Sonographically Guided Core Biopsy of A Parotid Mass
David C. Howlett1,
Leon J. Menezes2,
Khari Lewis1,
Andrew B. Moody2,
Nick Violaris3 and
Michael D. Williams2
1 Department of Radiology, Eastbourne District General Hospital, East Sussex
BN21 2UD, United Kingdom.
2 Department of Maxillofacial Surgery, Eastbourne District General Hospital,
King's Dr., Eastbourne, East Sussex BN21 2UD, United Kingdom.
3 Department of Ear, Nose and Throat Surgery, Eastbourne District General
Hospital, Eastbourne, East Sussex, BN21 2UD, United Kingdom.
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Fig. 1 —32-year-old woman with normal parotid gland. Longitudinal
sonogram shows main intraparotid vessels. Retromandibular vein (large
arrow) is superficial to external carotid artery (small arrow).
Facial nerve is not shown but passes just superficial to retromandibular vein.
Deep parotid lobe (D) is deep in relation to plane passing through path of
nerve, and superficial lobe (S) is superficial to this plane.
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Fig. 2A —68-year-old woman with painless, progressive parotid gland
enlargement and Sjögren's syndrome. Biopsy findings confirmed diagnosis
of non-Hodgkin's lymphoma complicating Sjögren's syndrome. Sonograms show
16-mm pseudocystic mass in tail of right parotid gland. Tip of biopsy needle
(arrow, A) is positioned so that on needle discharge with
15-mm setting of biopsy device, needle traverses but does not exit lesion.
Confirmation of needle placement is seen in B.
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Fig. 2B —68-year-old woman with painless, progressive parotid gland
enlargement and Sjögren's syndrome. Biopsy findings confirmed diagnosis
of non-Hodgkin's lymphoma complicating Sjögren's syndrome. Sonograms show
16-mm pseudocystic mass in tail of right parotid gland. Tip of biopsy needle
(arrow, A) is positioned so that on needle discharge with
15-mm setting of biopsy device, needle traverses but does not exit lesion.
Confirmation of needle placement is seen in B.
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Fig. 3 —48-year-old man with painless parotid mass. Sonogram of
pleomorphic adenoma shows rounded and circumscribed hypoechoic solid mass in
superficial lobe of parotid. Distal acoustic enhancement is evident.
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Fig. 4 —55-year-old man with painless slow-growing parotid mass.
Sonogram of Warthin's tumor shows circumscribed hypoechoic mass with
inhomogeneous internal architecture containing solid and prominent cystic
components.
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Fig. 5 —67-year-old woman with painless, rapidly enlarging parotid
mass. Sonogram of mucoepidermoid carcinoma shows ill-defined, hypoechoic mass
in superficial lobe of parotid gland. Lesion is of heterogeneous echotexture,
and distal acoustic shadowing is present. Sonographic features are those of
primary malignant tumor of parotid, although histologic subtypes cannot be
differentiated with sonography.
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Fig. 6 —70-year-old man with painless parotid gland enlargement.
Longitudinal sonogram shows diffuse involvement of parotid gland in
Sjögren's syndrome. Gland appears coarse and hypoechoic and contains
multiple small hypoechoic foci that are in keeping with sialectatic changes of
Sjögren's syndrome.
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Copyright © 2007 by the American Roentgen Ray Society.
