Sialosis or sialadenosis (plurals: sialoses or sialadenoses) refers to diffuse, non-inflammatory, non-neoplastic recurrent/persistent enlargement of the major salivary glands, caused by hypertrophy of the acinar components. Typically, the parotid gland is most affected, although submandibular gland enlargement is not uncommon.
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Pathology
It is uncommon and has a variety of systemic causes:
endocrine: diabetes mellitus, hypothyroidism, Cushing syndrome
metabolic: alcohol use, anorexia, bulimia, obesity, malnutrition
gastrointestinal: liver disease, coeliac disease
neurogenic: dysautonomia, multiple system atrophy
iatrogenic: anticholinergic drugs, antihypertensives, heavy metals, psychotropic drugs
others: depression
The commonest causes are diabetes mellitus (50% of sialosis cases 3) and alcohol use, but some cases have no known underlying systemic disease.
Radiographic features
Sialography
sparse peripheral ducts
Ultrasound
enlarged, hyperechoic salivary glands, most often parotid and bilateral, without focal lesions or increased blood flow
CT
a normal or enlarged gland
normal density throughout most of the disease
end stage glands may be diffusely dense and large
greater fatty infiltration in diabetic sialadenosis
reduction of fatty tissue in alcoholic sialadenosis
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