Skip to main content
SpringerLink
Log in

HIV-related parotid lymphoepithelial cysts

Immunohistochemistry and 3-D reconstruction of surgical and autopsy material with special reference to formal pathogenesis

  • Original Article
  • Published:
Virchows Archiv Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bernier JL, Bhaskar SN (1958) Lymphoepithelial lesions of salivary glands. Cancer 6:1156–1179

    Google Scholar 

  2. Brigati DJ, Myerson D, Leary JJ, Spalholz B, Travis SZ, Fong CKY, Hsiung GI (1983) Detection of viral genomes in cultured cells and paraffin-embedded tissue sections using biotin-labeled hybridization probes. Virology 126:32–50

    Google Scholar 

  3. Bruner JM, Cleary KR, Smith FB, Batsakis JG (1989) Immunocytochemical identification of HIV (p24) antigen in parotid lymphoid lesions. J Laryngol Otol 103:1063–1066

    Google Scholar 

  4. Caselitz J, Osborn M, Wustrow J, Seifer G, Weber K (1986) Immunohistochemical investigations on the epimyoepithelial islands in lymphoepithelial lesions. Lab Invest 55:427–432

    Google Scholar 

  5. Center For Disease Control (1993) Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Morb Mortal Wkly Rep 41:1–19

    Google Scholar 

  6. Cleary KR, Batsakis JG (1990) Lymphoepithelial cysts of the parotid region: a ‘new face’ on an old lesion. Ann Otol Rhinol Laryngol 99:162–164

    Google Scholar 

  7. Cordell JL, Falini B, Erber WN (1984) Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP)complexes. J Histochem Cytochem 32:219–229

    Google Scholar 

  8. Couderc L-J, D'Agay M-F, Danon F, Harzie M, Brocheriou C (1987) Sicca complex and infection with human immunodeficiency virus. Arch Intern Med 147:898–901

    Google Scholar 

  9. D'Agay M-F, Roquancourt A de, Peuchmaur M, Janier M, Brocheriou C (1990) Cystic benign lymphoepithelial lesion of the salivary glands in HIV-positive patients. Virchows Arch [A] 417:353–356

    Google Scholar 

  10. Daniels TE (1992) Benign lymphoepithelial lesion and Sjögren's syndrome. In: Ellis GL, Auclair PL, Gnepp DR (eds) Surgical pathology of the salivary glands. Saunders, Philadelphia, pp 83–106

    Google Scholar 

  11. Dardick I, Parks WR, Little J, Brown DL (1988) Characterization of cytoskeletal proteins in basal cells of human parotid salivary gland ducts. Virchows Arch [A] 412:525–532

    Google Scholar 

  12. Donath K, Seifert G (1972) Ultrastruktur und Pathogenese der myoepithelialen Sialadenitis. Virchow Arch [A] 356:315–329

    Google Scholar 

  13. Draeger A, Nathrath WBJ, Lane EB, Sundström BE, Stigbrand TI (1981) Cytokeratins, smooth muscle actin and vimentin in human normal salivary gland and pleomorphic adenomas. APMIS 99:405–415

    Google Scholar 

  14. Elliott JN, Oertel YC (1989) Lymphoepithelial cysts of the salivary glands. Am J Clin Pathol 93:39–43

    Google Scholar 

  15. Finfer MD, Schinella RA, Rothstein SG, Persky MS (1988) Cystic parotid lesions in patients at risk for the acquired immundodeficiency syndrome. Arch Otolaryngol Head Neck Surg 114:1290–1294

    Google Scholar 

  16. Fox RJ, Kang Ho-Il (1992) Pathogenesis of Sjögren's syndrome. Rheum Dis Clin North Amer 18:517–537

    Google Scholar 

  17. Gall JG, Pardue ML (1971) Nucleid acid hybridization in cytological preparations. Methods Enzymol 38:470–480

    Google Scholar 

  18. Godwin JT (1952) Benign lymphoepithelial lesion of parotid gland; report of 11 cases. Cancer 5:1089–1103

    Google Scholar 

  19. Hsu SM, Raine L, Fanger H (1981) Use of avidin-biotin peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. J Histochem Cytochem 29:577–584

    Google Scholar 

  20. Isaacson PG (1994) Malignant lymphomas of the salivary gland. In: Isaacson PG, Norton AJ (eds) Extranodal lymphomas. Churchill Livingstone, Edinburgh, pp67–83

    Google Scholar 

  21. Itescu S, Brancato LJ, Buxbaum J, Gregersen PK, Risk CC, Croxson TS, Solomon GE, Winchester R (1990) A diffuse infiltrative CD8 lymphocytosis syndrome in human immunodeficiency virus (HIV) infection: a host immune response associated with HLA-DR5. Ann Internal Med 112:3–10

    Google Scholar 

  22. Kornstein MJ, Parker GA, Mills AS (1988) Immune histology of the benign lymphoepithelial lesion in AIDS-related lymphadenopathy. Hum Pathol 19:1359–1361

    Google Scholar 

  23. Labouyrie E, Merlio JPH, Beylot-Barry M, Delord B, Vergier B, Brossard G, Lacoste D (1993) Human immunodeficiency virus type 1 replication within cystic lymphoepithelial lesion of the salivary gland. Am J Clin Pathol 100:41–46

    Google Scholar 

  24. Mandel L, Reich R (1992) HIV parotid gland lymphoepithelial cysts. Oral Surg Oral Med Oral Pathol 74:273–278

    Google Scholar 

  25. Morris MR (1988) Unusual lymphadenopathies or cystic lesions and the parotid gland. Otol Head Neck 98:268

    Google Scholar 

  26. Morris MR, Moore DW, Shearer GL (1987) Bilateral multiple lymphoepithelial cysts of the parotid gland. Otol Head Neck 97:87–90

    Google Scholar 

  27. Palmer RM, Eveson JW, Gusterson BA (1986) “Epimyoepithelial” islands in lymphoepithelial lesions. Virchows Arch [A] 408:603–609

    Google Scholar 

  28. Poletti A, Manconi R, Volpe R, Carbone A (1988) Study of AIDS-related lymphadenopathy in the intraparotid and perisubmaxillary gland lymph nodes. J Oral Pathol 17:164–167

    Google Scholar 

  29. Ryan JR, Ioachim HL, Marmer J, Lebeau JM (1985) Acquired immune deficiency syndrome-related lymphadenopathies presenting in the salivary gland lymph nodes. Arch Otolaryngol 111:554–556

    Google Scholar 

  30. Schiodt M, Greenspan D, Daniels TE (1989) Parotid gland enlargement and xerostomia associated with labial sialadenitis in HIV-infected patients. J Autoimmun 2:415–425

    Google Scholar 

  31. Seifert G (1995) Ätiologie und Differentialdiagnose der Sialadenitis. Laryngorhinootologie 74:274–281

    Google Scholar 

  32. Seifert G, Waller D (1982) Klassifikation der Parotiszysten — Differentialdiagnose der Speichelgangszysten und lymphoepithelialen Zysten. Laryngol Rhinol Otol 61:78–86

    Google Scholar 

  33. Shaha A, DiMaio T, Webber C, Thelmo W, Jaffe BM (1993) Benign lymphoepithelial lesions of the parotid. Am J Surg 166:403–406

    Google Scholar 

  34. Smith FB, Rajdeo H, Panesar N, Bhuta K, Stahl R (1988) Benign lymphoepithelial lesion of the parotid gland in intravenous drug users. Arch Pathol Lab Med 112:742–745

    Google Scholar 

  35. Sperling NM, Pi-Tang Lin, Lucente FE (1990) Cystic parotid masses in HIV infection. Head Neck 12:337–341

    Google Scholar 

  36. Tunkel DE, Loury MC, Fox CH, Goins MA, Johns ME (1989) Bilateral parotid enlargement in HIV-seropositive patients. Laryngoscope 99:590–595

    Google Scholar 

  37. Ulirsch RC, Jaffe ES (1987) Sjögre's syndrome-like illness associated with the acquired immunodeficiency syndrome-related complex. Hum Pathol 18:1064–1068

    Google Scholar 

  38. Werning JT (1992) Infectious and systemic diseases. In: Ellis GL, Auclair PL, Gnepp DR (eds) Surgical pathology of the salivary glands. Saunders, Philadelphia, pp 39–59

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Pathology, Ludwig Maximilians University, Thalkirchnerstrasse 36, D-80337, München, Germany

    S. Ihrler, C. Zietz, J. Diebold & U. Löhrs

  2. Clinic for Ear, Nose and Throat Diseases, Ludwig Maximilians University, D-80337, München, Germany

    A. Riederer

Authors
  1. S. Ihrler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Zietz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Diebold
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. U. Löhrs
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Riederer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00192436

Key words

Search

Navigation