mercoledì 11 novembre 2009

Bilateral parotid gland MALT lymphoma in a patient with Sjögren’s and sicca syndrome







Findings

CT Neck: Enlarged and cystic change of the bilateral parotid glands and submandibular glands without discrete enhancing mass.
MR neck: Diffuse cystic replacement and enlargement of the bilateral parotid glands (and to a lesser degree submandibular glands). No discreet enhancing parotid mass identified.

Differential diagnosis
- Non-Hodgkin's lymphoma parotid
- Benign lymphoepithelial lesions – HIV (BLL-HIV)
- Sarcoid
- Warthin tumor


Diagnosis: Bilateral parotid gland MALT lymphoma in a patient with Sjögren’s and sicca syndrome.



Key Points

Sjögren's syndrome is the second most common autoimmune disease after rheumatoid arthritis.
Sjögren's syndrome is a chronic autoimmune exocrinopathy causing salivary and lacrimal gland destruction.
Clinical: Recurrent acute episodes of glandular swelling (and dry eye, mouth, skin).
CT findings: Parotid enlargement, numerous cystic lesions, +/- punctuate calcifications
MR findings: Diffuse cystic lesions (T1 hypo, T2 hyper); heterogeneous mild enhancement of nodular parenchyma and fibrosis on T1+C, with non-enhancing cysts
Appearance of cysts helps in staging: Cysts 1-2 mm suggest Stage I or II disease. Larger cysts of > 2mm suggest Stage III, IV
Stages II-IV are readily seen on parotid US
Non-Hodgkin's lymphoma frequently complicates chronic Sjögren's parotid involvement
Bilateral parotidectomy in this patient was performed for recurrent infection / intractable pain and the surgical pathology showed bilateral MALT lymphoma

1 commento:

  1. HOW I GOT CURED OF HERPES VIRUS.

    Hello everyone out there, i am here to give my testimony about a herbalist called Dr Imoloa. i was infected with herpes simplex virus 2 in  2013, i went to many hospitals for cure but there was no solution, so i was thinking on how  i can get a solution out so that my body can be okay. one day i was in the pool side browsing and thinking of where i can get a solution. i go through many website were i saw so many testimonies about dr imoloa on how he cured them. i did not believe but i decided to give him a try, i contacted him and he prepared the herpes for me which i received through DHL courier service. i took it for two weeks after then he instructed me to go for check up, after the test i was confirmed herpes negative. am so free and happy. so, if you have problem or you are infected with any disease kindly contact him on email                      drimolaherbalmademedicine@gmail.com. or  / whatssapp --+2347081986098.
    This testimony serve as an expression of my gratitude. he also have
     herbal cure for, FEVER, BODY PAIN, DIARRHOEA, MOUTH ULCER, MOUTH CANCER FATIGUE, MUSCLE ACHES, LUPUS, SKIN CANCER, PENILE CANCER,  BREAST CANCER, PANCREATIC CANCER, CHRONIC KIDNEY DISEASE, VAGINAL CANCER, CERVICAL CANCER, DISEASE, JOINT PAIN, POLIO DISEASE,  PARKINSON'S DISEASE, ALZHEIMER'S DISEASE, BULIMIA DISEASE,   INFLAMMATORY JOINT DISEASE CYSTIC FIBROSIS,  SCHIZOPHRENIA, CORNEAL ULCER, EPILEPSY, FETAL ALCOHOL  SPECTRUM, LICHEN PLANUS, COLD SORE, SHINGLES, CANCER, HEPATITIS A, B.  DIABETES 1/2, HIV/AIDS, CHRONIC RESPIRATORY DISEASE,  CARDIOVASCULAR DISEASE,  NEOPLASMS, MENTAL AND BEHAVIOURAL DISORDER, CHLAMYDIA, ZIKA VIRUS, EMPHYSEMA, TUBERCULOSIS LOW SPERM COUNT, ENZYMA, DRY COUGH, ARTHRITIS, LEUKAEMIA, LYME DISEASE, ASTHMA, IMPOTENCE, BARENESS/INFERTILITY, WEAK ERECTION, PENIS ENLARGEMENT. AND SO ON.

    RispondiElimina