A case with tuberculosis of parotid gland

Abstract

Parotis bezinin tüberkülozu oldukça nadir olup genellikle yavaş seyirlidir. Parotisin diğer kitlelerinden ayırt edilmeleri zor olup, klinik bulgular nonspesifiktir. Görüntüleme bulguları da spesifik olmayıp, tanı genellikle histopatolojik değerlendirme sonrasında konur. Bu makalede, sağ parotis bezi lojunda kitle ile başvuran 72 yaşındaki bayan hastayı sunduk. Bu şişlik 4 ay önce başlamış ve gittikçe büyümüştü. Muayenede sağ parotis bölgesinde yaklaşık 2 cm boyutlarında yarı hareketli kitle saptandı. Balgamda aside dirençli basil negatifti. Laboratuvar bulguları ve akciğer grafisi normaldi. Ultrasonografi ve manyetik rezonans görüntülemede parotis bezinde 2 cm boyutlarında heterojen kitle ve komşuluğunda lenf nodları tespit edildi. Parotis bezinden ve komşu lenfadenopatiden ince iğne aspirasyon biyopsisi yapıldı. Nonkazeifiye granülomlar görüldü, ancak basil üretilemedi. Antitüberküloz tedaviden fayda gören hasta parotis tüberkülozu olarak değerlendirildi.

Evaluation of tuberculous parotitis cases with the pooled analysis method

“…Extrapulmonary involvement is mostly observed in the kidneys, bone, meninx, and lymph nodes. [5,6] The most prevalent form of extrapulmonary involvement is tuberculosis of the head and neck region, which accounts for roughly 15% of all mycobacterial infections. It has been determined that approximately 70% of the parotid gland is involved when the salivary glands are primarily involved.…”

“…In parotid lesions, FNAB has a sensitivity of 81-100% and the specificity of 94-100%. [6,9] Other imaging modalities, such as ultrasound, CT, and MRI, are sensitive in detecting tuberculous lesions in the parotid gland, they are not specific. The majority of the imaging findings were found to be neoplasms.…”

“…When CT reveals linearly arrayed nodules in the superficial lobes of the glands in patients with unilateral parotid nodules, which is a pathognomonic finding, tuberculosis should be considered. [5,6,9] On MRI, lesions are usually observed as non-specific, homogeneous hypointense on T1-weighted images and hyperintense on T2-weighted images. [5,9,10] Since imaging findings are indistinguishable from neoplasms, surgical intervention, such as superficial parotidectomy, can usually be performed and the diagnosis made postoperatively.…”

“…[5,9,10] Since imaging findings are indistinguishable from neoplasms, surgical intervention, such as superficial parotidectomy, can usually be performed and the diagnosis made postoperatively. [6,10] Large necrotic masses or abscess formations can be treated with anti-tuberculosis medications, despite conventional clinical practice, with the exception of cases that are unresponsive to treatment. [11] Epithelial cells, giant cells and epithelioid granuloma structures with caseous necrosis are typical tuberculosis histological features.…”

“…[15] Researches on TP began in 1977, and by 1985, almost 100 new cases had been reported to the literature till 2003, mostly based on parotidectomy materials. [6,[16][17][18] In a retrospective study conducted by Vayıso¤lu et al [19] in our country, 48 patients with tuberculosis in the head and neck region were examined and their clinical findings, treatment methods, and treatment outcomes were evaluated between January 2000 and June 2009. Parotid gland tuberculosis was diagnosed in two (4%) cases.…”