ABSTRACT
Malignant transformation arising in benign lymphoepithelial cysts is a complex and rare occurrence, and related research is limited. This study presents a case of the malignant degeneration of lymphoepithelial cyst in parapharyngeal space. Clinicopathological features and differential diagnosis are discussed with literature review to provide reference for clinical diagnosis and treatment management.
Subject(s)
Humans , Carcinoma , Diagnosis, Differential , CystsABSTRACT
Thyroglossal duct cyst is a congenital malformation occurring due to incomplete closure of the thyroglossal duct. The infrequency with which it is encountered in thyroid makes it a formidable diagnostic challenge. Authors report this case because of the rarity of intrathyroid location of thyroglossal cyst.
ABSTRACT
Pancreatic lymphoepithelial cysts (LECs) are rare pancreatic cysts with squamous epithelial lining surrounded by dense lymphoid tissue. A preoperative diagnosis of LECs is difficult due to imaging diversity and inadequate documentation because of their rarity. We present a case of surgically confirmed pancreatic LEC with magnetic resonance imaging (MRI) findings as heterogeneous signal intensity on T2-weighted images with multiple septa-like structures, slightly hypo-signal intensity on T1-weighted images, and thin-wall enhancement on dynamic contrast images. LECs are benign lesions without any malignant potential. Therefore, the inclusion of LEC in the differential diagnosis of cystic pancreatic lesions may reduce unnecessary surgical procedures.
Subject(s)
Diagnosis , Diagnosis, Differential , Lymphoid Tissue , Magnetic Resonance Imaging , Pancreas , Pancreatic CystABSTRACT
The objective of this study was to describe a case of a lymphoepithelial cyst in the palatoglossus arch. A 16-years-old black man said that he was observed a lesion in his mouth. On the physical exam, a pedicled, consistent, smooth surface 1.5 x 1 cm lesion, similar in color to the adjacent mucosa, was found. The lesion was surgically removed and the microscopic exam showed mucosal fragments with pedicled lesion; the cystic cavity sometimes lined with pseudostratified cylindrical epithelium and others with stratified squamous flat interface of the epithelium. Around the cyst, a well-delimited mass of lymphoid tissue, presenting lymphoid follicles, was also seen. Lymphoepithelial cyst has clinical characteristics similar to those of others lesions that occur in the oral cavity. The diagnosis should be based on conservative biopsy, with total removal of lesion(AU)
El objetivo de este estudio fue describir un caso clínico de quiste linfoepitelial en el arco palatoglosso. Paciente de 16 años de edad, sexo masculino, raza negra, que durante la anamnesis relató que observó una lesión en la boca. Al examen físico se observó una lesión pediculada, de consistencia firme, superficie lisa, de 1,5 x 1,0 cm de tamaño, con color similar al de la mucosa adyacente. La lesión fue removida quirúrgicamente y el examen microscópico mostró fragmentos de mucosa con lesión pediculada, la cavidad del quiste a veces revestida por epitelio cilíndrico pseudoestratificado y otras veces por la interfase plana del epitelio escamosa estratificado. Alrededor del quiste, una masa bien delimitada de tejido linfoide con presencia de folículos linfoides. El quiste linfoepitelial tiene las mismas características clínicas de otras lesiones que ocurren en la cavidad oral, el diagnóstico debe ser realizado por biopsia, de manera conservadora, con eliminación total de la lesión(AU)
Subject(s)
Humans , Male , Adolescent , Mouth Neoplasms/surgery , Lymphoid Tissue/surgery , Mouth Mucosa/injuries , Medical History Taking/methodsABSTRACT
Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year-old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.
Un quiste linfoepitelial bucal es raro, con pocos casos reportados en la literatura. El objetivo de este artículo es describir un caso clínico, centrándose en los aspectos clínicos y diagnósticos, tratamiento y pronóstico. La lesión tuvo un año de evolución, y se había desarrollado como un nódulo fibroso en la mucosa yugal de un paciente de 71 años de edad con leucoderma. Teniendo en cuenta la hiperplasia fibrosa inflamatoria, fibroma y mucocele como diagnósticos diferenciales, se llevó a cabo una biopsia por escisión. Una cavidad quística limitada por epitelio pseudoestratificado sin proyecciones en el tejido conjuntivo, con tejido linfoide en el interior fue identificado microscópicamente. No se observaron eventos adversos postoperatorios, y el seguimiento clínico al año confirmó el pronóstico favorable de este tipo de lesión.
Subject(s)
Humans , Male , Aged , Mouth Diseases/surgery , Mouth Diseases/diagnosis , Epithelium/pathology , Cysts/surgery , Cysts/diagnosis , Lymphoid Tissue/pathology , Diagnosis, Differential , Mouth Diseases/pathology , Mouth Mucosa/pathology , Prognosis , Cysts/pathology , Treatment OutcomeABSTRACT
O cisto linfoepitelial oral é uma lesão rara, que se apresenta sob a forma de massa submucosa, assintomática, de pequenas dimensões, com coloração, que varia do róseo ao amarelado. A maioria dos caos é observada em áreas da cavidade oral que apresentam agregados linfóides, como o assoalho da boca e as uperfícies lateral e ventral da língua. Histologicamente, os cistos linfoepiteliais orais exibem uma cavidade cística, revestida de epitélio estratificado pavimentoso paraceratinizado, com lúmen cístico preenchido por células epiteliais descamadas e interface epitélio-conjuntivo plana. Tipicamente, a cápsula fibrosa exibe um denso infiltrado linfocítico, com formação de centros germinativos. O tratamento preconizado para essas lesões é a excisão cirúrgica conservadora, não havendo relatos de recidiva ou transformação neoplásica. O presente trabalho tem por objetivo relatar um caso clínico de cisto linfoepitelal oral, diagnosticado na borda lateral da língua de um paciente de 41 anos de idade, do sexo masculino bem como discutir aspectos relacionados aos achados clínico-patológicos e ao tratamento dessa lesão.
The oral lymphoepithelial cyst is a rare lesion, which manidests as a pinkish to yellowish small, a asymptomatic, submucosal mass. Most cases occur in regions of the oral cavity presenting lymphoid aggregates, such as the floor of the lymphoepithelial cysts exhibit a cystic cavity lined by a parakeratinized stratified squamous epithelium. The luminal space is filled with sloughed epithelial cells and the epithelial lining is devoid of rete ridges. Characteristically, the fibrous capsule shows a dense lymphoid tissue, with germinal centers. Conservative surgical excision is the treatment of choice for these lesions, with no reports of recurrence or neoplastic transformation. The aim of this study is to report a case of lymphoepithelial cyst, which was diagnosed in the tongue's lateral surface of a 41-year-old man, and to discuss asoects regarding clinicopathological features and therapeutic management of this lesion.
Subject(s)
Male , Mouth , Mouth Diseases , Mouth FloorABSTRACT
INTRODUÇÃO: O cisto linfoepitelial oral é uma lesão incomum, assintomática e de pequenas dimensões, geralmente descoberto durante exames de rotina da cavidade bucal. OBJETIVO: Relatar quatro casos de cisto linfoepitelial oral, confrontando seus aspectos com aqueles reportados em outros 119 casos publicados na literatura. RELATO DOS CASOS: Três casos em mulheres, com idade entre 16 e 23 anos, e um caso em homem, com 45 anos, caracterizados por nódulos assintomáticos, de pequenas dimensões e coloração variando do branco ao amarelado. Dois casos estavam localizados na superfície ventral da língua, um em assoalho bucal e outro em orofaringe. Histologicamente, as lesões revelaram cavidade cística contendo quantidade variável de células epiteliais descamadas, revestida por epitélio pavimentoso estratificado, predominantemente paraceratinizado, de interface plana com o tecido conjuntivo. A cápsula fibrosa exibiu um denso infiltrado linfocítico, com identificação de centros germinativos em apenas dois casos. CONCLUSÃO: A análise conjunta dos casos apresentados neste trabalho e de outros 119 casos relatados na literatura revela que os cistos linfoepiteliais orais exibem predileção pelo gênero masculino, com ápice de incidência na terceira década de vida. Em geral, essas lesões se apresentam como pequenos nódulos assintomáticos localizados no assoalho bucal. Histologicamente, a maioria dos casos revela epitélio cístico com padrão de maturação paraceratinizado e exibe centros germinativos na cápsula fibrosa.
INTRODUCTION: The oral lymphoepithelial cyst is a rare, asymptomatic lesion with small dimensions, commonly discovered during routine examination of the oral cavity. OBJECTIVE: To report four cases of oral lymphoepithelial cyst and compare their aspects with other 119 cases reported in the literature. CASE REPORT: Three cases in women, age range 16 to 23, and one case in a 45-year-old man, all of them presenting small, asymptomatic, yellowish-white nodules. Two cases were located in the ventral surface of the tongue, one in the buccal floor and one in the oropharynx. Histologically, the lesions showed cystic cavity with variable amount of desquamated epithelial cells, lined with a parakeratinized stratified squamous epithelium and a plane interface with the connective tissue. The fibrous capsule showed a dense lymphocyte infiltrate with germinal centers in only two cases. CONCLUSION: The analysis of the cases herein and the other 119 cases reported in the literature reveals that oral lymphoepithelial cysts present a predilection for males, with peak of incidence in the third decade of life. Characteristically, these lesions consist of small asymptomatic nodules located in the buccal floor. Histologically, most cases show a parakeratinized epithelial lining and germinal centers in the fibrous capsule.
Subject(s)
Humans , Male , Female , Cysts/pathology , Mouth Diseases/pathology , Diagnosis, Differential , Mouth Floor/pathologyABSTRACT
A lymphoepithelial cyst of the pancreas is a rare, benign disease. A 58-year-old man with no abdominal symptoms was found to have a cystic mass in the pancreas. Computed tomography showed a multi-septated cystic mass in the tail of the pancreas. We performed a distal pancreatectomy with a splenectomy. Histological examination revealed that the cyst wall was lined with squamous epithelium and surrounded by lymphoid tissue. Keratinous material was present in the cyst. A lymphoepithelial cyst of the pancreas should be considered in the differential diagnosis of all cystic pancreatic lesions. Fine-needle aspiration biopsy may be a useful strategy, but local surgical resection of the cyst, for most patients, should be considered to exclude malignancy.
Subject(s)
Humans , Middle Aged , Biopsy, Fine-Needle , Diagnosis, Differential , Epithelium , Keratins , Lymphoid Tissue , Pancreas , Pancreatectomy , SplenectomyABSTRACT
Lymphoepithelial cysts of the pancreas, which are lined by squamous epithelium and surrounded by mature lymphoid tissue, represent a rare clinicopathologic entity of cystic lesions of the pancreas and true pancreatic cysts. Here, we report a case of lymphoepithelial cyst of the pancreas and a review of the related Korean literature. A 58-year-old man presented to our hospital with an asymptomatic pancreatic mass and no remarkable medical history except hypertension. Physical examination and laboratory analyses showed no abnormalities. Ultrasonography (US) revealed a cystic lesion with heterogeneous internal echo within the body of the pancreas, and computed tomography (CT) revealed a low-density lesion (2.3*.5 cm) with well-defined margins and lobulating contour. To further characterize the mass, a biopsy was collected via endoscopic ultrasonography (EUS)-guided fine-needle aspiration. Histological examination revealed fibrous tissue and epithelial cells, but was insufficient for a definitive diagnosis. Laparotomy revealed that the mass was composed of keratinizing squamous epithelial cells surrounded by lymphoid tissue, thereby confirming the diagnosis of lymphoepithelial cyst of the pancreas
Subject(s)
Humans , Middle Aged , Biopsy , Biopsy, Fine-Needle , Endosonography , Epithelial Cells , Epithelium , Hypertension , Keratins , Laparotomy , Lymphoid Tissue , Pancreas , Pancreatic Cyst , Physical ExaminationABSTRACT
Lymphoepithelial cyst is a rare benign cystic tumor that is composed of a squamous epithelial cyst surrounded by lymphoid tissue, and this type of cyst is histologically similar to the branchial cleft cysts of the lateral neck. It is most often found in the head and neck and it is only rarely found in the pancreas, mediastinum and hypopharynx. Lymphoepithelial cysts of the esophagus have been described in Japan by Kataoka and Asami. We report here on a case of esophageal lymphoepithelial cyst that was removed endoscopically without serious complications.
Subject(s)
Branchioma , Endosonography , Esophagus , Head , Hypopharynx , Japan , Lymphoid Tissue , Mediastinum , Neck , PancreasABSTRACT
Lymphoepithelial cyst of the pancreas is a rare benign cystic tumor which is histologically characterized by cyst containing keratin, lined by mature squamous epithelium surrounded by lymphoid tissue, often with prominent follicles. Cystic lesions of the pancreas are more often detected because sensitive abdominal imaging tests are used for multiple indications, but preoperative differential diagnosis is difficult despite the advancements of imaging technologies. We herein report a case of lymphoepithelial cyst incidentally found on routine abdominal ultrasonography which showed characteristic findings on endoscopic ultrasonography preoperatively and discuss the radiologic features of lymphoepithelial cyst.
Subject(s)
Diagnosis, Differential , Endosonography , Epithelium , Lymphoid Tissue , Pancreas , UltrasonographyABSTRACT
Cystic lesions of the pancreas are relatively rare, but constitute an important category with a challenging differential diagnosis at the clinical, radiological, and pathological levels. A lymphoepithelial cyst of the pancreas is a rare, but distinctive cystic lesion, lined by a mature, keratinizing squamous epithelium, surrounded by lymphoid tissue. This type of lesion was first described by Luchtrath and Schriefers, in 1985. Although the histogenesis of this lesion is not known, it is benign. It can be successfully managed by local excision, with a "wait and watch" approach, in selected cases. A 52-year-old female presented with a history of intermittent epigastric pain of 3 months duration. A physical examination and laboratory studies showed no abnormal findings. Computed tomography of the abdomen revealed a 4.5x2.5 cm well circumscribed, thin rim enhanced, unilobulated cystic lesion closely attached to the uncinate process of the pancreas. Endoscopic retrograde chloangiopancreaticography showed no abnormalities in the duct system. A local mass excision was performed, due to the suspected diagnosis of a benign cystic lymphangioma. The histopathological diagnosis was a lymphoepithelial cyst of the pancreas. The patient was discharged with no complications, on the 8th postoperative day Here, this case is reported with a review of the relevant literature.
Subject(s)
Female , Humans , Middle Aged , Abdomen , Diagnosis , Diagnosis, Differential , Epithelium , Lymphangioma, Cystic , Lymphoid Tissue , Pancreas , Physical ExaminationABSTRACT
A 70-year old man presented with postprandial upper abdominal pain of two months duration, accompanied by indigestion, weight loss, and anorexia. There was no abnormality noted in the lab results. Abdominal CT showed a 3-cm round cystic mass in the tail of the pancreas. A distal pancreatectomy was done. The patient was discharged in 9 days. The cystic wall was composed of a keratinizing squamous epithelium surrounded by subepithelial, dense lymphoid tissue. Some clusters of the sebaceous gland were noted but there was no sweat gland or hair follicle. These findings were consistent with a lymphoepiethelial cyst with sebaceous differentiation. The patient was followed up for 12 months post operatively, and no recurrence was noted.
Subject(s)
Aged , Humans , Abdominal Pain , Anorexia , Dermoid Cyst , Dyspepsia , Epithelium , Hair Follicle , Lymphoid Tissue , Pancreas , Pancreatectomy , Pancreatic Neoplasms , Recurrence , Sebaceous Glands , Sweat Glands , Tomography, X-Ray Computed , Weight LossABSTRACT
A 70-year old man presented with postprandial upper abdominal pain of two months duration, accompanied by indigestion, weight loss, and anorexia. There was no abnormality noted in the lab results. Abdominal CT showed a 3-cm round cystic mass in the tail of the pancreas. A distal pancreatectomy was done. The patient was discharged in 9 days. The cystic wall was composed of a keratinizing squamous epithelium surrounded by subepithelial, dense lymphoid tissue. Some clusters of the sebaceous gland were noted but there was no sweat gland or hair follicle. These findings were consistent with a lymphoepiethelial cyst with sebaceous differentiation. The patient was followed up for 12 months post operatively, and no recurrence was noted.
Subject(s)
Aged , Humans , Abdominal Pain , Anorexia , Dermoid Cyst , Dyspepsia , Epithelium , Hair Follicle , Lymphoid Tissue , Pancreas , Pancreatectomy , Pancreatic Neoplasms , Recurrence , Sebaceous Glands , Sweat Glands , Tomography, X-Ray Computed , Weight LossABSTRACT
Lymphoepithelial cysts of the pancreas are extremely rare cystic lesion characterized by the presence of a mature, squamous epithelial lining surrounded by dense lymphoid tissue. They were first described in 1985 by Lchtrath and Schriefers. A 70-year-old male was admitted with a four month history of intermittent right upper quadrant abdominal pain radiating to the right subscapular area. Physical examination and laboratory studies did not show any abnormal findings. Computed tomography of the abdomen revealed a 2.7 cm well-circumscribed, uniloculated cystic lesion on the tail of the pancreas. Endoscopic retrograde pancreatography showed no abnormalities in the duct system. A distal pancreatectomy with a splenectomy was performed, with a suspected diagnosis of cystic neoplasms of the pancreas. Histopathologic diagnosis was a lymphoepithelial cyst of the pancreas. Although the histogenesis of lymphoepithelial cysts is not fully disclosed, they are benign and can be cured by local excision. This case is reported herein with a review of relevant literature.
Subject(s)
Aged , Humans , Male , Abdomen , Abdominal Pain , Diagnosis , Lymphoid Tissue , Pancreas , Pancreatectomy , Physical Examination , SplenectomyABSTRACT
The lymphoepithelial cyst (LEC) rarely occurs in the thyroid gland. The LEC has been thought to be related to developmental rest, namely solid cell nest, which is derived from ultimobranchial body. We report a case of lymphoepithial cyst in a 34- year-old woman clinically diagnosed with Hashimoto's thyroiditis. The cyst was located in mid to lower portion of the left lobe. It was a single unilocular cyst, which for the most part was lined with squamous epithelium, and at certain foci with ciliated columnar epithelium. The cyst wall showed a dense lymphocytic infiltration, numerous lymphoid follicles with germinal centers and admixed thyroid follicles. This morphology is similar to the branchial cleft cyst, with the exception of the thyroid follicles in the cyst wall. Near the cyst were several solid epidermoid cell nests. Immunohistochemical stain of this cyst-lining epithelium and solid cell nests showed CEA positivity. In view of the similarity in histomorphology and CEA positivity to branchial cleft cyst of the lateral neck, the LEC of the thyroid could also have been of branchial origin. However, the admixed thyroid follicles in the cyst wall suggests that the LEC of the thyroid gland might have derived from another branchial cleft as a ultimobranchial body, because it has the potential for thyroid follicular differentiation.
Subject(s)
Female , Humans , Branchial Region , Branchioma , Epithelium , Germinal Center , Neck , Thyroid Gland , Thyroiditis , Ultimobranchial BodyABSTRACT
An intraparotid benign lymphoepithelial cyst is a rare disease characterized by unilateral painless swelling of parotid region. The histogenesis is controversial. Surgical excision is recommended for diagnosis and curative treatment. We present a case of benign lymphoepithelial cyst arising in a patient with neurofibromatosis. A 46-year-old woman presented with a slowly growing multilocular cystic mass in the left cheek. The cystic mass measured 4 cm in maximal outer diameter and the cystic wall was thick and yellowish pale to gray, soft with well circumscribed margin. Microscopically, the multilocular cyst was lined by stratified squamous epithelium for the most part and underlying lymphoid tissue aggregates with follicles and sharply demarcated from adjacent salivary parenchyma which is of normal appearance and without lymphoid aggregates. Since this lesion is absolutely benign, it is important to separate this benign cyst from cystic salivary gland tumors.