Tao L C, Gullane P J
Department of Pathology, Toronto General Hospital, Canada.
Diagn Cytopathol. 1991;7(2):158-62. doi: 10.1002/dc.2840070212.
Two homosexual men with parotid swellings were shown to be human immunodeficiency virus (HIV)-positive. They initially presented with a painless solitary parotid mass accompanied by diffuse cervical lymphadenopathy. In case 1, the patient further developed bilateral multiple cystic lesions. Aspirate preparations from the cystic lesions contained numerous anucleate squames, and superficial and intermediate squamous cells intermingled with various follicular center cells and lymphocytes. Immunoblasts and active phagocytosis of nuclear debris were also noted. Histologically, the parotid cystic lesions showed squamous epithelium-lined clefts surrounded by abundant hyperplastic lymphoid tissue with prominent germinal centers. The cystic lesions did not involve submandibular and sublingual glands. The combination of bilateral multiple lymphoepithelial lesions of the parotid glands and diffuse cervical lymphadenopathy represents a new condition in patients who are likely to be HIV-positive. At the early stage of the disease, when the lesion is confined to a unilateral parotid gland, the cytologic findings of the parotid mass, in combination with a computed tomographic appearance of multiple cystic lesions, are distinctly different from findings in other neck and facial lesions. The patient should be tested for antibodies to the HIV virus to confirm this diagnosis, so that the appropriate precautions and treatment can be initiated.
两名患有腮腺肿大的同性恋男子被检测出人类免疫缺陷病毒（HIV）呈阳性。他们最初表现为单侧无痛性腮腺肿块，并伴有双侧颈部淋巴结肿大。在病例1中，患者进一步出现双侧多发性囊性病变。囊性病变的抽吸物涂片中有大量无核鳞状上皮细胞，以及表层和中层鳞状细胞，还混有各种滤泡中心细胞和淋巴细胞。同时还发现了免疫母细胞和对核碎片的活跃吞噬现象。组织学检查显示，腮腺囊性病变表现为裂隙内衬鳞状上皮，周围是大量增生的淋巴组织，生发中心明显。囊性病变未累及下颌下腺和舌下腺。双侧腮腺多发淋巴上皮病变合并双侧颈部淋巴结肿大，这在很可能为HIV阳性的患者中代表了一种新的病症。在疾病早期，当病变局限于单侧腮腺时，腮腺肿块的细胞学检查结果，结合计算机断层扫描显示的多发性囊性病变，与其他颈部和面部病变的表现明显不同。应对患者进行HIV病毒抗体检测以确诊，以便采取适当的预防措施并开始治疗。
