Spectrum of salivary gland disease in HIV-infected patients: characterization with Ga-67 citrate imaging.

Abstract

The authors retrospectively reviewed 45 gallium-67 citrate scans of 28 patients infected with the human immunodeficiency virus (HIV). Abnormal salivary gland radiotracer activity was seen in 13 patients with diffuse infiltrative lymphocytosis syndrome (DILS), five patients with undifferentiated salivary gland disease (USD), and 10 patients with acquired immunodeficiency syndrome (AIDS). More DILS patients (54%) had intense gallium uptake than did the AIDS and USD patients combined (13%) (P less than .05). DILS patients had markedly elevated CD8 cell counts and moderately reduced CD4 cell counts, while AIDS patients had normal CD8 cell counts and markedly reduced CD4 cell counts. These differences were statistically significant (P less than .05). The authors recommend that DILS be considered in the differential diagnosis when abnormal, particularly intense, bilateral salivary gland gallium uptake occurs in HIV-infected patients. This disease is more likely to occur when circulating CD8 lymphocytosis is present, while AIDS is the more likely diagnosis when the patient has a normal CD8 cell count and a markedly depressed CD4 cell count.