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Clinical Problem Solving: Radiology
October 18, 2010

Radiology Quiz Case 1: Diagnosis

Author Affiliations
 

C. DOUGLASPHILLIPSMD

Arch Otolaryngol Head Neck Surg. 2010;136(10):1033. doi:10.1001/archoto.2010.157-b

Chronic sclerosing sialadenitis, or Küttner tumor, which was first reported by Küttner in 1896, is a benign chronic inflammatory condition of the submandibular glands. It occurs almost exclusively in the submandibular gland of middle-aged adults unilaterally or bilaterally, but rare involvement of the parotid gland, minor salivary gland, and lacrimal gland has been reported.13It is histologically characterized by periductal fibrosis, dense lymphocytic infiltration with lymphoid follicle formation, loss of acini, and, eventually, marked sclerosis of the salivary gland.4It usually manifests as a firm, enlarged gland, with recurring tenderness, unrelated to mastication, which might raise strong clinical suspicion of a malignant neoplasm. However, chronic sclerosing sialadenitis has been underrecognized by otorhinolaryngologists and radiologists, even though it is one of the most common causes of chronic sialadenitis of the submandibular gland.

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