Cases reported "Parotid Diseases"

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1/284. Multiple oncocytic cysts with tyrosine-crystalloids in the parotid gland.

    A case of multiple oncocytic cysts with intraluminal tyrosine-rich crystalloids involving the parotid gland is described. The microscopic and ultrastructural findings are presented. ( info)

2/284. hiv-1 (p24)-positive multinucleated giant cells in HIV-associated lymphoepithelial lesion of the parotid gland. A report of two cases.

    BACKGROUND: Cystic benign lymphoepithelial lesion (CBLL) is a well-recognized parotid disorder the diagnosis of which can be made on the basis of clinical findings, human immunodeficiency virus (HIV) testing, image studies and fine needle aspiration (FNA). Most aspirations are cystic, and the lesion can be recognized if the triad of foamy macrophages, lymphoid and epithelial (squamous) cells is observed. CASES: The authors recently observed FNA cytologic features of two HIV-associated cases that exhibited numerous multinucleated giant cells (MGCs) but failed to show the epithelial component. A subsequent surgical resection was performed in one patient. Similarly to what has been described for nasopharyngeal (adenoid and tonsil) lymphoid tissue of HIV-positive patients, intense immunoexpression of S-100 and p24 (hiv-1) protein was present in MGC. CONCLUSION: The diagnosis of HIV-associated CBLL should always be considered if a parotid cystic lesion presents with numerous MGCs. Immunocytochemical detection of p24 (hiv-1) protein in MGC becomes a very useful diagnostic aid and extends to parotid CBLL many of those pathogenic features of hiv-1 infection already noted in other hiv-1-infected, lymphoid oropharyngeal lesions. ( info)

3/284. Intra-operative ultrasound-guided drainage of parotid abscess.

    parotitis complicated by parotid abscess remains a potentially life-threatening problem. Conventional surgical treatment involves incising the parotid parenchyma in the direction of the facial nerve until the abscess is located and evacuated. Intra-operative ultrasound greatly assists in localizing the abscess and in ensuring its complete drainage. Expeditious and exact localization of the abscess reduces operative time. Equally importantly, ultrasound-assisted drainage reduces surgical dissection and the potential for facial nerve damage. ( info)

4/284. HIV-associated parotid lymphoepithelial cysts.

    BACKGROUND: An outstanding feature of the diffuse infiltrative lymphocytosis syndrome, or DILS, a subset of hiv-1 disease, is asymptomatic bilateral parotid swelling. Recognition of the entity is important because people with this disease will seek routine dental care. CASE DESCRIPTION: The authors present a classic case of DILS. The patient exhibited bilateral parotid swellings caused by lymphoepithelial cysts, cervical lymphadenopathy, a CD8 circulating lymphocytosis and a CD8 lymphocytic infiltration into the labial salivary glands. A right superficial parotidectomy had been performed several years previously. However, no intervention was advised for the remaining left parotid because of its benign course. CLINICAL IMPLICATIONS: Since patients with DILS can develop lymphomas, periodic observation is mandatory. Any change in the growth pattern requires that a fine-needle aspiration biopsy be performed. ( info)

5/284. Bilateral and multicystic major salivary gland disease: a rare presentation of primary sjogren's syndrome.

    We present a case of a 15-year-old girl with bilateral parotid and sub-mandibular salivary gland enlargement as the sole presentation of primary sjogren's syndrome. The clinical, radiological, immunological and pathological features have been discussed. The relevant literature has been reviewed. To our knowledge this is the only reported case of sjogren's syndrome presenting as multicystic disease with bilateral major salivary gland involvement. ( info)

6/284. Postparotidectomy fistula: a different treatment for an old problem.

    There is little consensus on the optimal management of postparotidectomy salivary fistulas. Timely treatment is important since fistulas may result in wound dehiscence and infection. Management options include pressure dressings, total parotidectomy, tympanic neurectomy, graft interpositioning, surgical closure of the tract, radiation therapy, and pharmacotherapy. Unfortunately, many therapies require weeks to months for resolution and possess additional risks. The affected patient often suffers social embarrassment from the drainage. Through our work with neurologically impaired children with sialorrhea, we have had success with using glycopyrrolate, an anticholinergic frequently used to decrease salivary secretions. We present a case of a patient with a postparotidectomy fistula which was successfully treated with glycopyrrolate and pressure dressings. The rationale and potential use of glycopyrrolate for the treatment of a salivary fistula are the focus of this presentation. ( info)

7/284. Primary sialoangiectasia--a diagnostic pitfall in sjogren's syndrome: case report.

    A case of primary sialoangiectasia, which in this case was initially misdiagnosed as sjogren's syndrome, is described. Other diseases, including HIV infection, psoriatic arthritis, and acute parotitis, may cause glandular changes similar to the changes found in the syndrome. Therefore, sialography must be combined with other methods of assessment of the oral cavity when suspicion is high for sjogren's syndrome. Properly applied, sialography provides essential information regarding the severity of glandular damage and the progression of the disease. ( info)

8/284. Intravenous pyogenic granuloma mimicking pleomorphic adenoma in a fine needle aspirate. A case report.

    BACKGROUND: Intravenous pyogenic granuloma (IvPG) is a rare, benign lesion occurring usually as a subcutaneous mass in the neck or upper extremity. The cytologic features of IvPG have not been described before. CASE: A patient presented with a subcutaneous nodule on the lower border of the left parotid area. The clinical diagnosis was bronchial cleft cyst or lymphadenitis, and the fine needle aspiration diagnosis was pleomorphic adenoma. The tissue section, however, disclosed IvPG. CONCLUSION: Evaluation of subcutaneous nodules presenting cytologically as spindle cell lesions may be problematic, particularly in the neck and head region. Such lesions occurring in the parotid area may be interpreted as pleomorphic adenoma of the salivary gland. ( info)

9/284. Prophylactic antibiotics in recurrent parotitis in a patient with sjogren's syndrome.

    We describe a 41-year-old patient with primary sjogren's syndrome with a 16-year history of recurrent parotitis. The institution of prophylactic antibiotic coverage has succeeded, to date, in maintaining her in remission for 4 years. ( info)

10/284. eosinophilic granuloma (Kimura's disease) of the orbit: a case report.

    BACKGROUND: eosinophilic granuloma of the soft tissue, Kimura's disease, is a benign slow-growing tumor that is manifested clinically by one or more inflammatory nodules involving mainly the face and scalp, but rarely the eye. CASE REPORT: The patient was a 32-year-old male with swelling of the left lower eyelid, marked peripheral blood eosinophilia and increased serum immunogloblin E. MRI revealed swelling of all rectus muscles of the left eye, but no tumor mass. Corticosteroid treatment reduced the swelling of the eyelid, but it recurred after corticosteroid was discontinued. Eight years later the patient returned with a complaint of increased swelling of the left lower eyelid. An elastic, nontender, soft tumor mass was palpable subcutaneously in the left lower eyelid extending into the orbit. MRI revealed a tumor mass in the left orbital space. The parotid gland was also swollen and palpable. Both tumors were resected surgically, and histopathological study revealed prominent proliferation of lymphoid follicles with germinal centers showing interfollicular infiltration by eosinophils. The pathological findings in the parotid gland were similar. The diagnosis was Kimura's disease. CONCLUSION: This patient is unique in that he had no tumor at the first examination, only swelling of the rectus muscles, and a tumor mass appeared many years later. Unilateral swelling of the rectus muscles may be one of the first signs of Kimura's disease. Not only tumor but also swelling of the rectus muscles limited ocular movement. ( info)
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