Parotid gland abnormality found in children seropositive for the human immunodeficiency virus (HIV)

Abstract

Out of our series of 24 children seropositive for the Human Immunodeficiency Virus (HIV), parotid gland enlargement was noted in 4 children with AIDS-related complex (ARC) presenting also a Lymphocytic Interstitial Pneumonitis (LIP) on their chest radiographs. The ultrasound (US) aspect of the parotid gland suggests acinar enlargement (suggesting the presence of lymphocytic infiltration). The aspect displayed in the parotid mirrors the process developing in other areas (lungs, liver, spleen, lymph-nodes), i.e. a syndrome of lymphocytic (CD8) proliferation present at the stage of ARC.

Diagnostic ultrasound patterns of parotid glands in human immunodeficiency virus-positive patients in Mulago, Uganda

“…In Vona et al's study 9 of 64 cases, the prevalence of ''anechoic and nonhomogeneous areas'' (similar appearance to our LECs) was 60%. In Goddart et al's study 11 4 out of 24 HIVpositive children had parotid enlargement and these 4 children showed ''acinar enlargement'' on ultrasound (100%). In Martinoli et al's study, 8 from 9 patients 14 ''parotid nodules'' were sampled by ultrasound-guided Lymphoepithelial cysts with lymphadenopathy is the most common category and is ranked number 1 in the ''ranking order of frequency'' column.…”

“…Compared with other studies 4,[8][9][10][11][12] that use ultrasound imaging to investigate parotid enlargement in HIVpositive patients, our study involved the fairly large number of 200 patients. We also used a relatively modern, high-resolution ultrasound machine.…”

“…Ultrasound imaging is already widely accepted worldwide for diagnosis of soft tissue swellings of the head and neck region and is used by some researchers for imaging the parotid glands in HIV patients. 4,[8][9][10][11][12] The relative low cost of ultrasound imaging is an important consideration for resource-constrained African countries.…”

Sonography of the salivary glands

“…Usually the parotid glands are enlarged with multiple cystic or hypoechogenic lesions, and also mixed lesions and septae can be detected. Color Doppler shows a variety of avascular or hypervascularized lesions [66,67,68]. In most cases the cervical lymph nodes are enlarged.…”

Sonography of soft tissue masses of the neck

“…In the acquired immunodeficiency syndrome, bilateral cystic lesions are often found in the parotid parenchyma, and intraglandular lymph nodes are enlarged. 79,80 Unilateral hypertrophy of the masseter muscle may simulate a salivary gland neoplasm. Sonographically, the muscle can be measured at rest and during contraction to establish the correct diagnosis ( Figure 25).…”