Necrotizing sialometaplasia (NS) is a benign, self-limiting inflammatory reaction of salivary gland tissue which may mimic squamous cell carcinoma or mucoepidermoid carcinoma, both clinically and histologically, that creates diagnostic dilemma leading to unwarranted aggressive surgery. Most commonly affected site is the minor salivary glands of the palate. The pathogenesis is unknown but is believed to be due to ischemia of vasculature supplying the salivary gland lobules. A simple incisional biopsy is required to confirm the histological diagnosis and to rule out more serious disease processes. It is a self-limiting disease process and requires no treatment. It will be prudent to do repeat biopsy in case if the lesion does not heal within 3 months.
Sialoliths are calcified organic matter that is formed within the secretory system of the major salivary glands which commonly affects the submandibular gland or its duct and frequently causes acute and chronic infections. In recent years, advanced imaging techniques have improved the sensitivity of imaging diagnosis of diseases involving the major salivary glands. Various imaging methods like plain radiography, sialography, Ultrasound (US), Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Cone Beam Computed Tomography (CBCT) and nuclear scintigraphy/Positron Emission Tomography (PET) play a important role in diagnosis and planning the management, operative or otherwise. This article reviews a case report of a patient presenting with Sialolithiasis of right Wharton's duct with secondary acute bacterial sialadenitis in right submandibular salivary gland and methods used for imaging.
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