Chronic Sclerosing Sialadenitis of the Parotid Gland

Abstract

Chronic sclerosing sialadenitis (CSS), or Kuttner tumor, is a benign inflammatory process of the major salivary gland that occurs almost exclusively in the submandibular gland of middle-aged adults. It is rarely reported to involve the parotid gland or to occur in adolescents. 1 Chronic sclerosing sialadenitis is characterized histologically by periductal fibrosis, dense lymphocytic infiltration with lymphoid follicle formation, loss of the acini, and, eventually, marked sclerosis of the salivary gland. 2 , 3 This lesion has been recognized as a distinct clinicopathologic entity in the latest edition of the World Health Organization classification of tumorlike lesions of the salivary glands. 2 Because CSS manifests as a hard mass, it usually raises a strong clinical suspicion of a malignant neoplasm. In recent years, gray scale sonography and color Doppler sonography (CDS) have been widely used in the evaluation of major salivary gland masses, and fine-needle aspiration cytologic examination and needle biopsy have been used increasingly as cost-effective and safe techniques to confirm or evaluate salivary gland lesions.4-6 We report the sonographic and CDS manifestations and sonographically guided needle biopsy histologic features of an adolescent with CSS of the unilateral parotid gland.