Friday, June 27, 2008

Submandibular sialadenitis







Findings

There is diffuse soft tissue and glandular edema in the left sublingual and submandibular region. There is a large calcification in the left sublingual region representing a sialolith.

Differential diagnosis:
- Submandibular sialadenitis
- Submandibular carcinoma
- Malignant lymph node


Diagnosis: Submandibular sialadenitis


Key points

Presentation
- Unilateral painful submandibular gland (SMG) swelling with eating or salivation
- Painless mass

Treatment: Removal of submandibular gland in some cases.
Radiologic Evaluation: CT with contrast.

A sialolith is a calculus found in the salivary duct
- 85% are found in the submandibular duct, Wharton's duct
- 10% are found in the parotid duct
- 5% in the sublingual duct

Acute sialadenitis:
- Unilateral enhancing enlarged SMG with dilated duct behind the calculus
- Intraglandular ductal dilatation
- SMG cellulitis and/or myositis

Chronic sialadenitis:
- SMG small
- Fatty infiltration
- Intraductal calculus

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