Diagnostic ultrasound patterns of parotid glands in human immunodeficiency virus-positive patients in Mulago, Uganda

Abstract

Objectives: The purpose of this study was to determine sonographically, in parotid glands of human immunodeficiency virus-positive patients, the condition of glands with or without enlargement, and propose a classification system for the patterns observed using diagnostic ultrasound imaging. Methods: In this prospective clinical study, ultrasound scans were performed on 200 patients aged 4-62 years at Mulago Hospital, Uganda. Results: There were four main distinct ultrasound pathological patterns in the parotids, i.e. lymphocytic aggregations (LAs), lymphoepithelial cysts (LECs), fatty infiltration (FI) and lymphadenopathy only. There were additional subdivisions depending on the presence of echogenic foci and intraparotid lymphadenopathy. Of those patients (n 5 64) without parotid enlargement, only 8% showed normal ultrasound features, whereas 34% showed LECs and 31% showed LAs. Of those (n 5 136) with parotid enlargement, 46% showed LECs, 23% showed FI and 15% showed LAs. The overall prevalence of LECs in the study sample was 42%. LECs were multiple, mainly between 7 mm and 12 mm in diameter and 26% showed internal echogenic foci either mobile or stationary. In contrast, LAs tended to be ill-defined, less than 5 mm and were not associated with posterior acoustic enhancement. Features differentiating LAs from LECs have not been previously described. Parotid FI (lipodystrophy) was noted in patients on highly active antiretroviral therapy, who showed lesser prevalence of LECs after 12 months of treatment. Conclusions: Our study of 200 patients is probably the largest such study in the English language literature. The wide spectrum of diagnostic ultrasound patterns was categorized into four main groups (ten subgroups).

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

“…The US examination of the parotid glands showed that 67.65% of children with a history of parotid gland enlargement and 50% of children with no history showed changes in the parotid glands consistent with the diagnosis of HIV/SGD, corroborating the results of Goddart et al . and Kabenge et al …”

Parotid lymphoepithelial cysts in human immunodeficiency virus: a review

“…3,11 The cysts are painless, slow-growing, 11 frequently bilateral, 4,11 soft in consistency and involve the superficial lobe of the parotid gland, 4 with multiple cysts being more common than single. 12 Their size varies from 0.5 cm to 5 cm in diameter.…”

“…3 Computed tomography and magnetic resonance imaging. Multiple small cysts with enlarged parotid glands are usually observable on CT and MRI scans.…”

“…1 The cysts are early indicators of HIV infection, with an incidence rate of 3-6 per cent in affected adults 2 and 30 per cent in the paediatric population. 3 Hildebrandt (1895) was the first to report benign lymphoepithelial cyst of the parotid gland. Its association with HIV infection was first described by Ryan and colleagues in 1985.…”

Altered autophagy and sympathetic innervation in salivary glands from high-fat diet mice

“…Moreover the parenchyma of salivary glands are subjected to other influences such as hormones that affect changes in its morphological characteristics leading to local or systemic alterations. 1 One such change is adipose tissue infiltration between acini parenchyma associated with conditions like: Human Imunodeficiency virus (HIV), 2 hypertriglyceridemia, 3 but most commonly with ageing in the absence of any obvious disease process 4,5 .…”