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Hi Steve,
A workmate of mine recently scanned this neck where we were uncertain about the appearance of the inferior edge of a parotid. She thought it looked a bit hypoechoic but was unsure. The patient complained about swelling in the salivary glands and it seemed like that hypoechoic area correlated to the swelling.
Not sure if it was an actual lesion? Accessory parotid? Just normal echogenicity change?Thanks!
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Tricky one,
Was there anything palpable?
A few options:
A normal benign lymph node in the gland with a broad fatty hilum
Localised fatty change in the parotid gland as it doesn’t have really crisp margins.
A localised area of sialadenitis seems less likely to me as does a diffuse disease like Sjogrens or IGG4 disease.
An old area of sialadenitis from a previous episode can leave textural changes (Kuttners tumour)
It doesn’t really look like a pleomorph or a warthins but I suppose it needs exclusion.
I would be guided a bit on the clinical presentation and how it felt.
A CT may help or a follow up ultrasound.
If anyone else would like to chime in with a suggestion please help us out!
Steve.
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