Lymphoepithelial lesion of the parotid gland

Benign lymphoepithelial lesion of the minor salivary gland - A rare presentation as a palatal swelling

Benign lymphoepithelial lesion (BLEL) is characterized by extensive lymphocytic infiltration of the major salivary glands and may be associated with Sjogren's syndrome or HIV infection. The involvement of the palatal minor salivary glands is extremely rare. We report an isolated case of BLEL affecting the palatal minor salivary glands, presenting as a palatal swelling in a 37-year-old female patient. Serological tests ruled out potential comorbid conditions. Cone-beam computed tomography showed a palatal soft-tissue mass with thinning of the adjacent cortical plates. A histopathological examination revealed salivary gland tissue with significant acinar destruction, dense lymphocytic infiltration and focal myoepithelial islands. Therefore, BLEL may be considered as a rare differential diagnostic possibility of a palatal soft-tissue mass lesion.

Sonographic diagnosis for Mikulicz disease

OBJECTIVE

The aim was to investigate the diagnostic imaging characteristics of Mikulicz disease (MD), especially sonographic ones, and to clarify the differences between them and those in Sjögren syndrome (SS), based on new criteria of MD.

STUDY DESIGN

The sonographic and sialographic images, as well as clinical, histopathologic, and serologic findings of 9 patients satisfying the new criteria of MD were analyzed and compared with those in SS.

RESULTS

All swollen submandibular glands showed bilateral nodal hypoechoic areas with high vascularization on sonograms and a parenchymal defect on sialograms, whereas parotid glands showed normal or slight change on both images. Nodal areas in submandibular gland sonograms were unclear on computerized tomography and on magnetic resonance imaging, but showed accumulation on gallium scintigraphy.

CONCLUSION

Mikulicz disease showed a high rate of bilateral nodal change in submandibular glands, which was completely different from SS. For detection and follow-up of these changes, sonography may be the best imaging modality.

Interpretation of the origin of a submandibular mass by CT and MRI imaging

OBJECTIVE

To clarify the useful findings for determining whether the submandibular mass is intraglandular or extraglandular.

STUDY DESIGN

Forty-eight patients with swelling of the submandibular region were reviewed. The relationship between the lesion and the submandibular gland and the displacement of the anterior facial vein were analyzed.

RESULTS

The accuracy of the predictions based on the relationship between the lesion and the submandibular gland (SMG) was 87% on contrast-enhanced CT (CECT), 85% on CT sialography (CTS), and 91% on MRI. Although the displacement of the facial vein outside the lesion suggested an intraglandular lesion, and inside the lesion suggested an extraglandular lesion, these were not sufficient to differentiate the lesions in 7 out of 23 CECT cases and 4 out of 11 MRI cases.

CONCLUSION

The finding of a relationship between the lesion and the SMG is the most important finding of this study.