Cystic parotid masses in HIV infection

Cystic enlargement of the parotid gland is a newly described manifestation of infection with human immunodeficiency virus (HIV). A review of 15 such patients with respect to clinical presentation, natural history, and management is presented. Follow-up ranges from 1 to 27 months, averaging 10 months. In 47% of the patients, parotid swelling was the chief complaint leading to the diagnosis of HIV infection. T-cell analysis revealed the tendency for this lesion to occur in the early stages of immunodeficiency when T-cell counts are high. Histologic examination revealed findings resembling benign lymphoepithelial lesion. It is felt that these lesions are a local manifestation of a systemic disease and treatment should be tailored with this in mind. Surgical excision may not be necessary. Fine-needle aspiration (FNA) was found to be useful diagnostically and therapeutically. Recognition of this entity is essential for the head and neck specialist in providing an early diagnosis of HIV infection.