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Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 689-690
Tuberculosis of parotid gland - a case report


85 Avittom Road, Medical College, Post Thiruvananthapuram-11, India

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Date of Submission18-Feb-2006
Date of Acceptance10-Oct-2006
 

Keywords: Parotid, tuberculosis

How to cite this article:
Alex L, Balakrishnan M, Ittyavirah A K. Tuberculosis of parotid gland - a case report. Indian J Radiol Imaging 2006;16:689-90

How to cite this URL:
Alex L, Balakrishnan M, Ittyavirah A K. Tuberculosis of parotid gland - a case report. Indian J Radiol Imaging [serial online] 2006 [cited 2020 Dec 4];16:689-90. Available from: https://www.ijri.org/text.asp?2006/16/4/689/32300

   Introduction Top


Although tuberculosis is rampant in India, tuberculous infection of parotid gland is uncommon [1]. Kant and associates in 1977 reported 35 cases,[2] and Yaniv and Avedillo added 2 more cases in 1985[3]. Sharma K. reported yet another case of parotid tuberculosis in 1996 [4].


   Case Report Top


27 years old female patient presented with swelling right cheek of 2 years duration with rapid increase in size over a period of 3 months. There was no associated pain or fever.

Haematological parameters were within normal limits. Ultrasound evaluation showed enlarged parotid with an isoechoic to hyperechoic lesion. Doppler showed no significantly increased vascularity in the focal lesion. On CT study, 2cm hyperdense lesion was seen in right parotid gland. The lesion showed enhancement with contrast [Figure - 1]. No significantly enlarged cervical lymphnodes were seen. FNAC was done, but it was inconclusive.

Patient underwent right facial nerve sparing subtotal parotidectomy. Few small deep cervical lymphnodes were also removed. Peroperative diagnosis was parotid tumor.


   Histopathology Top


Gross section showed an intraparotid enlarged node [Figure - 2]. Granulomatous sialadenitis with caseating granulomatous lymphadenitis was established on histopathology. suggesting tuberculosis [Figure - 3]. The upper deep cervical lymph nodes also showed evidence of granulomatous lymphadenitis.

Tb IgM estimation done later was positive with positive tuberculin test. Chest X-ray was within normal limits.


   Discussion Top


Tuberculosis of salivary gland is rare. Granulomatous lesion may present as localized nodule and can make diagnosis difficult. The source of infection in parotid tuberculosis is controversial. There are different postulations on the source of infection in parotid tuberculosis. Extension of infection along Stenson's duct from the oropharynx and vascular mode of spread from primary focus in the body or through wounded oral mucosa are some of the postulations. According to Berman and Fein, spread by lymphatic vessels, particularly from infected tonsils and external auditory canal, plays an important role [5].

With respect to the types of mycobacteria involved, bovine strains have been considered important etiologic agent with or without preliminary involvement [3]. The causative role of atypical mycobacteria in infection is remote.

If the diagnosis is made preoperatively, parotid tuberculosis can be treated with antitubercular drugs only otherwise, full course of antitubercular therapy to be given after parotidectomy. Though rare, the possibility of tuberculosis may be considered as a differential diagnosis in parotid lesions too, because early diagnosis and treatment are mandatory.


   Acknowledgement Top


Dr. Valsalakumari, Consultant Pathologist, Sree Uthradom Thirunal Hospital, Trivandrum.

 
   References Top

1.Ustuner TE, Sensoz O, Kocer U; Primary tuberculosis of parotid gland. Plast Reconser Surg 1991; 88: 884-885.  Back to cited text no. 1    
2.Kant R, Sahi RP, Mahendra NN; Primary tuberculosis of parotid gland. J. Indian Med Assoc 1977; 68: 212.  Back to cited text no. 2    
3.Yaniv E, Avedillo H; Parotid tumor as a presenting symptom of tuberculosis. A report of 2 cases. S Afr Med J 1985; 68: 613.  Back to cited text no. 3    
4.Sharma K ; Tuberculosis of the parotid gland. Canadian J. of Surg. 1996; 39: 253-254.  Back to cited text no. 4    
5.Berman M, Fein MJ; Primary tuberculosis of parotid gland. Ann. Surg. 1932; 95: 52-57.  Back to cited text no. 5    

Top
Correspondence Address:
L Alex
85 Avittom Road, Medical College, Post Thiruvananthapuram-11
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32300

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    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]

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    Introduction
    Case Report
    Histopathology
    Discussion
    Acknowledgement
    References
    Article Figures

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