HIV-associated salivary gland disease

Imaging of
parotid anomalies in infants and children. HIV-related disorders in 3 different patients. Diffuse homogeneous parotid enlargement on axial T1-weighted image, after intravenous administration of gadolinium chelate (a), lympho-epithelial cysts on frontal T2-weighted image (b) and benign lympho-epithelial lesions, hypoechoic on ultrasonography (c)
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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.

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 .

Clinical presentation

HIV-associated salivary gland disease generally presents with:

  • unilateral/bilateral facial swelling
  • fever
  • myalgia
  • xerostomia
  • 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.

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
CT/MRI 
  • usually bilateral salivary gland enlargement with intraglandular cystic and solid masses
  • increase in size and number of cervical lymph nodes

Treatment and prognosis

Antiretroviral therapy was useful in treatment of HIV-related lymphoepithelial parotid cysts. There is reportedly a good prognosis in children .

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.

Differential diagnosis