Differential diagnosis:
· Benign lymphoepithelial lesions – HIV ( BLL-HIV)
· Bilateral Warthin tumor
· Sjogren syndrome
· lymphoma
Clue for the diagnosis:
· Benign lymphoepithelial lesions – HIV ( BLL-HIV)
- HIV +ve patient
- Multiple cystic and solid masses enlarging both parotid glands usually associated with tonsilar hyperplasia & cervical reactive adenopathy
- Thin rim enhacement of cystic lesions
- 5% of HIV+ve patients develop BLL of parotids
· Bilateral Warthin tumor:
- Masses are painless, slowly growing.
- 90% of patients are smokers
- Mean age = 60 years.
- Most commonly within parotid tail superficial to angle of mandible.
- Parenchymal inhomogeneity is characterestic.
· Sjogren syndrome
- Chronic systemic autoimmune exocrinopathy that causes salivary and lacrimal gland tissue destruction.
-
* 1ry SJS – dry eyes , dry mouth , no collagen vascular disease.
- * 2ry SJS – dry eyes , dry mouth , with collagen vascular disease, most commonly rheumatoid arthritis.
- CT shows bilateral enlarged parotids with multiple cystic and solid intraparotid lesions with or without intraglandular calcification.
· lymphoma
- Clinically: chronic systemic NHL already apparent.
- Usually bilateral solid masses in both parotids.
Diagnosis:
·
Benign lymphoepithelial lesions – HIV (
BLL-HIV)