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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1. 贾志莺, 张连花. 涎腺结核6例的声像图表现及分析[J]. 中国超声医学杂志, 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, 马东, 姜加学. 腮腺结核的CT诊断[J]. 实用医技杂志, 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, 庞伟强, 田培林. 颈部淋巴结结核的CT表现[J]. 医学影像学杂志, 2004, 14(7):536-538.
14. 罗敏, 魏懿, 肖家和. 腮腺淋巴结结核病的CT表现[J]. 中华放射学杂志, 2009, 43(11):1212-1214.
15. 施彦华, 古丽·阿不都克然木. 彩色多普勒超声在腮腺结核诊断中的应用价值[J]. 中国现代医生杂志, 2010, 48(23):87-94.
16. Yousem DM, Kraut MA, Chalian AA. Major salivary gland imaging[J]. Radiology, 2000, 216(1):19-29.
17. 刘其顺, 梁长虹, 黄飚等. 腮腺淋巴瘤的CT及MRI诊断[J]. 中华放射学杂志, 2005, 39(4):406-409.
18. 刘连生, 李恒国, 陈志强, 等. 腮腺少见病变的CT及MR诊断[J]. 中国临床医学影像杂志, 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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