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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.1-3It 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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