SALIVARY GLAND DISORDERS

TOPIC: SALIVARY GLAND DISORDERS

🌟 IMPORTANT POINTS TO REMEMBER

🔹Aplasia and Hypoplasia Of Glands: Unilateral gland is missing or is very small compared to the contralateral side with congenital reasons.

🔹Acute Inflammation: Symptoms are pain or heat sensation; sonographs of acute inflammation–affected gland show swelling and increased vascularity.

🔹Chronic Inflammation: Ductal dilatation can also be seen on CT or MR images. Sonograph of the glands with a chronic sialadenitis shows the decreased echo level and heterogeneous internal echoes.

🔹Sialolithiasis: Sialolithiasis often causes obstructive inflammation. Sialography can demonstrate the location of the sialoliths as a filling defect. The glandular damage is seen better on sonographs, where sialolith is seen as a hyperechoic structure with acoustic shadows.

🔹Sjögren Syndrome: Sjögren syndrome is a systemic autoimmune disease affecting the exocrine glands, of which salivary glands are mainly affected. Sialographs of this disease show numerous punctate globular cavitary collections of the contrast material in the periphery. Appearances are called cherry blossom and apple tree. On CT and MR images, degenerated parotid and submandibular glands give a ‘salt and pepper appearance’ because of fat deposition.

🔹Sialosis: Sialosis is a non-inflammatory recurrent swelling of the glands. CT, MR images and sonographs show bilateral swelling of the parotid glands.

🔹Ranula: On CT, the lesion is observed as a homogeneous, water density mass with clear boundary. On MR images, the lesion shows low signal intensity on T1-weighted images, and very high signal intensity on T2-weighted images.

🔹Pleomorphic Adenoma: When the sialography is performed with CT, the tumour is detected, surrounded by the gland with contrast material. On CT, the tumour is observed as a round or a lobular mass with smooth boundary. 

🔹On MR images, a typical pleomorphic adenoma shows markedly high signal intensity on T2-weighted images because of the myxoid substance in the tumour.

🔹Warthin Tumour: Warthin tumour is observed as a round- or oval-shaped mass with smooth, well-delineated contour.

🔹Mucoepidermoid Carcinoma: Low-grade tumour appears as a round, hypoechoic mass with well-delineated contour.

📌 MULTIPLE CHOICE QUESTIONS (MCQs)

💡The sonograph of chronic sialadenitis shows

1. Decreased echo level
2. Increased echo level
3. Unaltered echo level
4. No echo levels

Answer : 1

💡Sialolithiasis most commonly occurs in

1. Parotid gland
2. Submandibular gland
3. Sublingual gland
4. Pituitary gland

Answer : 2

💡Sialolith appears in intraoral occlusal radiography as

1. Radiolucent
2. Radio-opaque
3. Does not appear
4. All of the above

Answer : 2

💡In Sjögren syndrome the sialograph appearance is of

1. Cherry blossom
2. Apple tree
3. Both a and b
4. None of the above

Answer : 3

💡Mucous retention cyst which occurs mainly in sublingual gland is

1. Ranula
2. Sialosis
3. Sialolith
4. None of the above

Answer : 1

💡Sialolith can be diagnosed with the help of

1. CT
2. Sialography
3. Sonography
4. All of the above

Answer : 4

💡Sjögren’s syndrome is

1. Herediatery disorder
2. Autoimmune disease
3. None of the above
4. Both a and b

Answer : 2

💡Salt and Pepper appearance of salivary gland is seen in

1. Parotitis
2. Pleomorphic Adenoma
3. Sjögren’s syndrome
4. Mucoepidermoid carcinoma

Answer : 3

💡Most common salivary gland tumor is

1. Mucoepidermoid carcinoma
2. Pleomorphic adenoma
3. Warthin’s tumor
4. Both b and c

Answer : 2

💡The only salivary gland affected in warthin’s tumor is

1. Submandibular salivary glands
2. Sublingual salivary glands
3. Parotid gland
4. Minor salivary glands

Answer : 3