Multilocular Thymic Cyst in a Patient with Diffuse Infiltrative Lymphocytosis Syndrome

Abstract

Diffuse Infiltrative Lymphocytosis Syndrome (DILS) is a multisystem disorder characterised by bilateral salivary gland enlargement and/or xerostomia in patients with Human Immunodeficiency Virus (HIV) infection. A 16 year old young male patient, presented with bilateral painless parotid swelling for five years. On evaluation, he was found to have oral thrush and bilateral cervical lymphadenopathy. He turned out to be positive for HIV with a cluster of differentiation 4 (CD4) count of 237/mcl. On Positron Emission Tomography- Contrast Tomography (PET-CT), a multiloculated thymic cyst (13×9×6 cm) was noted. He was diagnosed to have DILS with a large multiloculated thymic cyst. The patient was managed with tenofovir, lamivudine and efavirenz along with cotrimoxazole prophylaxis and fluconazole and was followed uptil nine months for the regress of the conditions. The case highlights the rare association between DILS and thymic cyst.