The Benign Lymphoepithelial Cyst and a Classification System for Lymphocytic Parotid Gland Enlargement in the Pediatric HIV Population

Dave, Sandeep P.; Pernas, Francisco G.; Roy, Soham

doi:10.1097/01.mlg.0000246196.35413.35

Cited by 72 publications

(84 citation statements)

References 38 publications

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“…Not only did HAART improve the overall quality of life of HIV-infected patients, but HAART indirectly reduced parotid gland swelling. [10][11][12] The effect of HAART on parotid gland swelling represents a great achievement regarding cosmetic and HIV-related stigma for patients. HAART has also reduced the need for surgery as a symptomatic treatment of BLEC.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients

Syebele

Bütow

2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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Objective. T h i s s tu dy ' s ai m w as to a s s e ss th e ef f e c t of h i gh l y a c ti v e an ti r e tr ov i r al d r u g s (HAART) on benign lymphoepithelial cysts (BLEC) of the parotid and ranulas.Study design. The records of 10 HIV-positive patients who presented with BLEC were reviewed, and 14 HIV-positive patients who presented with ranulas were prospectively enrolled. Patients in 2 both groups received the same combination of HAART and were clinically evaluated for the first three months. Patients with ranulas were followed up for an additional three months. A clinical reduction in the size of the lesions was considered to be a positive outcome.Results. All parotid glands with BLEC resolved within three months. No positive results were observed in ranulas during the first three months. However, some of the ranulas displayed a positive result after the initial three months of HAART. Conclusion.In contrast to BLEC, ranulas in HIV-positive patients seem to present a mixed and delayed response to HAART.Numerous publications report about HIV-related salivary gland disease (HIV-SGD). HIV-related enlargement of the parotid salivary gland, particularly benign lymphoepithelial cysts (BLEC), remains the most reported form of HIV-SGD. [1][2][3][4][5][6] Other salivary glands are affected as well 1 .However, little has been reported about ranulas as being part of HIV-related salivary gland Currently, the generally accepted standard mode of treatment for ranulas is surgical removal of the offending ipsilateral salivary gland either with or without the attached cystic lesion. [13][14][15] However, this radical surgical approach might face limitations in the current clinical presentations of some cases of ranulas in HIV-positive patients. Current cases seem to include more cases of plunging and bilateral ranulas (Fig. 1). More importantly, there are reported cases of BLEC co-existing with ranulas in the same subject and in multiple sites (Fig. 1A). This c l i n i c a l p r e s e n t a t i o n o f b o t h p a t h o l o g i e s i s o f g r e a t e t i o l o g i c a l i m p o r t a n c e a n d p r e s e n t s therapeutic implications in the context of HIV-SGD. The quest for a less invasive modality of 4 treatment for ranulas in HIV-positive patients might, therefore, become a greater challenge. To date, there is no evidence-based proof of treatment for ranulas with HAART. 12 The welldocumented benefit of HAART for BLEC in HIV-positive patients has led these authors to hypothesize that the very same drugs may positively affect ranulas in the context of HIV-SGD. A comparative approach has not been performed before.The aim of this study is, therefore, to assess how ranulas in HIV-positive patients respond to HAART, and compare the results with those of BLEC in parotid salivary glands in the context of HIV-SGD. Furthermore, a secondary objective is to define the time-frame within which to assess the effectiveness of the therapy in both groups. PATIENTS AND METHODSThis was a clinical study with both retrospective an...

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Section: Discussionmentioning

confidence: 99%

Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients

Syebele

Bütow

2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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“…Later and due to the increased incidence of HIV infection the number of such cases increased. 1,2 LBLC of the salivary glands affects the parotid more frequently than the sub maxillas [6][7][8] [6][7][8][9]13,23,25 Within…”

Section: Discussionmentioning

confidence: 99%

“…Suele aparecer en pacientes con síndrome poliadenopático persistente, con un núme-ro de linfocitos CD4 poco o medianamente disminuido y relativo aumento de células CD8 en sangre. [6][7][8][9]13,[16][17][18]23,25 Dentro de los estudios complementarios a realizar destacamos la TC, RM y ecografía; donde apreciaremos múltiples quistes parotídeos bilaterales asociados a adenopatías cervicales. Según distintos autores 11,12 las imágenes de TC y RM en pacientes VIH son patognomónicas, y no requerirían más estudios complementarios.…”

Section: The Lblc Is a Topic That Should Be Taken Into Account When Dunclassified

Lesión linfoepitelial quística benigna de glándula parótida en paciente con infección por VIH

García

González-García

et al. 2009

Rev Esp Cirug Oral y Maxilofac

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Mujer de 44 años de edad que acude a consultas de Cirugía Oral y Maxilofacial derivada por su Médico de Familia. Presenta de forma bilateral, en región correspondiente a cola de parótida tumoraciones de consistencia elástica, no fijas a planos adyacentes, asintomáticas y de varios meses de evolución. Dentro de sus antecedentes destaca infección por VIH. En la TC cervico-facial se observan lesiones de aspecto quístico en ambas glándulas parótidas Figura 2. Imagen de la paciente en la que se aprecia la tumoración laterocervical izquierda (en región correspondiente a cola de parótida izquierda). Página del Residente IntroducciónLa Lesión Linfoepitelial Quística Benigna (LLQB) es un trastorno poco frecuente que afecta a las glándulas salivales, fundamentalmente a la glándula parótida y que se ha asociado a la infección por el VIH. Desde el punto de vista clínico, a nivel parotídeo y cervical, se manifiesta por la presencia de una tumoración elástica no dolorosa, de crecimiento progresivo y asociada a adenopatías cervicales. La LLQB es una entidad a tener en cuenta en el diagnósti-co diferencial de las masas cervicales en pacientes infectados por el VIH. DiscusiónLa infección por el VIH se ha asociado a diversas entidades que afectan a las glándulas salivales como son el linfoma, síndrome de Sjögren, sarcoma de Kaposi y la lesión linfoepitelial quística benigna. 1-6 Antes de la década de los ochenta las LLQB de parótida constituían menos del 3% de los tumores benignos de esta glándula, posteriormente y debido al aumento de la incidencia de la infección VIH, se ha incrementado el numero de casos. 1,2 La LLQB de las glándulas salivales afecta con más frecuencia a la parótida que a las submaxilares. 6-8 Histológicamente la lesión está compuesta por uno o varios quistes llenos de líquido gelatinoso claro, tapizados por epitelio metaplásico escamoso o columnar y rodeados por un infiltrado linfoide, que contiene islotes de células

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“…1,2 Benign lymphoepithelial lesions (BLEL) of parotid salivary glands are among the most commonly described BLEL. [2][3][4] These lesions appear more often in the early stage of HIV infection, and may be its first manifestation. There is no universally accepted treatment for BLEL of parotid glands.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Simple observation, fine needle aspiration as well as sclerotherapy have also been suggested, with variable results. 3,7 Finally, BLEL of parotid glands have been reported to respond dramatically well to antiretroviral therapy (ART). Benign lymphoepithelial lesion of parotid glands have, under ART, regressed to almost their original size in some cases (Fig 1 A,B).…”

Section: Introductionmentioning

confidence: 99%

Regression of both oral mucocele and parotid swellings, following antiretroviral therapy

Syebele¹

2010

International Journal of Pediatric Otorhinolaryngology

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The Benign Lymphoepithelial Cyst and a Classification System for Lymphocytic Parotid Gland Enlargement in the Pediatric HIV Population

Cited by 72 publications

References 38 publications

Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients

Comparative study of the effect of antiretroviral therapy on benign lymphoepithelial cyst of parotid glands and ranulas in HIV-positive patients

Lesión linfoepitelial quística benigna de glándula parótida en paciente con infección por VIH

Regression of both oral mucocele and parotid swellings, following antiretroviral therapy

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