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Head and neck lesions in the immunocompromised host
K Marsot-Dupuch1, J Quillard, M C Meyohas
1Department of Neuroradiology, University Hospital of Bicêtre, 94275 Le Kremlin Bicêtre Cedex, France. kathlyn.marsot-dupuch@bct.ap-hop-paris.fr
European Radiology
|January 30, 2004
Summary
Immunosuppressed patients frequently develop head and neck lesions, including infections and neoplasms affecting salivary glands, sinonasal tract, and temporal bones. Early diagnosis and prompt treatment are crucial for managing these potentially life-threatening conditions.
Area of Science:
- Head and Neck Pathology
- Immunocompromised Host
- Oncology
Background:
- Head and neck lesions affect 40-50% of immunosuppressed patients, including those with HIV, diabetes, organ transplants, or on immunosuppressive drugs.
- Commonly affected sites include salivary glands, lymph nodes, sinonasal tract, orbits, temporal bones, and pharyngo-laryngeal mucosa.
- Lesions manifest as granulation tissue, inflammation, or neoplasms, with temporal bone involvement being frequent in pediatric cases.
Purpose of the Study:
- To review the spectrum of head and neck lesions in immunosuppressed patients.
- To highlight the common sites, manifestations, and potential complications of these lesions.
- To emphasize the importance of early diagnosis and management in this vulnerable population.
Main Methods:
- Review of clinical presentations and pathological findings in immunosuppressed patients.
- Analysis of organ-specific involvement and associated conditions.
- Discussion of diagnostic imaging and therapeutic strategies.
Main Results:
- Salivary gland involvement presents as painless enlargement and xerostomia, with lymphoepithelial cysts, sialosis, and lymphoma as possibilities.
- Sinonasal diseases are most frequent in adults (66%), associated with decreased survival; invasive aspergillosis is a lethal complication.
- Pediatric temporal bone involvement is common, leading to otomastoiditis and necrotizing otitis; Kaposi's sarcoma is a key neoplasm in AIDS patients.
Conclusions:
- Immunosuppressed patients are prone to aggressive head and neck infections and neoplasms.
- Timely intervention is critical to prevent severe complications and improve outcomes.
- Understanding these lesions is vital for effective patient management.