Presentation
Nodule in left parotid region for 2 weeks. No significant pain.
Patient Data
A hypoechoic ovoid well-defined lesion is noted in the superficial lobe of left parotid gland.
Size 21 x 17 x 9 mm.
Hilum with vascularity is noted within the lesion favoring lymph node.
Surrounding cortex is asymmetrically thickened.
A smaller hypoechoic nodule is noted in the superficial lobe of right parotid 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.
Case Discussion
Findings favor 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.
Etiology now presumed to be tuberculosis, which is common in the patient's geographic area.