A 61-year-old woman had a three-year history of periodic swelling of the right parotid gland associated with a dull aching pain and xerostomia but no fever or facial nerve dysfunction. The swelling was responsive to 4 mg/ day of methylprednisolone. There were no ophthalmic or arthritic complaints. The parotid sialogram showed punctate sialectasis (Fig 1). The medical history is pertinent in that the patient had a right radical mastectomy with axillary node dissection five years before for adenocarcinoma of the right breast. She has been observed, with no evidence of recurrence.
Physical examination disclosed a diffusely enlarged left parotid gland without a discrete mass. There was no neck or axillary adenopathy. The left breast was normal, and the pelvic examination revealed no abnormality.
A needle aspirate of the left parotid gland indicated increased numbers of lymphocytes. We believed her response to steroids, her history of xerostomia, and the results of