Bilateral Parotid Gland Swelling Research Articles

A case of renal sarcoidosis complicated by parotid gland and uterine lesions

BackgroundSarcoidosis is a systemic disease that can affect multiple organs. While pulmonary sarcoidosis is most commonly observed, renal sarcoidosis occurs less frequently. We herein report a case of sarcoidosis with an exceptionally rare distribution including renal lesions.Case presentationA 51-year-old Japanese female was referred because of bilateral parotid swelling and renal dysfunction. Computed tomography scan showed the swelling of bilateral kidneys, parotid glands, and uterus. Ga scintigraphy also showed remarkable accumulation in these organs. Renal biopsy and cytological evaluations of parotid gland and uterus were performed and she was diagnosed as sarcoidosis of these organs. Treatment was initiated with prednisolone 40 mg/day and then renal dysfunction subsequently improved. In addition, the swelling of parotid glands and uterus improved and Ga accumulation in each organ had disappeared.ConclusionThis is a first case of renal sarcoidosis complicated by parotid glands and uterus lesions. Pathological findings and the reactivity observed in Ga scintigraphy indicated the presence of lesions in these organs.

Heerfordt’s syndrome: an uncommon manifestation of sarcoidosis

Heerfordt’s syndrome – the combination of facial palsy, parotid swelling, anterior uveitis and fever, is a rare manifestation of sarcoidosis. Here, we present case history of a patient with bilateral lower motor neuron facial nerve palsy, who was found to have bilateral parotid gland swelling and bilateral hilar lymphadenopathy. Computed tomography guided fine needle aspiration cytology from hilar lymph node findings were consistent with sarcoidosis. Subsequently, based on clinical features and cytological findings, the case was diagnosed as incomplete Heerfordt’s syndrome.
 Birdem Med J 2021; 11(1): 67-69

A Case of Bilateral Parotid Gland Swelling after Dental Treatment under Intravenous Sedation with Propofol

A Case of Bilateral Parotid Gland Swelling after Dental Treatment under Intravenous Sedation with Propofol

Unilateral parotid gland enlargement in a patient with primary Sjögren syndrome

A 47-year-old woman came to our clinic for sudden pain and enlargement of her left parotid gland (figure 1A). A diagnosis of primary Sjogren syndrome was made 20 years ago...

The diagnostic value of fine needle aspiration biopsy in bilateral swellings of the parotid.

Background. Fine needle aspiration biopsy (FNAB) is a frequently used method in the diagnosis of masses and it has been employed in pre-operative diagnosis of salivary gland lesions for many years. There are many publications in the literature on diagnostic value of FNA in salivary gland masses. However, studies involving FNA results of multiple lesions of salivary glands are rare. Objective. The purpose of present study is to determine the diagnostic value of FNAB in the bilateral, especially in the diffuse, swellings of the parotid gland and detection of pitfalls and their consequences. Methods. A total of 19 cases of bilateral swelling of parotid gland were included in this study. Demographic and clinical features of patients, results of FNAB and postoperative histopathological examination in some cases were analyzed retrospectively. Results. Eleven (57,89%) of patients were female, 8 (42,11%) were male. The age range of patients was 33-74 and mean age was 49,05. Benign non-neoplastic disease in 15 (78,95%), and benign neoplastic disease in 4 (21,05) of 19 cases were detected with FNAB. Conclusion. FNAB is the accessible, inexpensive and reliable method in the diagnosis and selection of the treatment tactics of the bilateral parotid swellings. Biopsies from both sides separately are advisable to prevent diagnostic errors in the bilateral parotid swellings, especially in the cases of Warthin tumour.

A case of a male presenting with fever, parotitis, epididymo-orchitis, and kidney injury

A 53-year-old male was admitted to the emergency room with 5-day history of fever, bilateral parotid gland swelling, and right esticular pain for 2 days. He also complained of headaches, genralized arthralgias, myalgias, and severe lumbago. He lived in a ural area in Northeast China and had worked in the field 2 weeks rior to the onset of symptoms. He was previously in good health, nd there was no history to suggest a sexually transmitted infecion. He was treated with ibuprofen for 2 days before admission ithout remission of symptoms. The physical examination on admission revealed swelling of the arotid glands bilaterally (Fig. 1) and right scrotum. The vital signs ere as follows: temperature, 37.5 ◦C; heart rate, 80/min; respiatory rate, 20/min; and blood pressure, 120/60 mmHg. Petechiae ere noted in the throat, and the abdomen was soft. Lymhadenopathy was palpable in the neck. There was no conjunctival uffusion, facial suffusion, or cutaneous petechiae. The neurologic xamination was unremarkable. Initial laboratory studies (Table 1) revealed that the leukoyte count was 4890/ L, the hemoglobin level was 12.8 g/dL, the

Immunoglobulin G4-Related Disease in the Head and Neck: Two Case Reports and Literature Review

Immunoglobulin G4-related disease (IgG4-related disease) is a fibroinflammatory disorder defined by elevated serum IgG4 level and plasma cells tissue infiltration accompanied by fibrosis or sclerosis. In this article, we report two patients of IgG4 syndrome: a 60-year-old male with complaints of nasal congestion, rhinitis, anosmia and hearing loss, and a 28-year-old female with bilateral orbital and parotid gland swelling. Histopathological findings and high serum IgG4 level confirmed diagnosis of IgG4-related disease. Both patients were treated successfully with glucocorticoids and methotrexate. Herein, we also review clinical presentations of IgG4-related disease in head and neck, and related diagnostic and therapeutic approach. ©2015 Turkish League Against Rheumatism. All rights reserved.

Primary Sjogrens Syndrome in a Child.

Primary Sjogrens Syndrome in a Child.

Lymphoepithelial cyst as a herald of HIV seropositivity in a patient with known history of neurocysticercosis and suspected parotid cysticercosis

Among those with acquired immune deficiency syndrome, salivary gland pathology and other less common signs of human immunodeficiency virus (HIV) seropositivity are emerging. Generally speaking, lymphoepithelial lesions of the parotid gland are uncommon with a reported incidence of 0.6%, but they are beginning to overtake other oral lesions such as candidiasis as predominant oral manifestations of clinical HIV infection. Here, we describe a patient with a known history of neurocysticercosis with presumed extracranial cysticercosis as demonstrated by the clinical manifestation of bilateral parotid gland swelling and a ring-enhancing, hypodense lesion of the left parotid gland on CT. He was found to have a lymphoepithelial cyst arising in a lobe of the left parotid gland per pathological evaluation after left superficial parotidectomy, and this served as the initial sign of HIV positivity, which was confirmed by serological studies.

CR0361 A case of bilateral parotid gland swelling caused by sarcoidosis

CR0361 A case of bilateral parotid gland swelling caused by sarcoidosis

Parotid sialometry: A standard technique in the diagnosis of parotid sialadenosis

Abstract Sialadenosis is a clinical condition characterized by bilateral, painless, diffuse and recurrent parotid gland swelling. Histologically, the only feature of note is acinar cell hypertrophy, with no apparent change in the duct structure or cellular infiltrate. The functional changes in the parotid parenchyma in this condition are ill understood. The association between malnutrition and parotid gland swelling was first reported in Egypt. The pathogenesis of the condition remains unclear. The aim of this study is to explain the development of parotomegaly by analysing the parotid secretory pattern in parotomegaly patients Patients with malnutrition were studied at Ain Shams University Hospitals. 47 patients, 19 male patients and 28 female patients, were studied, of these eight patients (three male patients and five female patients) suffered parotomegaly. Thirty-one patients with morbid obesity were recruited. 23 patients were female and eight were male. Six patients in this group had parotomegaly. Results were compared with those of 30 healthy volunteers recruited from medical and nursing staff, medical students and patients attending the ENT clinic for minor procedures. Parotid saliva was collected by the standard technique The results of salivary analysis in 47 patients suggested a pattern of inhibitory proteodyschylia, with increased salivary flow rate and reduced total protein level and amylase activity compared with 30 healthy volunteers. This inhibitory proteodyschylia pattern is identical to the secretory pattern induced experimentally by blocking B-adrenergic receptors in the parotid A possible explanation for the development of parotomegaly in malnutrition is a degenerative neuropathy affecting the B-adrenergic innervation of the parotid that cause acinar cell congestion by zymogen granules, which is manifested clinically as parotomegaly.

A Case of Juvenile Sjögren's Syndrome with Interstitial Nephritis

Primary Sjögren's syndrome (SS) is a rare autoimmune disease, especially in children. Juvenile primary SS with interstitial nephritis is rare in Japan. We report on a 12-year-old girl in whom salivary gland swelling had recurred from the age of 5 years, SS was diagnosed at the age of 10 years, and interstitial nephritis developed at the age of 12 years. The patient presented with a chief complaint of swelling of both parotid glands. The patient had a history of recurrent parotitis from 5 years of age, with episodes recurring 5 to 6 times a year and resolving within 3 days each time. However, at the age of 11 years, the patient had continuous mild swelling of the parotid glands. Examination on admission showed bilateral nontender parotid gland swelling; mild swelling of the lower extremities, xerostomia, and xerophthalmia but no exanthem. Laboratory findings were as follows: serum protein, 10.1 g/dL; immunoglobulin (Ig) G, 3,828 mg/dL; antinuclear antibodies, 1,280-fold; anti-Ro/SS-A antibody, 512-fold; anti-Ro/SS-B antibody, 4-fold; creatinine, 0.45 mg/dL; blood β2-microglobulin, 2.2 mg/L (slightly elevated); and cystatin C, 0.86 mg/L. Urinalysis showed proteinuria and a β2-microglobulin concentration of 11,265 mg/L. Thus, this patient had low molecular weight proteinuria. Schirmer's test showed decreased tear secretion (5 mm), and fluorescein staining showed marked bilateral superficial punctate keratitis. A lip biopsy showed infiltration by small round cells (mild to moderate), interstitial fibrosis, loss of salivary gland parenchyma, and atrophy, with no obvious epimyoepithelial islands, leading to a diagnosis of SS. Light microscopic examination of the renal biopsy specimens showed expansion of mononuclear cell infiltration in the renal interstitium, inflammatory cell infiltration of interstitial areas with edema and mild fibrosis, and tubulitis and mononuclear cell infiltration that included many lymphocytes and plasma cells. There were no pathological findings of glomerulonephritis. Small arteries showed no obvious abnormalities. Immunofluorescent staining showed slight, nonspecific deposition of IgM, but no deposition of IgG, complement 1q, 3, or 4. On the basis of the renal biopsy showing nonspecific chronic interstitial nephritis, renal tubular atrophy, and interstitial enlargement, tubulointerstitial nephritis associated with SS was diagnosed.

Sialendoscopy and Two Cases of Bilateral Parotid Duct Stenosis

Although parotid duct obstruction may cause recurrent painful gland swellings, bilateral parotid duct stenosis is rare. Sialendoscopy enables the ductal system to be seen directly, allowing more precise diagnosis of idiopathic gland swelling particularly in stenosis. We report 2 cases involving painful bilateral parotid gland swelling and stenosis. A 61-year-old man with type II (right and left-side) stenosis, and a 35-year-old man with type II (right-side) and III (left-side) stenosis. Both were confirmed in sialendoscopy. Sialendoscopy enables stenosis to be directly and precisely assessed for planning effective treatment.

Mantle Cell Lymphoma Presenting as Mikulicz Syndrome

A middle-aged woman presented with insidious onset swelling of bilateral lacrimal and parotid glands. Mikulicz syndrome is a symptom complex caused by a variety of systemic disorders like lymphoma, sarcoidosis, amyloidosis, human immunodeficiency virus infection, tuberculosis, etc. Biopsy from her lacrimal glands revealed mantle cell lymphoma. Although involvement of salivary and lacrimal glands as a part of generalized lymphomatous involvement is not uncommon, Mikulicz syndrome as a presenting manifestation of a lymphoma is very rare.

Bilateral parotid gland involvement in Wegener granulomatosis

Wegener granulomatosis (WG) is a disease characterised by granulomatous inflammation and a vasculitis predominantly affecting small vessels.1 We describe a patient with WG who presented with bilateral parotid gland involvement,...

Pathology Quiz Case

A N OTHERWISE healthy 26-year-old white woman presented with bilateral parotid gland swelling in January 2000. She reported that she had had a severe bout of mononucleosis in November 1999, with fevers, chills, odynophagia, fatigue, severe myalgias and arthralgias, and enlarged parotid glands. Further history revealed occasional dry eyes, dry skin, and a “clicking” with swallowing. She denied shortness of breath, cough, dysphagia, odynophagia, skin lesions, and recent weight loss. Except for persistent parotid swelling, her symptoms had resolved. Before presenting at our clinic, she had received 4 short courses of corticosteroids that had significantly reduced the swelling. The results of the head and neck examination were unremarkable except for nontender swelling of the parotid glands, which was greater on the left side (Figure1). The pulmonary, cardiac, abdominal, skin, and extremity examinations revealed no abnormalities. Laboratory tests were negative for antinuclear antibodies, rheumatoid factor, and anti-nuclear riboprotein antibodies. The erythrocyte sedimentation rate and complete blood cell count were normal, as were the results of serum chemistry studies. The angiotensin-converting enzyme level was elevated at 76 U/L (reference range, 18-55 U/L). The mumps IgG titer was positive at 1.89 g/L, which was consistent with prior immunization. The chest radiograph did not demonstrate hilar adenopathy or parenchymal disease. Computed tomography of the head revealed bilateral parotid gland enlargement with uniform density (Figure2). Fine-needle aspiration of the parotid glands revealed blood elements with rare stromal fragments. A touch preparation obtained from the left parotid gland showed a mixed Band T-cell population consistent with a reactive pattern, but the findings were nonspecific. A biopsy specimen from the left parotid gland revealed numerous noncaseating granulomas. The histopathologic features are shown in Figure 3 and Figure 4. Stains for fungi and acid-fast bacilli were negative. What is your diagnosis?

Shrinking Lung Syndrome in Systemic Lupus Erythematosus and Sjogren’s Syndrome

Shrinking lung syndrome (SLS) is a rare complication of systemic lupus erythematosus (SLE) characterized by unexplained dyspnea, a restrictive pattern on pulmonary function tests, and an elevated hemidiaphragm. A total of 59 cases are reported in literature including the current case. The mean age of these patients is 36.85 years (range, 15-61 years), and the female-to-male ratio is 6:1. This disorder is seen primarily during the later stages of SLE. The most common presenting features include dyspnea and pleuritic chest pain. Myositis has been reported in only 8 of 59 patients (13%). Diagnosis is made with chest x-ray showing an elevated hemidiaphragm and a restrictive pattern on pulmonary function testing without any evidence of interstitial lung disease along with decreased transdiaphragmatic pressure (Pdi). Corticosteroids are the most common method of treatment. Immunosuppressive therapy, beta-agonists, and theophylline are used in those resistant to steroids. The prognosis is generally good. This article reports the case of a 22-year-old man presenting with a 7-month history of dry mouth and dry eyes accompanied by increasing difficulty in breathing, progressing to dyspnea at rest. The patient's history included bilateral parotid gland swelling and nephrotic syndrome diagnosed 4 years earlier. Pertinent physical and laboratory findings included positive Schirmer's test results; bilateral parotid gland enlargement; bibasilar lung crackles; synovitis of the second and third proximal interphalangeal joints; a positive antinuclear antibody (Ro/SSA), Sm, and anticardiolipin antibodies; and elevated right hemidiaphragm on chest x-ray. Pulmonary function tests demonstrated restrictive lung disease with normal high-resolution computerized axial tomography. A dramatic response to oral prednisone (60 mg daily) was observed in all of the patient's complaints in a matter of several days. A diagnosis of SLE with secondary Sjogren's syndrome (SS) and SLS was made. Although SLS has been reported in association with SLE, there has been only one previous report of SLS in SLE/SS overlap syndrome. Early recognition with appropriate treatment can decrease the morbidity associated with this rare syndrome.

Cell‐mediated immune‐pancytopenia complicating primary sjögren's syndrome

A 64-year-old woman with mild bilateral parotid gland swelling and bilateral lower extremity purpura was admitted for evaluation of xerostomia and pancytopenia. The patient had an increased erythrocyte sedimentation rate, pancytopenia, and positive tests for antibodies to nuclear antigen, SS-A, and SS-B. Impaired cell-mediated immunity was also present. Bone marrow aspiration showed a hypoplastic marrow with an increased percentage of lymphocytes. A positive Schirmer's test and keratoconjunctivitis were also noted. A diagnosis of primary Sjögren's syndrome was made by sialography and histological salivary gland findings. Therapy with prednisolone improved the pancytopenia. Addition of the patient's peripheral blood mononuclear cells to cultures of bone marrow mononuclear cells derived from a healthy volunteer dose dependently inhibited colony formation, including mixed hemopoietic colonies. On the other hand, addition of the patient's serum failed to inhibit colony formation by normal bone marrow mononuclear cells. These results suggested that one of the causes of pancytopenia in primary Sjögren's syndrome might be mediated by the inhibition of mononuclear cells to the hemopoietic progenitors.

全身麻酔後に生じた耳下腺炎の１例

全身麻酔後に生じた耳下腺炎の１例

Bilateral Recurrent Parotid Gland Swelling after Endoscopy

Bilateral recurrent parotid gland swelling after fiberoptic endoscopy is described in a patient who was on carbenoxolone sodium as part of a double blind protocol for gastric ulcers. The possible etiologies for this unusual complication of endoscopy as well as the past literature are reviewed.