Presentation
Bilateral parotid swelling
Patient Data
Diffuse homogeneous enlargement of both parotid gland is seen, particularly involving the superficial lobes. The adjacent masseter muscles also appear infiltrated.
FNA Histology
MICROSCOPIC DESCRIPTION:
The smears are mildly cellular and contain scattered macrophages and lymphoid cells presenting as dispersed cells and small clusters. Also present is a large cluster of epithelioid cells (granuloma) and scattered multinucleate giant cells throughout, in a background of blood. One small salivary gland acinus is included. No malignant cells are identified.
DIAGNOSIS:
FNA Left Parotid: Non-necrotizing granulomatous inflammation. Negative for malignancy. Features favor sarcoidosis.
Case Discussion
Key learning points:
1. Causes of bilateral parotid swelling include: acute and chronic infection including viral parotitis, lymphoma, Sjogren's and sarcoidosis.