The algorithm for imaging the salivary glands depends on the clinical scenario with which the patient presents to the clinician. Role of high resolution ultrasound in parotid lesions in. The parotid gland is the largest of the salivary glands and secretes saliva via the parotid duct into the oral cavity to facilitate mastication and swallowing. The advantage of ultrasonography in the diagnosis of salivary gland enlargements is its ease to use, less expensive, less time. Pleomorphic adenoma of the salivary glands radiology.
A report of 22 cases with pathologic correlation l. Ultrasonographyguided coreneedle biopsy of parotid gland. Thyroid and parathyroid ultrasound and ultrasoundguided fna. Pleomorphic adenomas, also known as benign mixed tumors bmts, are the most common salivary gland tumors. A normal lymphnode embedded within the parotid gland. A pictorial essay taneja a1, sachdev is2, sethi s3, garga uc4 abstract the major salivary glands are parotid, submandibular and sublingual glands. A substantial num ber of the pathologic conditions affecting these organ systems are. Calculi of the parotid gland usually arise in the periphery of the duct system or within the glandular parenchyma. Ultrasound provides useful diagnostic information in patients with salivary gland disease and should be considered the first line imaging investigation. Afip atlas of tumor pathology series 4 tumors of the. They may be bilateral or multifocal in up to 20% of cases and are the most common neoplastic cause of multiple solid parotid masses. Ultrasonographyguided coreneedle biopsy of parotid gland masses article pdf available in american journal of neuroradiology 259. Details about afip atlas of tumor pathology series 4 tumors of the salivary glands volume 9.
A group of gland lobes, referred to as the accessory parotid gland, are situated along its course. Role of ultrasound in the assessment of benignity and malignancy of parotid masses. An adenocarcinoma cannot be excluded on ultrasound criteria alone. The parotid gland consists of parotid lobules, which produce a serous secretion, and a supportive fibrous tissue known as the stroma. Pleomorphic adenoma, the most common salivary gland tumor, is also known as benign mixed tumors bmts, because of its dual origin from epithelial and myoepithelial elements. Plus, youll receive 15% off your next order of books or personal journal. However, sonographic appearence of some diseases may overlap, thus producing diagnostic pitfalls. Diagnosis and management offers comprehensive coverage of all aspects of this topic. Ultrasound of the thyroid and parathyroid glands is used preoperatively to rule out thyroid nodules that may need to be evaluated prior to parathyroid surgery. Efsumb course book 2nd edition is now being released in individual chapters for. We present 4 cases of carcinoma ex pleomorphic adenoma of the parotid gland. The clinician who performs ultrasonography of the thyroid gland will also, not infrequently, encounter pathology outside of the thyroid and the lymph nodes during scanning of the neck. Otolaryngologistsheadand neck surgeons, as well as endocrinologists and radiologists, will find this book.
Small malignant neoplastic changes of the salivary glands and metastases to salivary glands may present an image of a benign lesion in an ultrasound examination fig. Parathyroid ultrasound is a relatively inexpensive and noninvasive test that does not require radiation. All patients presented with nonspecific unilateral parotid mass. Liver pathology, vascular liver diseases, clinical importance of liver ultrasound.
Because of the importance of identifying small calculi in the gland or salivary duct as the cause of the symptom complex, nonenhanced computed tomography is often the best initial study for the evaluation of the painful gland. Ultrasound guided biopsy of liver or kidney duration. Ultrasonographic evaluation of salivary gland enlargements. Radiography, sailography, scintigraphy, computerized tomography, mri and ultrasonography are the available diagnostic aids to diagnose salivary gland lesions. Lymphangioma, salivary gland neoplasm, swelling lobes and was hypoechoic with lobulated contours. Doctors give unbiased, helpful information on indications, contraindications, benefits, and complications. Ultrasoundguided core needle biopsy for salivary original. It will allow narrowing the differential diagnosis and, in many times, it will provide a final one. Clinical ultrasound, 2volume set 3rd edition elsevier. There are up to 600 minor salivary glands located throughout the oral cavity within the lamina propria of the oral mucosa. Bandyopadhyay on ultrasound guided biopsy parotid or salivary gland. Internal vascularity confirms a solid mass versus a complex cystic lesion. Purchase clinical ultrasound, 2volume set 3rd edition. Sialolithiasis is the most common disease of salivary glands, accounting for approximately 50% of all major salivary gland pathology 5.
The submandibular salivary gland is most commonly affected 8090% of cases with almost all the remaining cases located in the parotid duct 1,2,5,6. The salivary glands are similar to the thyroid gland in many ways, including in their intermediate echogenicity and their mostly superficial position in the. Parotid gland ultrasound what doctors want you to know. Thyroid and parathyroid ultrasound medical ultrasonography.
The facial nerve with a highly variable course and the external carotid artery pass through the gland. Ultrasound books, journals, series, textbooks, reference works. Ultrasoundguided core needle biopsy is a safe, simple and accurate procedure for the diag nosis of salivary gland lesions and can be performed as an outpatient procedure. Ct and ultrasound features of basal cell adenoma of the parotid gland. Beginning with the embryology, anatomy and physiology of the salivary glands, the first section of the book discusses radiographic imaging, infections, cystic conditions, sialoadenitis and sialolithiasis, and systemic diseases. Tumors of the thyroid and parathyroid glands, atlas of tumor pathology series 4. Us is useful for differential diagnosis of diseases of salivary glands. The major salivary glands consist of the larger, paired salivary glands within the neck parotid gland s.
Ultrasound guided biopsy parotid or salivary gland. Us of the major salivary glands must be the initial imaging method to study the superficial pathology of these structures. Radiology reproductive medicine resident speech language pathology spine. Fullcolor photomicrographs of disease pathology here is a complete reference on the fundamental science, treatment, and management of salivary gland disorders. Covering anatomy, physiology, histology, cytology, pathology, and imaging, this text is a premier resource for physicians who diagnose and treat salivary gland diseases both medically and surgically.
For this reason, the safest approach in the case of focal changes in the salivary glands is their verification by an ultrasoundguided fineneedle aspiration biopsy fnab. Fatty jowls, or masseter muscle hypertrophy can both resemble parotid gland enlargement, but both of these conditions can easily be distinguished from parotid gland pathology by us. In all cases highresolution ultrasound and mri allowed accurate diagnosis and delineation of the extent of lesion. On imaging, they commonly present as well circumscribed rounded masses, most commonly located within the parotid gland, hypoechogenic on ultrasound and bright on t2wi with homogeneous enhancement on mri. Shrinkage or atrophy and fibrosis of the salivary glands are commonly seen following radiation therapy for. Vascular lesions of parotid gland in adult patients. Afip atlas of tumor pathology series 4 tumors of the salivary glands vol.
Draft parotid glandpathology parotid lymph nodea normal lymphnode embedded within the parotid gland. Ultrasound us is a quick and noninvasive method to evaluate the salivary glands and is the first imaging technique for their assessment. Stones calculi within salivary ducts are most common within the submandibular gland, probably due to production of saliva more saturated with calcium, more mucous content and the duct being long and tortuous calculi are composed of mixtures of different calcium phosphates hydroxyapatite. Carcinoma ex pleomorphic adenoma of the parotid gland. The scan will evaluate the size, shape and condition of any of the following. Ct and ultrasound features of basal cell adenoma of the. Ct and mr imaging findings with emphasis on intratumoral cystic components. A good knowledge of the normal appearance of the thyroid gland is compulsory for an accurate ultrasound diagnosis. Atlas of salivary gland pathology focuses on the diagnostic approach to salivary gland neoplasiaone of the more challenging fields within surgical pathologyemphasizing the need to understand downstream implications with respect to patient surveillance and treatment. In 3 of the 4 cases, diffusionweighted and apparent diffusion coefficient adc mapping images clearly revealed carcinoma as a hypercellular area with low adc values and pleomorphic adenoma as a hypocellular area with high adc values. Atlas of thyroid lesions provides a broad overview of the variety of lesions in the thyroid gland and their different characteristics and features, in the unique combination of ultrasound, cytologic and histologic appearance nodules in the thyroid gland are quite common.
They are 12 mm in diameter and are not encapsulated, unlike the major. Ultrasound has become the diagnostic procedure of choice in guidelines for the management of thyroid nodules. Parathyroid ultrasound advanced parathyroid surgery of ny. Studies estimate that more than 70% of the adult population in the united states has thyroid lesions when examined by. Warthin tumors, also known as lymphomatous papillary cystadenomas, are benign, sharply demarcated tumors of the salivary gland. It is the commonest of all salivary gland tumors constituting up to twothirds of all salivary gland tumors. Case report a case of parotid hemangioma of infancy. Role of ultrasound and doppler in the diagnosis indian journal of neonatal medicine and research. Mistakes in ultrasound examination of salivary glands. Ultrasound is usually the first line method for examining for any one of the 3 pairs of major salivary glands found in the face and neck area. Ultrasound of salivary glands and the nonendocrine neck. Ultrasound of the salivary glands and soft tissue lesions of the neck. All the diagnostic aids have their own limitations in the diagnosis of salivary gland diseases. Common sites are the genu of the main submandibular gland the bend that occurs as the duct passes around the posterior border of the mylohyoid or within the intraglandular ducts of the submandibular gland 2.