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Wk 9, Case 4 - Review

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Patient History
Multiple parotid cysts identified on prior brain MRI.

Findings
Contrast-enhanced MRI of the neck was performed from the skull base to the thoracic inlet. The study demonstrates multiple intraparotid cysts which involve both the bilateral parotid glands and accessory parotid glands overlying the masseter muscles. These findings are consistent with diffuse sialectasis and could be due to systemic rheumatologic or immunologic abnormality such as Sjogren's disease. Bilateral sialectasis can also be idiopathic or postinfectious. No evidence of aggressive enhancing intraparotid masses are identified. Submandibular glands appear to be within normal limits. Lacrimal glands appear to be slightly atrophic.

Imaging of the neck demonstrates no evidence of enlarged cervical lymph nodes using standard size criteria.

No evidence of aggressive lesions are identified involving the nasopharynx, oropharynx, oral cavity, larynx or hypopharynx.

Reidentified is encephalomalacia involving the mesial left temporal lobe likely due to prior surgery.

C6 through T1 partial congenital vertebral body partial fusion.

Conclusions
1. Bilateral parotid sialectasis likely due to rheumatologic or immunological abnormality and should be correlated with relevant history.
2. No evidence of enlarged lymph nodes using standard size criteria.

Case Discussion

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Suresh K Mukherji, MD, FACR, MBA

Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging

Tags

Neuroradiology

MRI

Head and Neck

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