Presentation
Recurrent left parotid swelling of 2 years duration.
Patient Data
The left parotid gland is enlarged, with multiple diffuse tiny cystic lesions less than 4 mm in size. The gland parenchyma is hyperenhancing compared to the other side. Features are suggestive of juvenile recurrent parotitis.
Multiple bilateral enlarged upper cervical lymph nodes, with preserved oval shape and central fatty hilum, larger on left side, likely reactive upper cervical lymph nodes.
Normal MR appearance of the right parotid gland.
Mild enlarged nasopharyngeal adenoid, encroaching upon the nasopharyngeal airway.
Concentric mucosal thickening of both maxillary, right sphenoid sinuses and ethmoid air cells.
Case Discussion
The patient has recurrent left parotid swelling of 2 years duration (more than 13 times). Previous ultrasound showed an enlarged heterogeneous left parotid gland with multiple rounded hypoechoic foci seen scattered in its parenchyma and increased vascularity on Doppler study. The condition is associated with bilateral reactive deep cervical lymph nodes.
The patient also has a known history of alpha thalassemia, which can be a sort of immunodeficiency as an association with the condition.
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