The CT Features of Parotid Tuberculosis_West China Medical Journal

Authors：

 ZHANGHong-jing ,  WEIYi , DENGKai-hong , XIAOJia-he , YANGXi-biao

Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

WEIYi, Email: weiyi_scu@hotmail.com

Keywords：

Parotid diseases; Lymph gland; Tuberculosis; Tomography; X-ray computed

DOI：

10.7507/1002-0179.20140626

Video：

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Objective To analyze the CT features of parotid tuberculosis, in order to increase the cognition and diagnostic level of the disease. Methods Nine cases of parotid tuberculosis confirmed by pathology and laboratory examinations between August 2009 and December 2012 were collected retrospectively, and we analyzed their CT features which were then compared with pathological findings. Results All the 9 cases involved unilateral parotid, among which 7 were on the left side and 2 on the right side. Eight cases were parotid lymph node tuberculosis located in parotid superficial lobe, including 3 cases of single lesion and 5 cases of multiple lesions. There were 30 lesions in total with diameters ranging from 0.5 cm to 4.5 cm, presenting slightly lower density on CT scan. Twenty-five lesions were moderate homogeneous enhancement; four lesions were ring-like enhancement; and one lesion was lace-like enhancement. Six cases of parotid lymph node tuberculosis had thickened platysma, and subcutaneous fat and skin were at different levels. Six cases in the group were accompanied with enlargement of cervical lymph nodes. One case of parotid gland essence tuberculosis involved its superficial and deep lobe diffusely presenting heterogeneous slightly low density, in which we could see some patchy low density and nodular calcification. All the parotid gland essence presented diffuse enhancement with irregular liquefactive necrosis, mildly swelling of adjacent platysma and fat, without enlargement of cervical lymph node. Conclusion CT signs of parotid tuberculosis are closely related to its pathologic changes. For the lesions in unilateral parotid superficial lobe, we should consider the diagnosis of parotid lymph node tuberculosis with the signs of homogeneous enhancement, thickness of close platysma, subcutaneous fat and skin, and enlargement of cervical lymph node.

Citation： ZHANGHong-jing, WEIYi, DENGKai-hong, XIAOJia-he, YANGXi-biao. The CT Features of Parotid Tuberculosis. West China Medical Journal, 2014, 29(11): 2081-2084. doi: 10.7507/1002-0179.20140626 Copy

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14.	羅敏, 魏懿, 肖家和. 腮腺淋巴結結核病的CT表現[J]. 中華放射學雜志, 2009, 43(11):1212-1214.
15.	施彥華, 古麗·阿不都克然木. 彩色多普勒超聲在腮腺結核診斷中的應用價值[J]. 中國現代醫生雜志, 2010, 48(23):87-94.
16.	Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging[J]. Radiology, 2000, 216(1):19-29.
17.	劉其順, 梁長虹, 黃飚等. 腮腺淋巴瘤的CT及MRI診斷[J]. 中華放射學雜志, 2005, 39(4):406-409.
18.	劉連生, 李恒國, 陳志強, 等. 腮腺少見病變的CT及MR診斷[J]. 中國臨床醫學影像雜志, 2011, 22(5):340-343.
19.	Penn R, Steehler MK, Sokohl A, et al. Nontuberculous mycobacterial cervicofacial lymphadenitis-a review and proposed classification system[J]. Int J Pediatr Otorhinolaryngol, 2011, 75(12):1599-1603.

1. 賈志鶯, 張連花. 涎腺結核6例的聲像圖表現及分析[J]. 中國超聲醫學雜志, 2009, 25(4):424-425.
2. Franzen A, Franzen CK, Koegel K. Tuberculosis of the parotid gland:a rare differential diagnosis of parotid tumor[J]. Laryngorhinootologie, 1997, 76(5):308-311.
3. Coen LD. Tuberculosis of the parotid gland in a child[J]. J Pediatr Surg, 1987, 22(4):367-368.
4. Silvers AR. Som PM. Salivary glands[J]. Radiol Clin North Am, 1998, 36(5):941-966.
5. Erkan AN, Cakmak O, Kayaselcuk F, et al. Bilateral parotid gland tuberculosis[J]. Eur Arch Otorhinolaryngol, 2006, 263(5):487-489.
6. 唐晨虎, 馬東, 姜加學. 腮腺結核的CT診斷[J]. 實用醫技雜志, 2005, 12(18):2532-2532.
7. Zheng JW, Zhang QH. Tuberculosis of the parotid gland:a report of 12 cases[J]. J Oral Maxillofac Surg, 1995, 53(7):849-851.
8. Wong ML, Jafek BW. Cervical mycobacterial disease[J]. Trans Am Acad Ophthalmol Otolaryngol, 1974, 78(2):75-87.
9. Sethi A, Sareen D, Sabherwal A, et al. Primary parotid tuberculosis:varied clinical presentations[J]. Oral Dis, 2006, 12(2):213-215.
10. Wei Y, Xiao JH, Pui MH, et al. Tuberculosis of the parotid gland:computed tomographic findings[J]. Acta Radiol, 2008, 49(4):458-461.
11. Reede DL, Bergeron RT. Cervical tuberculous adenitis:CT manifestations[J]. Radiology, 1985, 154(3):701-704.
12. Kim YH, Jeong WJ, Jung KY, et al. Diagnosis of major salivary gland tuberculosis:experience of eight cases and review of the literature[J]. Acta Otolaryngol, 2005, 125(12):1318-1322.
13. 葛江梅, 龐偉強, 田培林. 頸部淋巴結結核的CT表現[J]. 醫學影像學雜志, 2004, 14(7):536-538.
14. 羅敏, 魏懿, 肖家和. 腮腺淋巴結結核病的CT表現[J]. 中華放射學雜志, 2009, 43(11):1212-1214.
15. 施彥華, 古麗·阿不都克然木. 彩色多普勒超聲在腮腺結核診斷中的應用價值[J]. 中國現代醫生雜志, 2010, 48(23):87-94.
16. Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging[J]. Radiology, 2000, 216(1):19-29.
17. 劉其順, 梁長虹, 黃飚等. 腮腺淋巴瘤的CT及MRI診斷[J]. 中華放射學雜志, 2005, 39(4):406-409.
18. 劉連生, 李恒國, 陳志強, 等. 腮腺少見病變的CT及MR診斷[J]. 中國臨床醫學影像雜志, 2011, 22(5):340-343.
19. Penn R, Steehler MK, Sokohl A, et al. Nontuberculous mycobacterial cervicofacial lymphadenitis-a review and proposed classification system[J]. Int J Pediatr Otorhinolaryngol, 2011, 75(12):1599-1603.

West China Medical Journal

The CT Features of Parotid Tuberculosis

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