In this review the high resolution ultrasound appearances of the normal anatomy and pathology involving the submandibular gland are demonstrated. The submandibular gland is affected by a number of disease processes that may be difficult to distinguish clinically. Its superficial location makes it ideal for ultrasound evaluation and a useful adjunct to clinical examination. In the assessment of submandibular pathology ultrasound allows intraglandular and extraglandular lesions to be localized and differentiated. These lesions can be further characterized as being benign or malignant and the extent of any extraglandular extension determined. Ultrasound is the first-line investigation in the assessment of sialolithiasis due to its high specificity and sensitivity. In severe infective sialadenitis ultrasound can confirm the presence and guide drainage of abscesses. Ultrasound also has an important role in the assessment of chronic inflammatory disorders such as sarcoidosis and Sjogren's syndrome.
Sonographically guided core biopsy is a highly accurate technique for evaluation of parotid lesions and can be safely performed as an outpatient procedure. Sonographically guided core biopsy has potential advantages over fine-needle aspiration cytologic examination, particularly in the typing and grading of lymphoma and carcinoma and in improved differentiation of reactive nodal hyperplasia from lymphoma. The use of sonographically guided core biopsy may help reduce the need for surgical biopsy and facilitates prompt referral to the appropriate clinical team.
Extramedullary plasmacytoma is a rare plasma cell neoplasm that can occur in the head and neck. In this article we describe a case of multiple synchronous extramedullary plasmacytomas involving the Lipper airway, pharynx, and larynx. The clinical, imaging, and pathologicfeatures of this neopla sm are discussed, together with potential treatment options.
IntroductionExtramedullary plasmacytomas are rare neoplasms that occur in soft tissues at single and multiple sites.'? Most extramedullary plasmacytomas occur in the upper aerodigestive tract and oral cavity. In this report we describe the clinical, imaging, and pathologic features and report a case in which multiple lesions involved the upper airway and pharynx.
Case reportA 71-year-old man presented with a 6-month history of a hoarse voice. He had no other symptoms , and the initial clinical examination was unremarkable . Microlaryngoscopy revealed a mucosal nodule on the soft palate with several other nodules present in the left and right supraglottic regions (figure 1).Biopsies were taken from a left supraglottic nodule, which demonstrated the replacement of the submucosal stroma with dense sheets of plasma cells. On immunohistochemical staining, these cells showed kappa immunoglobulin
We report 2 cases of mucosa-associated lymphoid tissue lymphoma of the salivary glands, complicating Sjögren's syndrome. The sonographic and histological features are described in depth. The use of sonography as a diagnostic aid in such patients is discussed.
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