EBV-ASSOCIATED PRIMARY LYMPHOMAS IN SALIVARY-GLANDS OF HIV-INFECTED PATIENTS

The lymph nodes within and around salivary glands are commonly involve d in inflammatory processes, but rarely the site of primary lymphomas. We observed six cases of primary salivary gland lymphoma in HIV-infec ted patients and studied them in parallel with three cases of primary salivary gland lymphoma unrelated to HIV and three cases of HIV-relate d salivary gland lymphadenopathies in order to characterize this new e ntity. We found that all salivary gland lymphomas in HIV-infected pati ents were of high histologic grade while salivary gland lymphomas unre lated to HIV were predominantly of low grade MALT type. All lymphomas in both categories expressed the B-cell phenotype. Just as HIV-unrelat ed lymphomas frequently arise on the background of chronic inflammator y lymphoid processes, lesions characteristic of HIV-lymphadenopathy we re still present in some lymphomas of HIV-infected patients. EBV RNA t ranscripts (EBER) were demonstrated in three, and latent membrane prot ein (LMP) in two of the six HIV-related and in none of the three HIV-u nrelated lymphomas. The three EBER-positive lymphomas were of the hist ologic types known to express the virus in most cases. The presence of HIV in the form of the core protein p24 and envelope glycoprotein gp- 41 on the dendritic reticular cells of germinal centers was ascertaine d in the cases of HIV-related lymphadenopathies but also in the coexis tent lymphadenopathies of lymphomas. The practical importance of diagn osing the salivary lymphadenopathies and lymphomas associated with the HIV-infection resides in avoiding their misdiagnosis and surgical rem oval as tumors of salivary glands.