Benign lymphoepithelial cysts (BLC) are rare disorders of salivary gla
nds (0,6%). In patients infected by HIV, they are seen more often. In
comparison to sporadic BLC, the patients are younger, the diameter of
the cysts is up to 5 cm and they are often located bilaterally. At the
Department of ENT, Head and Neck Surgery of the Ludwig-Maximilians-Un
iversity, Munich, ten HIV-infected patients (two females) showed lymph
oepithelial cysts (six times bilaterally). One of these revealed a met
astasis of a small cell neoplasma near the cysts, another patient show
ed a non-Hodgkin's lymphoma of low grade malignancy (MALT-type), and o
ne patient additionally had bilateral Warthin's tumours. The BLCs were
mostly located in the parotid tail. In three cases, the cysts were fo
und on the inferior border of the parotid and once at the submandibula
r gland. The age ranged from 27 to 71 years (medium 45.7 years). The m
ode of HIV infection was homosexuality five times, drug abuse twice, h
eterosexuality once, and blood products once. In two cases, the channe
l of transmission was unknown. The majority of the patients showed min
or HIV illness (CDC II [n=2] /CDC III [n=4]); the rest had advanced im
munodeficiency (CDC IV [n=4]). All the cysts were examined by ultrason
ography and NMR. According to the clinical findings and the general st
age of health, BLCs were either enucleated (n=8) or a superficial paro
tidectomy (n=5) and selective biopsy of lymph nodes (n=3) suspected to
be malignant were performed. HIV-p24 antigen could be detected immuno
cytochemically in the germinal centres of the lymphatic follicles loca
ted in the wall of the BLCs. Antibodies to HIV and HIV antigen also co
uld be demonstrated in the cystic fluid. Bilateral cystic disorders of
the great salivary glands are highly suspicious as signs pointing to
an HIV infection, and patients should be examined adequately.