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[Cystic parotid lesions in HIV infection]
A Galli1, P Giannobi, F Parmigiani
1Divisione di Otorinolarigoiatria e Chirurgia Cervico-Facciale, Ospedale, San Gerardo Monza.
Abstract:
The appearance of parotid lesions of cystic aspect with a HIV's infections has been described in the past by foreign Authors above all coming from USA and from Africa. Similar cases has been recorded in France but only among children. The Authors report a casuistry constituted by five male sex's and white race's subjects, everyone HIV positive, suffering from mono or bilateral benign lymphoepithelial cysts. Every patient under examination presented a positive history because of the use of intravenous drug. Four of the five subjects underwent a surgical treatment of parotidectomy. Echotomography, CT and RM scanning seem to be the more sensitive diagnostic techniques. The peculiar histopathologic aspects allow us to differentiate these lesions both from the classical benign lymphoepithelial cysts and from the Warthin's tumor. The increase of the signalling of these cases seems to be connected with the progressive diffusion of the infection and with major survival of the patients thanks to chemotherapy. The majority of the Authors is agreed to recommend the surgical treatment for the possible malignant degeneration of this kind of forms. A careful clinical and diagnostic analysis of every patient with parotid swelling, above all if at risk for HIV's infection, is strictly necessary.
Insights
HIV-positive individuals can develop benign lymphoepithelial cysts in the parotid gland, often linked to intravenous drug use. Surgical treatment is recommended due to potential malignant degeneration.
Area of Science:
- Medicine
- Pathology
- Infectious Diseases
Background:
- Parotid gland cystic lesions in HIV-positive individuals have been documented globally, particularly in the USA and Africa.
- Previous reports in France focused on pediatric cases, highlighting a potential demographic difference.
Observation:
- This study presents five HIV-positive adult males with unilateral or bilateral benign lymphoepithelial cysts.
- All subjects had a history of intravenous drug use.
- Imaging techniques like echotomography, CT, and MRI were found to be highly sensitive for diagnosis.
Findings:
- Histopathological analysis revealed distinct features differentiating these cysts from classical benign lymphoepithelial cysts and Warthin's tumors.
- The increasing incidence correlates with HIV infection spread and improved patient survival due to chemotherapy.
Implications:
- Surgical parotidectomy was performed on four patients.
- Early clinical and diagnostic evaluation is crucial for HIV-infected individuals presenting with parotid swelling.
- The potential for malignant transformation necessitates surgical intervention and careful monitoring.