Salivary glands
Diffuse infiltrative lymphocytosis syndrome (DILS)

Author: Sally Tanakchi (see Authors page)
Editor: F. Zahra Aly, M.D., Ph.D.

Revised: 12 March 2018, last major update October 2015

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Diffuse infiltrative lymphocytosis syndrome[TIAB]
Cite this page: Tanakchi, S. Diffuse infiltrative lymphocytosis syndrome (DILS). website. Accessed July 21st, 2018.
Definition / general
  • Clinical mimic of Sjögren syndrome causing parotid gland enlargement, dry eye and dry mouth
  • Associated with HIV and persistent CD8+ lymphocytosis
  • Frequently involves salivary glands (present in 1 - 6% of U.S. HIV+ patients vs up to 50% in Africa) and lungs, also affects lacrimal glands, kidney, muscle nerve, liver, GI and breast
  • In lungs, may radiographically present as diffuse bilateral pulmonary infiltrates mimicking pneumocystis jiroveci
  • DILS may be less prevalent now due to HAART therapy which decreases the CD8 counts
  • Proposed diagnostic criteria for diagnosis include:
    • HIV seropositivity
    • Bilateral salivary gland infiltration to salivary gland
Case reports
Microscopic (histologic) description
  • Resembles Sjögren syndrome
  • Lymphocytic infiltration of CD8+ cells
  • Less destruction of salivary gland than Sjögren syndrome
  • Salivary ductal epithelial atypia is common in the Cameroon in advanced HIV patients
  • Lymphoepithelial cysts are frequently, characterized by follicular hyperplasia and cystic dilation of ducts lined by pseudostratified squamous epithelium
Microscopic (histologic) images

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Various images

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Acinar atrophy

Electron microscopy images

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Ductal epithelial cell

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Enveloped virus particles