Benign lymphoepithelial lesion is a type of benign enlargement of the parotid and/or lacrimal glands. This pathologic state is sometimes, but not always, associated with Sjögren's Syndrome.

Historically, bilateral parotid and lacrimal gland enlargment was characterized by the term Mikulicz's disease if the enlargement appeared apart from other diseases. If it was secondary to another disease, such as tuberculosis, sarcoidosis, lymphoma, and Sjögren's Syndrome, the term used was Mikulicz's syndrome. Both names derive from Jan Mikulicz-Radecki, the Polish surgeon best known for describing these conditions. Today, the terms "Mikulicz's disease" and "Mikulicz's syndrome" are viewed as ambiguous and outdated.

Locations

Occurring in 80% of cases, the gland most likely to be affected is the parotid gland. Lacrimal glands are also affected.

Characteristic

Benign lymphoepithelial lesion is most likely to occur in adults around 50 years of age. There is a prediliction for gender with 60% - 80% being female. The gland affected has a diffuse swelling. The swelling can be asymptomatic, but mild pain can also be associated.

Most cases of benign lymphoepithelial lesions appear in conjunction with Sjögren's Syndrome. When Sjögren's Syndrome is present, the swelling is usually bilateral. Otherwise, the affected glands are usually only on one side of the body.

In most caess, a biopsy is needed to distinguish benign lymphoepithelial lesions from sialadenosis (sialosis).

Histology

The appearance of this tumor microscopically has an intense lymphocytic infiltrate. Germinal center formation may or may not occur. Salivary acini are destroyed, leaving only the ductal epithelium. Due to the hyperplasia (overgrowth) of the ductal cells and surrounding myoepithelial cells, epimyoepithelial islands appear and are the characteristic feature of benign lymphoepithelial lesion.

Treatment

Treatment usually consists of surgical removal of the affected gland. Prognosis is usually good. Nonetheless, there is a rare but malignant version, called malignant lymphoepithelial lesion (lymphoepithelial carcinoma), which may develop.

References

• Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.

Oral pathology