Benign lymphoepithelial lesions

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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~~ that enlarge the parotid glands, and are usually associated with cervical lymph node enlargement, and nasopharyngeal lymphofollicular hyperplasia.

Epidemiology

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~~ ~20% of cases.

Location

BLLs most commonly arise in the parotid gland, and are only rarely seen in the submandibular glands or sublingual glands.

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

-<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>
+<p><strong>Benign lymphoepithelial lesions (BLL </strong>or <strong>BLEL)</strong>, also misleadingly known as <strong>AIDS-related parotid cysts (ARPC)</strong>, are mixed solid and cystic lesions that <a title="Parotid gland enlargement" href="/articles/parotid-enlargement">enlarge</a> the <a href="/articles/parotid-gland">parotid glands</a>, and are usually associated with cervical <a title="Lymph node enlargement" href="/articles/lymph-node-enlargement">lymph node enlargement</a>, and nasopharyngeal lymphofollicular hyperplasia.</p><h4>Epidemiology</h4><p>Despite their aforementioned alternative name, BLL are seen usually in HIV positive patients without <a href="/articles/hivaids">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><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><h5>Location</h5><p>BLLs most commonly arise in the parotid gland, and 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>Radiographic features</h4><ul>
~~-<li>prominent nasopharyngeal adenoidal tissue : seen in 35% of HIV positive patients <sup>4</sup>~~
+<li>prominent nasopharyngeal adenoidal tissue: seen in 35% of HIV positive patients <sup>4</sup>
~~-</ul><h4>See also</h4><ul><li><a href="/articles/parotid-enlargement">parotid enlargement</a></li></ul><p> </p>~~
+</ul><h4>See also</h4><ul><li><a href="/articles/parotid-enlargement">parotid enlargement</a></li></ul>

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