CT features and pathologic characteristics of lymphoepithelial carcinoma of salivary glands

Objective: To investigate and analyze the typical CT findings of salivary gland lymphoepithelial carcinoma. Methods: CT findings in 8 patients with lymphoepithelial carcinoma (LEC) in salivary gland were studied retrospectively. Surgical resection was performed in all cases. Results: 8 cases were subdivided to primary tumor and secondary tumor. In primary tumor group, 5 were localized in the parotid gland, 2 were found in the submandibular glands; 6 lesions had with homogeneous density, 1 was associated with cystic degeneration and 1 with calcification; the margins of lesions in 5 cases were poorly defined, while well-defined in 2. On enhanced CT: obvious enhancement was achieved in all of the 7 solitary lesions, among which 4 were homogenously enhanced while the other 3 had heterogeneous enhancement. In the 2 cases of nodules in deep lobe, retromandibular vein was affected; 7 patients had positive Epstein-Barr virus (EBV) test, with Ki-67 measurements ranged from 40% to 80%. 1 patient had LEC secondary to Benign Lymphoepithelial Lesion (BLEL), with involvement of bilateral parotid glands; the lesion was manifested as multiple differently-sized nodules, with partial cystic change, all of the nodules had clear margins, and obvious ring-shape enhancement was seen in the nodules with cystic change; the patient with secondary LEC had negative EBV test and a Ki-67 value of 20%. Conclusion: In most cases, LEC was primary and occurred in the parotid glands. The probable diagnosis could be made based upon Dual-phase contrast-enhanced CT scan findings combined with positive expression of EBV.