Ultrasonography of cystic parotid lesions in HIV infection. Similarity of sonographic appearance with Sjögren's syndrome

Abstract

Bilateral cystic parotid glands occur in some cases of human immunodeficiency virus (HIV) infection. This abnormality, which is associated with cervical adenopathy, can be defined by sonography in the superficial gland, as noted in three men. In retrospect, this parotid disease has similarity to the sonographic finding of Sjögren's syndrome, except for the finding of cervical adenopathy, an observation not previously appreciated.

Parotid gland ultrasonography as a diagnostic tool in primary Sjogren's syndrome

“…Viral infections which generally involve both parotids can produce similar changes, and it is therefore difficult or impossible to differentiate them from SS parotids on the basis of the sonographic pictures alone [16]. Bilateral cystic changes in the parotid glands may be early signs of HIV infection [26,29]. Sonographically, these cysts are generally larger than in SS, the matrix is normoechoic, and the cervical adenopathy is more common in this condition than in SS.…”

“…Abscesses, haematomas and neoplasms with a necrotic or haemorrhagic centre are predominantly unilateral, involving only a certain part of the gland with a blurred contour and hypoechoic centre. These conditions are accompanied by ipsilateral cervical lymphadenopathy, similarly to lymphomas and tumours which are solid lesions sonographically [11,15,16,29]. In spite of the sonographic diagnostic possibilities, it must be emphasized that the diagnosis of salivary gland diseases must in all cases be based on a combined evaluation of the sonographic and clinical findings.…”

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

“…Mandel's study 10 showed LECs in all 13 cases (100%). Similarly, Gooding et al 12 showed LEC in all three cases (100%). In Vona et al's study 9 of 64 cases, the prevalence of ''anechoic and nonhomogeneous areas'' (similar appearance to our LECs) was 60%.…”

“…Compared with other studies 4,[8][9][10][11][12] that use ultrasound imaging to investigate parotid enlargement in HIVpositive patients, our study involved the fairly large number of 200 patients. We also used a relatively modern, high-resolution ultrasound machine.…”

“…Ultrasound imaging is already widely accepted worldwide for diagnosis of soft tissue swellings of the head and neck region and is used by some researchers for imaging the parotid glands in HIV patients. 4,[8][9][10][11][12] The relative low cost of ultrasound imaging is an important consideration for resource-constrained African countries.…”