Enlarged parotid lymph node
Nodule in left parotid region - 2 wks. No significant pain.
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A hypoechoic ovoid well-defined lesion is noted in superficial lobe of left parotid gland.
Size 21 x 17 x 9 mm.
Hilum with vascularity is noted within the lesion favouring lymph node.
Surrounding cortex is asymmetrically thickened.
A smaller hypoechoic nodule is noted in superficial lobe of right parotoid gland.
Size - 8 mm.
Central hilum and vascularity are present.
Bilateral submandibular gland and sublingual glands are normal.
No other abnormality is noted in neck ultrasound.
Findings favour enlarged intraparotid node in superficial lobe of left parotid gland. Normal gland shows presence of nodes; however, this one was big enough to be called abnormal. A smaller node is seen on right side.
Excision biopsy of left parotid gland lesion. Histopathology - Granulomatous lesion. Differential diagnosis given was sarcoidosis and tuberculosis.
Test for sarcoidosis - ACE (Angiotensin converting enzyme ) - negative.
Aetiology now presumed to be tuberculosis, which is common in the patient's geographic area.