Cytological features of a lymphoepithelial cyst of the salivary gland with application of the second edition of Milan System for Reporting Salivary Gland Cytopathology&nbsp;

Ishida,Mitsuaki; Kataoka,Isako; Tomiuka,Mari; Okanishi,Hiroyuki; Ariga,Kozue; Uragami,Mayumi; Deguchi,Chihiro; Ono,Shizuka; Takeda,Reika; Hirose,Yoshinobu

doi:10.3892/mco.2024.2750

Cytological features of a lymphoepithelial cyst of the salivary gland with application of the second edition of Milan System for Reporting Salivary Gland Cytopathology

Authors:
- Mitsuaki Ishida
- Isako Kataoka
- Mari Tomiuka
- Hiroyuki Okanishi
- Kozue Ariga
- Mayumi Uragami
- Chihiro Deguchi
- Shizuka Ono
- Reika Takeda
- Yoshinobu Hirose
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Affiliations: Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka 569‑8686, Japan
Published online on: June 5, 2024 https://doi.org/10.3892/mco.2024.2750
Article Number: 52
Copyright: © Ishida et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Lymphoepithelial cysts (LECs) of the salivary glands are relatively rare, benign cystic lesions. Characteristic histopathological features of LEC include presence of well‑circumscribed unilocular cysts surrounded by dense lymphoid tissue with lymphoid follicles. These cysts are lined by a combination of squamous, ciliated, columnar and mucous epithelia. Fine‑needle aspiration (FNA) cytology is the standard preoperative diagnostic procedure for salivary gland lesions. Although the cytological diagnosis of cystic salivary gland lesions is difficult, the use of Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in the cytodiagnosis of cystic salivary gland lesions has been reported. However, only a few studies have described the cytological features of LEC. To the best of our knowledge, the present study reviewed the cytological features of a case series of LEC and evaluated the application of MSRSGC for the first time. This retrospective study included 13 patients with LEC of the salivary glands who underwent pre‑operative FNA followed by surgical resection of the cyst. All the lesions were present in the parotid gland. Cytological analysis revealed no epithelial cell component in eight patients (62.5%) along with a proteinaceous background containing lymphocytes and/or foamy cells. Non‑keratinising squamous epithelium was observed in three patients. Amylase crystalloids were noted in two patients. None of the patients were cytodiagnosed with LEC. Eight, three, one and one patients were categorised as MSRSGC I, II, III, and IVa, respectively. The results of the present study demonstrated that cytodiagnosis of LEC was difficult due to the absence of epithelial component in 62.5% of the specimens. However, evaluation of its benignity was not difficult. Thus, it can be summarized that MSRSGC may be useful for cytological evaluation of LECs.

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