Nasopharyngeal Lymphatic Tissue in Patients Infected With Human Immunodeficiency Virus: A Prospective Clinicopathologic Study

Abstract

A prospective clinicopathologic study of the nasopharyngeal lymphatic tissue, using a standardized approach, was carried out in 66 patients infected with human immunodeficiency virus (HIV) in Aviano, Italy. Two hundred eighteen patients without HIV infection served as a control group. A significantly higher percentage of nasopharyngeal lymphatic tissue hypertrophy was observed in HIV-infected patients compared with the control group, both clinically and pathologically. The finding of a higher incidence of nasopharyngeal lymphatic tissue hypertrophy during some stages of the disease, when cervical lymph nodes are enlarged, suggests that the extranodal nasopharyngeal district behaves in the same way as the lymph nodes. Nasopharyngeal lymphatic tissue hypertrophy should be placed at the forefront of the hitherto known head and neck manifestations of HIV infection. An ear, nose, and throat examination is mandatory for all patients with known or suspected HIV infection.

Head and neck manifestations during HIV infection

“…The extranodal nasopharyngeal area behaves in the same way as the lymph nodes, with an hypertrophy during the early stages and a later reduction (Barzan et al, 1990). In the present series NLTH represented the most common overall head and neck finding.…”

“…A plexigas shield incorporated in the headlight protected the observer's face during the procedure. The nasopharyngeal situation was recorded in four classes following the clinical aspect of the lymphatic tissue of the posterior wall: class 0 (no lymphatic tissue detectable), class 1 (presence of lymphatic tissue up to 1 mm, thick), class 2 (moderate hypertrophy, between 1 and 3 mm), class 3 (marked hypertrophy, over 3 mm) (Barzan et al, 1990). For the purpose of this paper, classes 2 and 3 are grouped together as nasopharyngeal lymphatic tissue hypertrophy (NLTH).…”

Mucosal immune cell populations and the bacteriome of adenoids and tonsils from people living with HIV on suppressive antiretroviral therapy

“…PLWH in this study were on ART with suppressed viremia and presented with CD4 T cell counts above 350 cells/mm 3 . This study was born due to the fact that ENT manifestations are underreported in HIV infection (Barzan et al, 1990). When performing a literature review, we found that few reports had been published in the last 10 years (Bao and Shao, 2018).…”

“…These manifestations were early signs of HIV infection and AIDS (Moazzez and Alvi, 1998) little is known on ENT manifestations in PLWH on ART. We thought to address this gap in the literature; therefore, we present a study drawn from 3 years of experience in a tertiary hospital dedicated to respiratory diseases, where the role of ENT surgeons is critical to both diagnosis and management of these conditions (Barzan et al, 1990). The most common manifestations presented by PLWH on ART were recurrent tonsillitis and septal deviation and turbinate hypertrophy; these ENT conditions were inflammatory or obstructive in nature.…”

Nasopharyngeal Mucosa and Adenoids: Appearance at MR Imaging

“…Adenoids enlarge during early childhood and reach a maximum size in children aged 3 to 7 years after which they usually undergo appreciable atrophy (2,3). Nevertheless, adenoids that are enlarged because of benign lymphoid hyperplasia may persist or recur in adulthood because of several factors, including irritants and infections (4)(5)(6). Enlargement of the adenoid or moderate wall thickening in other parts of the nasopharynx may be seen at cross-sectional imaging, either incidentally or in patients being examined specifically for ear, nose, and throat symptoms, including those suggestive of nasopharyngeal malignancy (7).…”