Beruflich Dokumente
Kultur Dokumente
diseases
Helwa Mageed Asakly
20102050290
Sialadenosis/ sialosis
Disease mechanism:
nonneoplastic, noninflammatory enlargement of the
.parotid salivary gland
Usually related to Metabolic and secretory
.disorder
hormonal sialadenosis
malnutrition
alcoholics(dystrophic metabolic sialadenosis),
vitamin deficiencies
neurologic disorders(neurogenic sialadenosis)
: Imaging feature
Sialography:
Enlargement(splayed) / normal appearance
MDCT& MRI: more straightforward depiction,
but are nonspecific.
Treatment: identifying the cause of the
metabolic or secretory disorder.
conservative Tx : local massage, increase fluid
intake , sialagogues.
Cystic lesions
Rare <5%
Unilateral in parotid gland
Congenital/ lymphoepithelial/dermoid/acquired
Intraglandular/extraglandular.
Mucous extravasation pseudocysts.
Ranulas.
Benign lymphoepithelial cysts: are squeal of cystic
degeneration of salivary inclusions within lymph nodes.
Multicentric parotid cysts: associated with HIV benign
lymphoepithelial lesions of immunodeficiency syndrome
These lesion are accompanied by cervical
lymphadenopathy,
.occur bilateral, in the superficial portion of parotid gland
Imaging feature:
Indirectly visualized on sialography only by the
.displacement of the ducts arching around them
Well-circumscribed, non enhancing
Ultrasonography: sharply marginated and
echo-free(dark area)
Tx: surgical(local/total excision of the gland)
Benign tumors
treatment:
benign tumors of parotid gland : partially incised or
totally excised.
Submandibular & sublingual glands: totally excised.
Benign Mixed
tumor\pleomorphic adenoma
imaging feature:
MDCT: sharpely circumscribed, infrequently
lobulated and round homogeneous lesion that has
a higher density than the adjacent glandular tissue.
T2-weighted
image: increased
signal of the
tumorhyperintense to
muscle
warthin's tumor
: imaging features
.MRI& MDTC are the preferred techniques
non specific appearance and is typical of benign
.mixed tumor
.on MDTC: soft tissue or cystic density
MRI: heterogeneous and may demonstrate
.hemorrhagic foci
warthins tumors is characteristically intensely
.hot (high spot) on Tc-pertechnetate scan
hemangioma
Synonym :vascular nevus.
the most common benign neoplasm of proliferating endothelial
cells(congenital hemangioma) and vascular malformations
.resulting from abnormal vessel morphogenesis
85% arise in the parotid gland.
the most common salivary tumor during infancy and childhood.
AVG age at diagnosis in 10 years, 65% occurring in the first 2
decades.
unilateral, asymptomatic
2:1 F:M ratio.
Tx: local excision for pt who do not undergo spontaneous
remission.
malignant tumors
20% of tumors in the parotid are malignant,
50-60% of submandibular tumors, 90% of
sublingual , 60-75% of minor salivary gland
tumors.
imaging features: variable, and related to
grade, aggressiveness, location, and type of
tumor.
ill defined margins, invasion, and destruction of
adjacent osseous structures malignancy,
Tx of low grade malignancy of the parotid gland : *
.partially incised/ totally excised
Tx of high grade tumors: radical neck dissection, *
combination of surgery& therapeutic radiation&
.chemotherapy
Adenocarcinoma
of the left
parotid gland
Tissue signal in
T1-weighted
MRI is slightly
less than
remaining
gland(darker)
mucoepidermoid
carcinoma