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HIV-related parotid lymphoepithelial cysts. Immunohistochemistry and 3-D reconstruction of surgical and autopsy material with special reference to formal pathogenesis.
Ihrler S; Zietz C; Riederer A; Diebold J; Lohrs U; Institute of
March 30, 1997
Virchows Arch. 1996 Oct;429(2-3):139-47. Unique Identifier : AIDSLINE

Whether lymphoepithelial cysts in the parotid glands in HIV-infected patients develop from pre-existing salivary gland inclusions in intraparotid lymph nodes or from a lymphoepithelial lesion of salivary parenchyma is unclear. To examine their pathogenesis we performed a histological and immunohistochemical study of salivary specimens from 100 AIDS patients in different disease stages. There is a continuous morphological spectrum of changes within the salivary parenchyma, starting with lymphoid stroma infiltration and evolving to characteristic lymphoepithelial duct lesions with a immunohistochemically proven basal cell proliferation and to fully developed ductal cysts. Involvement of myoepithelial cells-postulated in comparable Sjogren-associated duct lesions-is excluded immunohistochemically. Computer-assisted 3-D reconstructions confirm an association of the cysts with the intralobular duct system. Our study disproves the prevailing hypothesis, which suggests that the lymphoid cell compartment of HIV-associated lymphoepithelial cysts stems from pre-existing intraparotid lymph nodes. The results demonstrate that a secondary lymphatic infiltration of salivary parenchyma provokes a lymphoepithelial lesion of striated ducts with basal cell hyperplasia. The frequent progression to a multifocal cystic lymphoepithelial lesion may be supported by ductal compression through a high degree of lymphofollicular hyperplasia in early disease.

Adult Aged Cadaver Child Child, Preschool Cysts/*COMPLICATIONS/PATHOLOGY/VIROLOGY Cytomegalovirus Infections/COMPLICATIONS Female Human HIV Infections/*COMPLICATIONS Image Processing, Computer-Assisted Immunohistochemistry Male Middle Age Parotid Diseases/*COMPLICATIONS/PATHOLOGY/VIROLOGY JOURNAL ARTICLE