HIV-associated salivary gland disease is a condition characterized by lymphatic infiltration of the salivary glands, especially the parotids. This condition of HIV patients can be part of the diffuse infiltrative lymphocytosis syndrome. The condition is one of the most important AIDS-associated oral lesions.
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Epidemiology
The incidence of HIV-associated salivary gland disease has been reported to be as high 48% in developing territories in those with HIV-1 infections 3.
Clinical presentation
HIV-associated salivary gland disease generally presents with:
unilateral/bilateral facial swelling
myalgia
swelling of salivary glands: a cause of bilateral salivary gland enlargement
Pathology
As a consequence of HIV infection, lymphoid infiltration into the gland, along with lymphoid epithelial lesion development are responsible for salivary gland enlargement and xerostomia 4.
Histology
The benign lymphoepithelial/myoepithelial lesions of HIV-associated salivary gland disease comprise intranodal cysts lined with epithelial cells.
Radiographic features
Radiological features are non-specific.
Ultrasound
numerous hypoattenuating/anechoic regions without posterior acoustic enhancement
anechoic cysts 2
CT/MRI
usually bilateral salivary gland enlargement with intraglandular cystic and solid masses
increase in size and number of cervical lymph nodes 2
Treatment and prognosis
Antiretroviral therapy was useful in the treatment of HIV-related lymphoepithelial parotid cysts 4. There is reportedly a good prognosis in children 2.
History and etymology
HIV-associated salivary gland disease was first used by Schiødt to characterize a swelling of major salivary glands with a complaint of dry mouth in patients with HIV, in absence of xerogenic agents or medications 3.
Differential diagnosis
-
infective
parotid abscess secondary to acute bacterial sialadenitis (acute parotitis)
inflammatory
immune-mediated
neoplastic
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