ORAL LYMPHOEPITHELIAL CYST: A CLINICOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL STUDY OF A SERIES OF CASES

Abstract

Objective: We aimed to perform a clinicopathologic and immunohistochemical analysis of a series of cases of oral lymphoepithelial cysts (OLECs). Study Design: Descriptive, clinicopathologic, and immunohistochemical study of 20 cases of CLEOs. Results: The mean age was 43.44 years with the female sex (n = 16; 80%) being the most affected. Lateral lesions of the tongue (n = 9; 45%), yellowish lesions (n = 8; 40%), cysts less than 0.6 cm (100%) in size, and misdiagnosed lesions (n = 14; 73%) were the most evident clinical features. Regarding the main microscopic characteristics (on hematoxylin-eosin stain), the majority of the cases were partially encapsulated (n = 13; 65%), covered by parakeratinized squamous cystic epithelium (n = 13; 65%) and exhibited prominent germinal centers (n = 8; 40%) and cysts near the oral mucosa (n = 14; 70%). Immunohistochemical stains revealed a strong positivity in the basal layer of the cystic epithelium for AE1/AE3 and for CD20 in lymphocytic infiltrate and showed a higher proliferation index (using the Ki-67 antibody) in the lymphocytic infiltrate compared with cystic epithelium, especially in the presence of germinative centers. Conclusion: OLEC is a pathologic entity with a discrete clinic presentation that presents evident clinical features but is commonly is misdiagnosed. This study presents a well-defined histologic and immunohistochemical profile. Objective: We aimed to perform a clinicopathologic and immunohistochemical analysis of a series of cases of oral lymphoepithelial cysts (OLECs). Study Design: Descriptive, clinicopathologic, and immunohistochemical study of 20 cases of CLEOs. Results: The mean age was 43.44 years with the female sex (n = 16; 80%) being the most affected. Lateral lesions of the tongue (n = 9; 45%), yellowish lesions (n = 8; 40%), cysts less than 0.6 cm (100%) in size, and misdiagnosed lesions (n = 14; 73%) were the most evident clinical features. Regarding the main microscopic characteristics (on hematoxylin-eosin stain), the majority of the cases were partially encapsulated (n = 13; 65%), covered by parakeratinized squamous cystic epithelium (n = 13; 65%) and exhibited prominent germinal centers (n = 8; 40%) and cysts near the oral mucosa (n = 14; 70%). Immunohistochemical stains revealed a strong positivity in the basal layer of the cystic epithelium for AE1/AE3 and for CD20 in lymphocytic infiltrate and showed a higher proliferation index (using the Ki-67 antibody) in the lymphocytic infiltrate compared with cystic epithelium, especially in the presence of germinative centers. Conclusion: OLEC is a pathologic entity with a discrete clinic presentation that presents evident clinical features but is commonly is misdiagnosed. This study presents a well-defined histologic and immunohistochemical profile.