLHIV_CT_0723

 

T1-weighted MR
BLLHIV_T1_0723

 

T2-weighted MR
BLLHIV_T2_0723

 

TI post-con fat-sat
BLLHIV_T1post_0723

References

Joshi J, Shah S, Agarwal D, Khasgiwal A. Benign lymphoepithelial cyst of parotid gland: Review and case report. J Oral Maxillofac Pathol. 2018 Jan;22(Suppl 1):S91-S97. doi: 10.4103/jomfp.JOMFP_252_17. PMID: 29491615; PMCID: PMC5824528.

Sujatha D, Babitha K, Prasad RS, Pai A. Parotid lymphoepithelial cysts in human immunodeficiency virus: a review. J Laryngol Otol. 2013 Nov;127(11):1046-9. doi: 10.1017/S0022215113002417. Epub 2013 Oct 29. PMID: 24169222.