Fact-sheet: Sialadenitis


Updated on 10/03/2018 at 8:53 AM

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Definition

Acute sialadenitis: acute inflammation of the parotid gland.

Main infectious inflammatory pathology of the salivary gland: mumps. No indication for imaging.

other:

- viral or bacterial sialadenitis

- chronic sialadenitis

- tuberculous sialadenitis

Clinical features

Bilateral pain and swelling of the parotid regions.
Cervical lymphadenopathy.

Laboratory findings

Infectious syndrome

Radiography

Contraindication to sialography!

Ultrasound

First-line examination: does not allow evaluation of the deep lobe of the parotid gland

Look for an obstructive cause.

  • Increased glandular volume
  • Heterogeneous hypoechogenicity.
    Hypervascularization on Doppler.
  • +/- ductal dilation

Complication: abscess, obstruction, gas bubbles (cellulitis)

CT

- Unenhanced slices allow assessment of parotid lithiasis, which is frequently radiolucent and not visible on standard radiographs

- In cases of inflammatory pathology, a contrast-enhanced cervical CT allows detection of an associated abscess or cellulitis

MRI

Diffusion-weighted sequence: differential diagnosis of abscess vs necrotic tumor (ADC drop within the abscess).
Chronic sialadenitis: MR sialography --> acinar dilations +/- strictures +/- lithiasis.

Management

Medical treatment.
Pulmonary complications in 25% of chronic sialadenitis cases.

Classification

  • Acute sialadenitis
  • Chronic sialadenitis: heterogeneous appearance of the gland, possibly hypotrophic, with punctate hypoechoic areas --> acinar dilations.

Differential diagnosis

Tuberculous parotid sialomegaly.
Sialitis.
Gland infection.
Concomitant pseudotumoral intraparotid cystic adenitis.