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Bilateral Parotid Masses
Images of a 39-year-old man ( A, computed tomography [ CT ]) and a 30-year-old man ( B and C, magnetic resonance imaging) with incidental parotid lesions. Ax, axial; Cor, coronal; SPGR, spoiled gradient.
A 54-year-old woman ( A, computed tomography [ CT ]) and a 39-year-old woman ( B and C, magnetic resonance imaging) with chronic dry eyes and mouth. Ax, axial; Cor, coronal.
A 66-year-old man ( A to C, computed tomography [ CT ]) and a 68-year-old woman ( D and E, magnetic resonance imaging) presenting with palpable parotid masses. Ax, axial; Cor, coronal; Tc, technetium.
A 59-year-old man ( A and B ) and a 71-year-old man ( C and D ) with multilevel, enlarging, bilateral neck masses. Ax, axial; Cor, coronal; CT , computed tomography.
DESCRIPTION OF FINDINGS
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Cases A and B demonstrate entities that commonly present with cystic lesions.
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Case A demonstrates several bilateral, fluid-attenuated, large (>10 mm), parotid, cystic-appearing lesions following fluid signal by MRI.
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Case B demonstrates innumerable small (1 to 3 mm), fluid-attenuated cysts present diffusely throughout the bilateral glands.
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Cases C and D demonstrate entities with typically solid-appearing lesions.
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Case C demonstrates large, bilateral, solid, enhancing lesions, many of which are found in the parotid tail. A technetium-pertechnetate study shows prompt uptake of radiotracer by these masses.
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Case D demonstrates numerous bilateral parotid masses with marked multilevel cervical chain lymphadenopathy.
Diagnosis
Case A
Lymphoepithelial cysts (HIV)
Case B
Sjögren syndrome
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