Benign cystic vs. solid lesions of the parotid gland in HIV patients

In this study of 13 patients with cystic lesions of the parotid gland, 9 patients were known to be antibody positive for the human immunodeficiency virus (HIV) and 4 were subsequently tested to be positive. All patients had computed tomographic (CT) confirmation of parotid gland cysts. Five patients had fluid aspirates showing high amylase levels. All cystic lesions had lymphoepithelial features and lymphoid histology similar to those seen in HIV infection. This study includes a review of 148 HIV patients reported in the literature, as well as our experience. Of all the reported cases, when gross pathology suggested cystic lesions, the incidence of malignancy was close to 1%. The incidence of malignancy for a solid mass, however, was close to 40%. We propose a nonsurgical management protocol which includes CT scan and needle aspiration with tissue for cytology and fluid for amylase level if possible. Watchful observation is advised for cystic pathology.