A 75-year-old man presented with a history of painless and palpable submandibular masses, which he had noticed 1 month earlier. On physical examination, firm and slightly tender masses were palpated at both submandibular areas. The saliva was clear, and the results of a complete blood cell count and a routine serum chemistry profile were within normal ranges. Sonographic examination was performed. Both submandibular glands showed a lobular shape, and the echotexture was hypoechoic and heterogeneous (Figure 1). On color Doppler study, prominent vascularity of the branching pattern was observed (Figure 2). Both parotid glands showed no gross abnormality. A computed tomographic scan with intravenous contrast revealed bilateral enlargement of the submandibular glands, and there was no significant enhancement in either gland (Figure 3).
Lee H, Kim J, Kim S, Choi EC. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2010;136(10):1030. doi:10.1001/archoto.2010.157-a