Benign lymphoepithelial lesions
Updates to Synonym Attributes
Updates to Article Attributes
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Benign lymphoepithelial lesions (BLL or BLEL), also misleadingly known as AIDS-related parotid cysts (ARPC), are mixed solid and cystic lesions which enlarge the parotid glands, and are usually associated with cervical lymph node enlargement, and nasopharyngeal lymphofollicular hyperplasia. Despite their aforementioned alternative name, BLL are seen usually in HIV positive patients without AIDS, and are not an AIDS defining illness. It is relatively common in the HIV population, with 5% of patients eventually developing BLL.
BLLs are only rarely seen in the submandibular glands or sublingual glands.
Pathology
Thought to arise from dilatation of intraglandular ducts from obstruction due to lymphoid hypertrophy. They are bilateral in ~ 20 % of cases.
Radiographic features
- well circumscribed cystic spaces
- may demonstrate thin rim enhancement on post contrast MRI
- ultrasound demonstrates these 'cystic' lesions to actually have multiple small septations, and commonly also small mural nodules (40%)
- a vascular pedicle may be seen entering the cystic region
BLLs are usually seen associated with other sites of lymphoid hyperplasia 4, including:
- prominent nasopharyngeal adenoidal tissue : seen in 35% of HIV positive patients4
- posterior triangle lymphadenopathy
- abnormal bone marrow signal
Differential diagnosis
- first branchial cleft cyst
- Warthin tumour
- Sjogren syndrome
- sialocoele
- sarcoidosis
- necrotic intraparotid lymph nodes
See also
-<p><strong>Benign lymphoepithelial lesions (BLL or BLEL)</strong>, also misleadingly known as <strong>AIDS-related parotid cysts (ARPC)</strong>, are mixed solid and cystic lesions which enlarge the <a href="/articles/parotid-gland">parotid glands</a>, and are usually associated with cervical lymph node enlargement, and nasopharyngeal lymphofollicular hyperplasia. Despite their aforementioned alternative name, BLL are seen usually in HIV positive patients without <a href="/articles/aids">AIDS</a>, and are not an <a href="/articles/aids-defining-illness">AIDS defining illness</a>. It is relatively common in the <a href="/articles/hiv">HIV</a> population, with 5% of patients eventually developing BLL. </p><p>BLLs are only rarely seen in the <a href="/articles/submandibular-gland">submandibular glands</a> or <a href="/articles/sublingual-gland">sublingual glands</a>. </p><h4>Pathology</h4><p>Thought to arise from dilatation of intraglandular ducts from obstruction due to lymphoid hypertrophy. They are bilateral in ~ 20 % of cases.</p><h4>Radiographic features</h4><ul><li>well circumscribed cystic spaces</li><li>may demonstrate thin rim enhancement on post contrast MRI</li><li>ultrasound demonstrates these 'cystic' lesions to actually have multiple small septations, and commonly also small mural nodules (40%)</li><li>a vascular pedicle may be seen entering the cystic region </li></ul><p>BLLs are usually seen associated with other sites of lymphoid hyperplasia <sup>4</sup>, including:</p><ul><li>prominent nasopharyngeal adenoidal tissue : seen in 35% of HIV positive patients <sup>4</sup></li><li>posterior triangle lymphadenopathy</li><li>abnormal bone marrow signal</li></ul><h4>Differential diagnosis</h4><ul><li><a href="/articles/first-branchial-cleft-cyst">first branchial cleft cyst</a></li><li><a href="/articles/warthin_tumour">Warthin tumour</a></li><li><a href="/articles/sjogren-syndrome-2" title="Sjogren Syndrome">Sjogren syndrome</a></li><li><a href="/articles/sialocoeles">sialocoele</a></li><li><a href="/articles/sarcoidosis-1">sarcoidosis</a> </li><li><a href="/articles/necrotic-intraparotid-lymph-nodes" title="necrotic intraparotid lymph nodes">necrotic intraparotid lymph nodes</a></li></ul><h4>See also</h4><ul><li><a href="/articles/parotid-enlargement" title="Parotid enlargement">parotid enlargement</a></li></ul><a name="Refernces"></a>- +<p><strong>Benign lymphoepithelial lesions (BLL or BLEL)</strong>, also misleadingly known as <strong>AIDS-related parotid cysts (ARPC)</strong>, are mixed solid and cystic lesions which enlarge the <a href="/articles/parotid-gland">parotid glands</a>, and are usually associated with cervical lymph node enlargement, and nasopharyngeal lymphofollicular hyperplasia. Despite their aforementioned alternative name, BLL are seen usually in HIV positive patients without <a href="/articles/hiv-aids-1">AIDS</a>, and are not an <a href="/articles/aids-defining-illness">AIDS defining illness</a>. It is relatively common in the <a href="/articles/hiv">HIV</a> population, with 5% of patients eventually developing BLL.</p><p>BLLs are only rarely seen in the <a href="/articles/submandibular-gland">submandibular glands</a> or <a href="/articles/sublingual-gland">sublingual glands</a>.</p><h4>Pathology</h4><p>Thought to arise from dilatation of intraglandular ducts from obstruction due to lymphoid hypertrophy. They are bilateral in ~ 20 % of cases.</p><h4>Radiographic features</h4><ul>
- +<li>well circumscribed cystic spaces</li>
- +<li>may demonstrate thin rim enhancement on post contrast MRI</li>
- +<li>ultrasound demonstrates these 'cystic' lesions to actually have multiple small septations, and commonly also small mural nodules (40%)</li>
- +<li>a vascular pedicle may be seen entering the cystic region</li>
- +</ul><p>BLLs are usually seen associated with other sites of lymphoid hyperplasia <sup>4</sup>, including:</p><ul>
- +<li>prominent nasopharyngeal adenoidal tissue : seen in 35% of HIV positive patients <sup>4</sup>
- +</li>
- +<li>posterior triangle lymphadenopathy</li>
- +<li>abnormal bone marrow signal</li>
- +</ul><h4>Differential diagnosis</h4><ul>
- +<li><a href="/articles/first-branchial-cleft-cyst">first branchial cleft cyst</a></li>
- +<li><a href="/articles/warthin-tumour">Warthin tumour</a></li>
- +<li><a href="/articles/sjogren-syndrome-1">Sjogren syndrome</a></li>
- +<li><a href="/articles/sialocoeles">sialocoele</a></li>
- +<li><a href="/articles/sarcoidosis-1">sarcoidosis</a></li>
- +<li><a href="/articles/necrotic-intraparotid-lymph-nodes">necrotic intraparotid lymph nodes</a></li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/parotid-enlargement">parotid enlargement</a></li></ul><p> </p>
Images Changes:
Image 2 MRI (STIR) ( update )
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Case 1: HIV associated with lymphoid hyperplasia
Image 3 MRI (STIR) ( update )
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Case 1: HIV associated with lymphoid hyperplasia
Image 4 CT (C+ arterial phase) ( update )
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Case 2: Axial axial
Image 5 CT (non-contrast) ( update )
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Case 2: 3D reconstruction
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