Is parotid lymphadenopathy a new disease or part of AIDS?
This report describes a series of 15 patients who presented with masses in the tail of the parotid gland which proved at biopsy to be benign hyperplastic lymphadenopathy similar to lymphoepithelial hyperplasia. There were 11 male and 4 female patients. All had a history of intravenous drug use. Ten patients complained of pain. Six patients had smaller masses on the contralateral side of the gland, whereas seven patients had minor axillary adenopathy. Needle aspiration was performed in 12 patients; although not conclusively diagnostic, it ruled out primary salivary tumors. Thick purulent material was aspirated in five patients. All 15 patients underwent parotid exploration. It was apparent after raising the flap that the disease was related to intraparotid and periparotid lymph nodes. Lymphadenopathy in the jugular region, which was not appreciated preoperatively, was also noted in all patients. Each patient underwent exposure of the main trunk of the facial nerve and limited superficial parotidectomy. The postoperative course in each patient was uneventful and no patient had a facial nerve deficit. Cerebral toxoplasmosis developed in one patient who died 3 months after surgery; AIDS developed in one other patient. Human immunodeficiency virus (HIV) titers were not performed routinely because none of the patients came for regular follow-up. None of these patients demonstrated lymphoma at the time of this procedure. Parotid lymphadenopathy, which occurs primarily in intravenous drug users, appears to be an early manifestation of pre-AIDS or AIDS-related complex. If patients have no other sizable lymphadenopathy for biopsy, we advocate exploration of the parotid region and excision of periparotid and intraparotid lymph nodes.
Shaha
A
A
Department of Surgery, State University of New York Health Science Center, Brooklyn.
Thelmo
W
W
Jaffe
B M
BM
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000473:pathology*; D000328:Adult; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008297:Male; D010305:Parotid Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery