Wednesday 29 March 2017

The CT and MRI Findings of Fibrinous Sialodochitis



Fibrinous sialodochitis is a very rare disease in which the recurrent swelling of the salivary gland is caused by the obstruction of the glandular duct by a fibrinous material. Few studies have reported both the computed tomography (CT) and magnetic resonance imaging (MRI) findings of fibrinous sialodochitis. We reported a forty-nine-year-old man with this disease including CT and MRI findings. His chief complaint was the recurrent swelling of the bilateral submandibular regions. When his primary dentist pushed them strongly, a whitish jelly-like material and a large amount of clear saliva were expelled from the duct orifices of the submandibular glands. A CT and MRI findings showed the retention of saliva in the glandular duct and no abnormal sign of the glandular parts. On a cytological examination, the material included fibrinous substances and numerous eosinophils. According to clinical, radiological and cytological findings, the patient was diagnosed with fibrinous sialodochitis. The management included the massage to compress the salivary glands, the administration of antihistamines and steroids, and irrigation of the ducts of submandibular glands using a saline solution. The number of times of the swelling of the submandibular regions decreased.

Fibrinous sialodochitis is a very rare disease. It is characterized by the recurrent swelling of the salivary gland, which is caused by the obstruction of the duct by a fibrinous material. When the salivary glands are compressed, a fibrinous material is expressed from the duct orifice, and the swelling disappears. To our knowledge, there were only sixteen case reports about fibrinous sialodochitis in the English literature. However, few studies have reported both the computed tomography (CT) and magnetic resonance imaging (MRI) findings of fibrinous sialodochitis. We herein present a case of fibrinous sialodochitis and report the CT and MRI findings.

A forty nine-year-old man was referred for the evaluation and treatment of recurrent swelling in the submandibular region from a general dental clinic to Osaka University Dental Hospital. His chief complaint was the recurrent swelling of the bilateral submandibular region over a one-year period. He did not have pain or fever. His medical and family histories were unremarkable. 

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