Benign Lymphoepithelial Parotid Lesions in Vertically HIV-Infected Patients

Abstract

Benign lymphoepithelial parotid lesions (BLL) are frequently reported in HIV-infected patients, although their clinical and prognostic significance in HIV infection has not been clearly defined. Ultrasonography (USG) has been shown to be a reliable method in monitoring the progression of such lesions. The purpose of this study was to describe the spectrum of sonographic and Doppler findings and to monitor any clinically evident physical change of parotid glands in a cohort of congenitally HIV-infected patients taking antiretroviral therapy. USG findings-based on their severity-have been grouped in three different patterns (0, 1, 2). Our cohort consisted of 51 patients with HIV in various Centers for Disease Control (CDC) stages and being given different antiretroviral protocols. The median USG follow-up was 36 months. The most frequent USG pattern was aspecific parotid gland enlargement (type 0, 45,1%). Patients with either lower CD4+ % (p < 0.20) and higher absolute and percent CD8+ cell count (p < 0.001 and p < 0.003) presented more frequently a type 2 USG pattern. None of them had any symptoms ascribed to "sicca syndrome" and only one patient developed non-Hodgkin's lymphoma during the follow-up, although his USG pattern at baseline was type 0. In summary, the spectrum of USG findings of BLL in vertically HIV-infected patients is broad. Because of the reported, although rare, possible malignant transformation of BLL in HIV-infected children, it is advisable to perform-even in asymptomatic patients-USG at least once per year or in concomitance with any physical modification of the parotid lesions.

Oral lesions in HIV positive AIDS adolescents perinatally infected undergoing HAART

“…The prevalence of PGE in HIV+/AIDS children is from 8.8% to 47% (12). PGE has been related to slow progression of HIV disease (13). If this assumption is true, Table 2.…”

HIV‐associated salivary gland disease – clinical or imaging diagnosis?

“…It was possible to note in the literature review that research involving US examination and computed tomography scanning of the affected glands was carried out only when the clinical manifestations of HIV/SGD were present 12,14 ; however, in view of the high percentage found in our sample of ultrasound images consistent with the diagnosis of HIV/ SGD, in children both with and without a history of parotid gland enlargement, it can be assumed that this disease has a higher prevalence than that reported in the aforementioned studies, for it can occur in a subclinical form. Therefore, the diagnosis of HIV/ SGD based only on the clinical evidence of an increase in size of one or more salivary glands 24 carries a high error rate, as seen in this study.…”

“…According to the literature, US examination and computed tomography scanning of the affected glands should be performed when clinical manifestations of HIV/SGD are observed; however, it is important to note that, due to the recurrent nature and spontaneous remission of the disease, it is possible that at the time of the visit the increased volume is not clinically visible.…”

Oral mucocele/ranula: Another human immunodeficiency virus‐related salivary gland disease?

“…The concept of HIV‐related salivary gland diseases (HIV‐SGD) has been developed to characterize various lesions of salivary glands that occur frequently in association with HIV infection . It is in this context that parotid salivary gland enlargement has been described globally as being associated with HIV infection . In some cases, parotid gland enlargement has been considered the initial manifestation of an underlying HIV infection.…”