Salivary glands
Inflammatory
Diffuse infiltrative lymphocytosis syndrome
Topic Completed: 1 October 2015
Minor changes: 30 October 2020
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PubMed Search: Diffuse infiltrative lymphocytosis syndrome[TIAB]
Table of Contents
Definition / general | Case reports | Microscopic (histologic) description | Additional referencesCite this page: Tanakchi S, Aly FZ. Diffuse infiltrative lymphocytosis syndrome. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/salivaryglandsDILS.html. Accessed January 23rd, 2021.
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 versus 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
- 32 year old woman with diffuse infiltrative lymphocytosis syndrome (DILS) associated with HIV1 infection (Dakar Med 2007;52:171)
- 58 year old man with renal failure associated with diffuse infiltrative lymphocytosis syndrome (Nat Clin Pract Nephrol 2008;4:110)
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
