3cm unilocular cystic lesion within the superficial portion of the right parotid gland. This contains a small amount of debris on the ultrasound images and is of homogeneous high T2 signal and of intermediate T1 signal.
12mm mixed solid cystic lesion inferiorly in the right parotid gland. Multiple other small less than 5 mm lesions within the bilateral parotid glands some of which are cystic and others of which are more compatible with intra-parotid lymph nodes.
Features of lymphoid hyperplasia with enlargement of the palatine and lingual tonsils and prominent cervical lymph nodes.
The appearances are suspicious for HIV infection with benign lymphoepithelial lesions of the parotids and lymphoid hyperplasia. The larger cyst debris and intermediate T1 signal is perhaps the result of recent haemorrhage.
Sjogren's disease would be the major differential diagnosis however the patient gender and normal appearance of the submandibular glands makes this less likely.
This patient was subsequently tested and found to be HIV positive.