Lymphoepithelial Sialadenitis Involving HIV-Infected and Sjogren Syndrome Patients: A Cytologic Study

Abstract

Lymphoepithelial salivary gland cysts are rarely seen in autoimmune diseases particularly Sjogren syndrome as well as in HIV for which medical management is advocated. To study the morphology of these cysts, correlate with the disease process and assess the final outcome. Case series. Fine needle aspiration clinic. HIV-infected and autoimmune disease patients with lymphoepithelial cysts. Antiretroviral therapy for HIVpatients and anti-inflammatory drugs for Sjogren syndrome. Three HIV-infected patients (two children and one adult) and three middle aged female patients presented with parotid and submandibular cysts, two of which were bilateral along with submandibular (one each in the HIV and the autoimmune group). In the adult HIV-patient, the cyst was found at the inception of the disease while the other pediatric HIV-patients just crossed a decade. Of the other three cases of Sjogren syndrome, two were primary and one, secondary to rheumatoid arthritis. All the cysts regressed completely with treatment of the respective diseases which was confirmed by ultrasonograms. Lymphoepithelial cysts are produced by release of serous secretion by the acinar and ductal cells within the epithelial islands in the process of their destruction. Possibly, antibody mediated increased secretion in the initial stages also plays a role. Lymphoepithelial cysts of HIV patients may occur in the course of treatment, not necessarily in the beginning, though it resolves spontaneously. Lymphoepithelial cysts of primary or secondary Sjogren syndrome may be repressed sufficiently by antiinflammatory/immunosuppressant treatment.

Salivary Gland Disorders in Pediatric Patients: A 20 Years’ Experience

“…Regarding lymphoepithelial sialadenitis, we reported a single case, in agreement with the rarity of this disorder according to the literature [21].…”

The usefulness of fine needle aspiration cytology in the diagnosis of parotid gland tumors

“…The similar results were obtained by Li et al, study [21] and de Oliveira et al, study [22] . The three main components that characterize the cytological smears of Warthin's tumor are oncocytes, lymphocytes and dirty fluid background, the differential diagnosis of Warthin's tumor includes lymphoepithelial cysts of salivary gland, chronic inflammatory and obstructive duct lesions exhibiting oncocytic metaplasia and lymphocytes [23,24] and 1.9% case suspicious of malignancy, this in agreement with Rossi ED et al, study [25] . In the suspicious for malignancy (SM) and malignant diagnostic categories, definitions and criteria are analogous to the same categories in other anatomic sites.…”