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Kara M, Caliskan E, Atay G, Sutcu M, Kaba O, Adaletli I, Hancerli Torun S, Somer A. Shear wave elastography of parotid glands in pediatric patients with HIV infection. Radiol Med 2018; 124:126-131. [PMID: 30259316 DOI: 10.1007/s11547-018-0945-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/17/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Parotid gland (PG) involvement is common among the patients with HIV infection. Shear wave elastography (SWE) is a noninvasive method used to measure the tissue stiffness of several organs including PG. The aim of this study was to evaluate the tissue stiffness values of PGs of HIV-infected children via SWE and compare the results with the counterparts of healthy subjects. MATERIALS AND METHODS This single-center, prospective study included the PG examinations of 23 pediatric HIV patients and 40 healthy children via grayscale ultrasound and SWE. Independent sample T test and Mann-Whitney U test were used in statistical analysis. RESULTS Stiffness of both PGs was significantly higher in patients' group when compared with control subjects. In addition, when the patients were separated into two groups according to the appearance of PG on grayscale ultrasound as homogeneous and heterogeneous, stiffness values were increased in the patients with homogeneous parenchymal appearance. No significant difference was achieved in terms of median CD4 and CD8 counts, HIV RNA levels or median duration of illnesses. CONCLUSIONS PG examination of HIV-infected children via SWE reveals increased tissue stiffness when compared with healthy subjects. SWE can be used as an ultrasound-assisted noninvasive technique in this manner.
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Affiliation(s)
- Manolya Kara
- Department of Pediatric Infectious Diseases, Istanbul University Faculty of Medicine, Turgut Ozal Street, No: 118, 34093, Fatih, Istanbul, Turkey.
| | - Emine Caliskan
- Department of Pediatric Radiology, Seyhan State Hospital, Adana, Turkey
| | - Gurkan Atay
- Department of Pediatric Intensive Care, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Murat Sutcu
- Department of Pediatric Infectious Diseases, Konya Training and Research Hospital, Konya, Turkey
| | - Ozge Kaba
- Department of Pediatric Infectious Diseases, Istanbul University Faculty of Medicine, Turgut Ozal Street, No: 118, 34093, Fatih, Istanbul, Turkey
| | - Ibrahim Adaletli
- Department of Pediatric Radiology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Selda Hancerli Torun
- Department of Pediatric Infectious Diseases, Istanbul University Faculty of Medicine, Turgut Ozal Street, No: 118, 34093, Fatih, Istanbul, Turkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseases, Istanbul University Faculty of Medicine, Turgut Ozal Street, No: 118, 34093, Fatih, Istanbul, Turkey
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Schmidt RL, Jedrzkiewicz JD, Allred RJ, Matsuoka S, Witt BL. Verification bias in diagnostic accuracy studies for fine- and core needle biopsy of salivary gland lesions in otolaryngology journals: a systematic review and analysis. Head Neck 2014; 36:1654-61. [PMID: 24114985 DOI: 10.1002/hed.23495] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 07/08/2013] [Accepted: 09/09/2013] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Diagnostic test accuracy (DTA) studies for needle biopsy are frequently published in otolaryngology journals, but this body of literature has not been assessed for verification bias. METHODS We conducted a systematic review of DTA studies on needle biopsy of salivary gland lesions appearing in otolaryngology journals. Studies were assessed by 2 reviewers for verification bias. RESULTS We identified 95 DTA studies for needle biopsy of salivary gland lesions. Eighty-one studies (84%) had verification bias. Five of the biased studies provided sufficient data to estimate the extent of bias. Verification bias was associated with an overestimate of sensitivity and an underestimate of specificity. Studies on core needle biopsy (CNB) had a lower rate of verification bias than fine-needle aspiration (FNA) studies. CONCLUSION Verification bias is common in DTA studies of needle biopsy for salivary gland lesions published in ear, nose, and throat (ENT) journals. Such studies overestimated sensitivity and underestimated specificity.
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Affiliation(s)
- Robert L Schmidt
- Department of Pathology and ARUP Laboratories, University of Utah School of Medicine, Salt Lake City, Utah
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Upile T, Jerjes W, Al-Khawalde M, Kafas P, Frampton S, Gray A, Addis B, Sandison A, Patel N, Sudhoff H, Radhi H. Branchial cysts within the parotid salivary gland. HEAD & NECK ONCOLOGY 2012; 4:24. [PMID: 22607735 PMCID: PMC3414791 DOI: 10.1186/1758-3284-4-24] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 05/18/2012] [Indexed: 11/10/2022]
Abstract
Cystic lesions within the parotid gland are uncommon and clinically they are frequently misdiagnosed as tumours. Many theories have been proposed as to their embryological origin. A 20-year retrospective review was undertaken of all pathological codes (SNOMED) of all of patients presenting with any parotid lesions requiring surgery. After analysis seven subjects were found to have histopathologically proven parotid branchial cysts in the absence of HIV infection and those patients are the aim of this review. Four of the most common embryological theories are also discussed with regard to these cases, as are their management.
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Affiliation(s)
- Tahwinder Upile
- Department of Head and Neck Surgery, Chase Farm & Barnet NHS Trust, Enfield, UK.
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lacovou E, Vlastarakos PV, Papacharalampous G, Kampessis G, Nikolopoulos TP. Diagnosis and treatment of HIV-associated manifestations in otolaryngology. Infect Dis Rep 2012; 4:e9. [PMID: 24470939 PMCID: PMC3892662 DOI: 10.4081/idr.2012.e9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 10/09/2011] [Accepted: 10/28/2011] [Indexed: 01/15/2023] Open
Abstract
Almost 30 years after its first description, HIV still remains a global pandemic. The present paper aims to review the current knowledge on the ear, nose and throat (ENT) manifestations of HIV infection, and present the available diagnostic and treatment options. A literature review was conducted in Medline and other available database sources. Information from related books was also included in the data analysis. It is well acknowledged that up to 80% of HIV-infected patients eventually develop ENT manifestations; among which, oral disease appears to be the most common. Oro-pharyngeal manifestations include candidiasis, periodontal and gingival disease, HSV and HPV infection, oral hairy leucoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma. ENT manifestations in the neck can present as cervical lymphadenopathy or parotid gland enlargement. Respective nasal manifestations include sinusitis (often due to atypical bacteria), and allergic rhinitis. Finally, otological manifestations include otitis (externa, or media), inner ear involvement (sensorineural hearing loss, disequilibrium), and facial nerve palsy (up to 100 times more frequently compared to the general population). Although ENT symptoms are not diagnostic of the disease, they might be suggestive of HIV infection, or related to its progression and the respective treatment failure. ENT doctors should be aware of the ENT manifestations associated with HIV disease, and the respective diagnosis and treatment. A multi-disciplinary approach may be required to provide the appropriate level of care to HIV patients.
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Monama GM, Tshifularo MI. Intralesional bleomycin injections in the treatment of benign lymphoepithelial cysts of the parotid gland in HIV-positive patients: Case reports. Laryngoscope 2009; 120:243-6. [DOI: 10.1002/lary.20577] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Namiq AL, Tollefson T, Fan F. Cryptococcal parotitis presenting as a cystic parotid mass: Report of a case diagnosed by fine-needle aspiration cytology. Diagn Cytopathol 2005; 33:36-8. [PMID: 15945091 DOI: 10.1002/dc.20246] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We report the fine needle aspiration (FNA) cytology findings that allowed us to diagnose cryptococcal parotitis in a 31-year-old HIV positive patient. The patient presented with painful and enlarged right parotid gland and a CT scan showed a cystic lesion with rim enhancement. The FNA cytology revealed yeasts of variable size, some of which had bright eosinophilic capsules in Diff-Quik stained preparations. Mucicarmine and silver stain supported the diagnosis of cryptococcal parotitis, which was later confirmed by fungal culture of the aspirated material. We thus show that fungal infection can present as a cystic parotid mass in an immunosuppressed patient and that the diagnosis can be made by FNA cytology.
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Affiliation(s)
- Asraa L Namiq
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
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Gurney TA, Murr AH. Otolaryngologic manifestations of human immunodeficiency virus infection. Otolaryngol Clin North Am 2003; 36:607-24. [PMID: 14567056 DOI: 10.1016/s0030-6665(03)00031-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The otolaryngologist is uniquely positioned to detect and pursue manifestations of HIV in the head and neck. The presentation of problems subsequent to HIV infection is quite varied, but close investigation will often reveal treatable problems.
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Affiliation(s)
- Theresa A Gurney
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, 400 Parnassus Avenue, A717, San Francisco, CA 94143, USA
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Suskind DL, Tavill MA, Handler SD. Doxycycline sclerotherapy of benign lymphoepithelial cysts of the parotid: a minimally invasive treatment. Int J Pediatr Otorhinolaryngol 2000; 52:157-61. [PMID: 10767463 DOI: 10.1016/s0165-5876(99)00301-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Benign lymphoepithelial cysts (BLCs) of the parotid gland are associated with human immunodeficiency virus infections in both children and adults. These cysts may become painful and unsightly, often initiating a request for therapeutic intervention. There are several treatment options described in the literature. We report the use of doxycycline sclerotherapy in the treatment of a child with BLCs of the parotid.
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Affiliation(s)
- D L Suskind
- Division of Otolaryngology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA
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Abstract
Head and neck manifestations of acquired immunodeficiency syndrome (AIDS) can involve the skin, ear, upper aerodigestive tract, and neck. Several head and neck manifestations of AIDS may be the only initial sign of this disease process and therefore primary-care physicians and otolaryngologists must be able to recognize and understand the management of these lesions. Cystic enlargement of the parotid gland and Kaposi's sarcoma are increasingly being encountered in the head and neck exam of HIV-infected patients. An example of each of these disease processes is presented with full discussion about the various treatment methods.
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Affiliation(s)
- M K Kim
- Department of Otorhinolaryngology and Bronchoesophagology, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
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Chhieng DC, Argosino R, McKenna BJ, Cangiarella JF, Cohen JM. Utility of fine-needle aspiration in the diagnosis of salivary gland lesions in patients infected with human immunodeficiency virus. Diagn Cytopathol 1999; 21:260-4. [PMID: 10495319 DOI: 10.1002/(sici)1097-0339(199910)21:4<260::aid-dc6>3.0.co;2-k] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fine-needle aspiration (FNA) has been increasingly utilized as a diagnostic tool in evaluating salivary gland masses, primarily to differentiate nonneoplastic from neoplastic lesions. Patients infected with human immunodeficiency virus (HIV) frequently present with salivary gland lesions. In this study, we reviewed the cytology of salivary gland lesions in HIV-infected patients and assessed the value of FNA in the diagnosis of salivary gland lesions in HIV-infected patients. One hundred and three FNAs of salivary gland lesions from 78 HIV-infected patients (63 males and 15 females) were included in our study. The patients' ages ranged from 7-65 yr, with a mean age of 40.9 yr. FNAs were classified into three categories: benign lymphoepithelial lesions (BLL) (77 cases or 74.8%), inflammatory processes (14 cases or 13.6%), including 3 reactive lymphoid hyperplasia, and neoplastic lesions (6 cases or 5.8%). The latter included three malignant lymphomas, a multiple myeloma, a metastatic adenocarcinoma from a lung primary, and a direct extension of basal-cell carcinoma. Six (5.8%) aspirates were nondiagnostic. No false-positive or false-negative cases were noted during follow-up of these patients. In conclusion, FNA is a simple and cost-effective procedure for the diagnosis of HIV-related salivary gland lesions. The majority of these lesions are cystic BLL and can be managed conservatively. Malignant lesions are rarely encountered and are readily recognized by FNA. Diagn. Cytopathol. 1999;21:260-264.
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Affiliation(s)
- D C Chhieng
- Department of Pathology, New York University Medical Center, New York, New York 10016, USA
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Mandel L, Kim D, Uy C. Parotid gland swelling in HIV diffuse infiltrative CD8 lymphocytosis syndrome. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 85:565-8. [PMID: 9619675 DOI: 10.1016/s1079-2104(98)90292-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
HIV can affect salivary gland tissue. Parotid swellings have been observed in a subset of patients who are HIV-positive; the swellings are the result of a condition that has been termed diffuse infiltrative CD8 lymphocytosis syndrome. Initially the glandular enlargement results from a massive CD8 cell lymphoproliferation, but with time lymphoepithelial cysts become manifest. Two case reports are presented to illustrate this progression of diffuse infiltrative CD8 lymphocytosis.
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Affiliation(s)
- L Mandel
- Division of Oral and Maxillofacial Surgery, Columbia University School of Dental and Oral Surgery and Columbia Presbyterian Medical Center, New York, NY 10032, USA
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