Vargas P A, Mauad T, Böhm G M, Saldiva P H N, Almeida O P
Department of Oral Pathology, Faculty of Odontology of Pieracicaba-University of Campinas, Piracicaba, Sao Paulo, Brazil.
Oral Dis. 2003 Mar;9(2):55-61. doi: 10.1034/j.1601-0825.2003.02868.x.
This study describes the involvement and the histological alterations found in the parotid glands of 100 patients who died with AIDS.
Sex, age, CD4 cell count and clinical history were obtained from the files of 100 patients who died with AIDS. Histological analysis of the parotid glands was performed using H&E, Gomori-Grocott, Ziehl-Neelsen and Mucicarmine. Histological findings were grouped in reactive, infectious, cystic, neoplastic and concomitant lesions.
None of the patients presented complaints or symptoms related to salivary gland alterations prior to death. The mean age of the patients and CD4 cell count were 36.4 years and 76.07 cells microliter-1, respectively. Histological alterations of the parotid glands were found in 51% of the patients. The most common alteration was non-specific chronic sialadenitis (29 cases), followed by infectious conditions (22 cases). Mycobacteriosis was the most common infectious disease (10 cases), followed by cytomegalovirus (nine cases), cryptococcosis (three cases) and histoplasmosis (two cases). Lymphoepithelial cysts occurred in six cases, Warthin's tumor and non-Hodgkin Lymphoma in one case each.
These results indicate that infection and other lesions in the parotid glands are more frequent than hitherto described in the specialized literature in AIDS patients. Clinicians should consider parotid gland involvement, when evaluating disease extension in advanced AIDS patients.
本研究描述了100例死于艾滋病患者腮腺的受累情况及组织学改变。
从100例死于艾滋病患者的病历中获取性别、年龄、CD4细胞计数及临床病史。采用苏木精-伊红染色、Gomori-Grocott染色、齐尔-尼尔森染色及黏液卡红染色对腮腺进行组织学分析。组织学发现分为反应性、感染性、囊性、肿瘤性及伴随性病变。
所有患者在死亡前均无与唾液腺改变相关的主诉或症状。患者的平均年龄及CD4细胞计数分别为36.4岁和76.07个/微升。51%的患者存在腮腺组织学改变。最常见的改变是非特异性慢性涎腺炎(29例),其次是感染性疾病(22例)。分枝杆菌病是最常见的感染性疾病(10例),其次是巨细胞病毒感染(9例)、隐球菌病(3例)和组织胞浆菌病(2例)。淋巴上皮囊肿6例,沃辛瘤和非霍奇金淋巴瘤各1例。
这些结果表明,艾滋病患者腮腺的感染及其他病变比专业文献中迄今所描述的更为常见。临床医生在评估晚期艾滋病患者的疾病进展时应考虑腮腺受累情况。