Abstract
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 Sjögren-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.
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Ihrler, S., Zietz, C., Diebold, J. et al. HIV-related parotid lymphoepithelial cysts. Vichows Archiv A Pathol Anat 429, 139–147 (1996). https://doi.org/10.1007/BF00192436
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DOI: https://doi.org/10.1007/BF00192436