Multiple echogenic foci in the bilateral parotid gland

[Xue Heng]

Hi, Steve. Here is a case of salivary glands.
The inpatient was a 26-year-old male in the respiratory department.
The clinical diagnosis was interstitial pneumonia.
I’m not certain why the clinician reffered US of salivary glands.
When I scanned the pateint, multiple echogenic foci were observed in the bilateral parotid gland.
In the submandible gland, there were also echogenic foci, but the number was much less than that in the parotid gland.
The bilateral sublingual gland seemed normal.
I have never seen such a case before.
Can you give me some suggestions? Thank you very much, Steve!

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[Stephen Bird]

Hi Xue,

I have not seen this before.

It is obviously a diffuse process and my differentials would be that this is an appearance following a prior event of sialadenitis. Given the bilateral nature and multi gland appearance post viral sialadenitis would seem most likely.

I also would consider an IGG4 differential diagnosis as it is multi gland locational.

I will send these images to Anil Ahuja and see if he has seen it before.

If anyone knows the answer it will be Anil,

Steve

[Xue Heng]

Thank you for analyzing this rare case.
Thank you for giving me how to think and narrow the diffrential diagnosis.

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