Wax T D, Layfield L J, Zaleski S, Bhargara V, Cohen M, Lyerly H K, Fisher S R
Department of Pathology, Duke University Medical Center, Durham, NC 27710.
Diagn Cytopathol. 1994;10(2):169-72; discussion 172-4. doi: 10.1002/dc.2840100216.
We report three cases of cytomegalovirus (CMV) sialadenitis which presented as parotid gland nodules in patients infected with the human immunodeficiency virus. While CMV is known to widely infect patients with the acquired immunodeficiency syndrome (AIDS), we are aware of only a single report of CMV sialadenitis in a patient with AIDS (Pialoux et al.: Rev Infect Dis 1991;13:338). Utilizing fine-needle aspiration (FNA) cytology as the initial investigative modality, two cases were correctly diagnosed preoperatively while the third case displayed atypical features and was interpreted erroneously as carcinoma leading to surgical intervention. Upon review of these cases of CMV sialadenitis, the characteristic intranuclear inclusions are best identified with Papanicolaou (Pap) staining. CMV sialadenitis should be considered in the differential diagnosis of painless salivary gland enlargement in patients with AIDS. We believe this lesion can be diagnosed preoperatively with FNA and the interpretation is aided by evaluating both Pap- and Giemsa-stained material.
我们报告了3例巨细胞病毒（CMV）涎腺炎病例，这些病例表现为感染人类免疫缺陷病毒的患者的腮腺结节。虽然已知CMV可广泛感染获得性免疫缺陷综合征（AIDS）患者，但我们仅知晓1例AIDS患者发生CMV涎腺炎的报告（Pialoux等人：《感染性疾病评论》1991年；13:338）。以细针穿刺（FNA）细胞学作为初始检查手段，2例在术前得到正确诊断，而第3例表现出非典型特征，被错误地诊断为癌并导致了手术干预。回顾这些CMV涎腺炎病例时，特征性的核内包涵体通过巴氏（Pap）染色最易识别。对于AIDS患者无痛性唾液腺肿大的鉴别诊断，应考虑CMV涎腺炎。我们认为，该病变可通过FNA进行术前诊断，评估巴氏染色和吉姆萨染色材料有助于诊断。
