Salivary Glands

Question 1

major salivary glands

Answer 1

parotid, submandibular, sublingual

Question 2

parts of the parotid glands

Answer 2

superficial and deep lobes, typically demarcated by the retromandibular vein/facial nerve

Stensen’s duct

intrinsic lymph nodes

Question 3

location of submandibular gland

Answer 3

partly in floor of mouth/neck

wraps around free posterior margin of mylohyoid muscle

Question 4

sublingual gland location

Answer 4

medial to mandible at anterior aspect of floor of mouth

Question 5

pleomorphic adenoma

Answer 5

most common parotid tumor; firm mass in middle aged female

benign; but typically resected due to risk of transformation to carcinoma ex pleomorphic adenoma

enhances on MRI

Question 6

Warthin tumor

Answer 6

second most common benign parotid tumor; can be bilateral and typically in elderly males

risk factors: smoking

cystic neoplasm; no enhancement

Question 7

mucoepidermoid carcinoma

Answer 7

uncommon parotid malignancy

enhancing mass, T2 hyperintense; looks identical to pleomorphic adenoma

Question 8

adenoid cystic carcinoma

Answer 8

most common submandibular/sublingual malignancy; second most common parotid gland malignancy

perineeural spread with CN palsy or paresthia

high risk of local recurrence; enhancing mass with perineural spread

Question 9

carcinoma ex pleomorphic adenoma

Answer 9

elderly patients with rapid enlargment of existing mass

hypointense on T1/T2

malignant degeneration of pleomorphic adenoma

Question 10

primary SCC parotid gland

Answer 10

may be due to chronic inflammation

aggressive large mass with nodal mets

Question 11

sialolithiasis/obstructive sialadenitis

Answer 11

sialolithiasis&raquo_space; obstruction&raquo_space; obstructie sialadenitis

mostly within the submandibular gland

Question 12

sarcoidosis, salivary disease

Answer 12

30% of sarcoid patients have involvement of parotid gland

uveoparotid fever: bilateral uveitis; parotid enlargement, facial nerve palsy

Question 13

panda sign

Answer 13

gallium 67 scintigraphy shows increased uptake in lacrimal/parotid glands in sarcoid

Question 14

sjogren syndrome

Answer 14

autoimmune disorder of major and minor salivary glands; middle aged females

increased risk of lymphoma

primary: only salivary/lacrimal glands
secondary Sjogren: secondary to connective tissue disorder

Question 15

Sjogren syndrome, imaging findings

Answer 15

atrophy/fatty replacement of salivary glandular tissue; multiple nodules and abnormal enhancement; numerous small cystic foci and punctate calcifications

Question 16

HIV lymphoepithelial lesions

Answer 16

lymphoid dysfunction in parotids with multiple bilateral lymphoepithelial cysts/solid masses

only parotid glands affected since they contain intrinsic lymphoid tissue