Labouyrie E, Merlio J P, Beylot-Barry M, Delord B, Vergier B, Brossard G, Lacoste D, Beylot J, Leng B, Fleury H
Laboratoire d'Anatomie Pathologique, Hopital Haut-Leveque, Pessac, France.
Am J Clin Pathol. 1993 Jul;100(1):41-6. doi: 10.1093/ajcp/100.1.41.
Cystic lymphoepithelial lesions of salivary glands (CLLSG) are nodular or diffuse salivary gland enlargements that are observed in patients who tested positive for human immunodeficiency virus type 1 (HIV-1). Two cases of CLLSG are reported. Particular emphasis is placed on the presence of HIV-1 major-core protein (P24), HIV-1 RNA sequences, Epstein-Barr virus (EBV) DNA sequences, and lymphocyte receptor gene rearrangement. Lymphoid alterations consisted of explosive hyperplasia with a prominent follicular reticular dendritic cell (DRC) network and numerous intrafollicular CD8+ lymphocytes. Intrafollicular DRC strongly expressed HIV-1 major-core protein and HIV-1 RNA, indicating that most DRCs actively replicated the HIV-1 virus. The presence of active HIV-1 replication within DRC and the absence of clonal EBV infected lymphoid population strongly suggest that CLLSG pathogenesis is primarily induced by HIV-1. The presence of oligoclonal immunoglobulin gene rearrangements in our cases, however, suggest the need of long-term follow-up of such patients to determine whether CLLSG could be a benign prelymphomatous disease.
唾液腺囊性淋巴上皮病变（CLLSG）是在1型人类免疫缺陷病毒（HIV-1）检测呈阳性的患者中观察到的结节性或弥漫性唾液腺肿大。报告了2例CLLSG病例。特别强调了HIV-1主要核心蛋白（P24）、HIV-1 RNA序列、爱泼斯坦-巴尔病毒（EBV）DNA序列以及淋巴细胞受体基因重排的存在。淋巴样改变包括爆发性增生，伴有突出的滤泡性网状树突状细胞（DRC）网络和众多滤泡内CD8 +淋巴细胞。滤泡内DRC强烈表达HIV-1主要核心蛋白和HIV-1 RNA，表明大多数DRC积极复制HIV-1病毒。DRC内存在活跃的HIV-1复制以及不存在克隆性EBV感染的淋巴样群体，强烈提示CLLSG的发病机制主要由HIV-1诱导。然而，我们病例中寡克隆免疫球蛋白基因重排的存在表明，需要对这些患者进行长期随访，以确定CLLSG是否可能是一种良性淋巴瘤前疾病。
