Intraparotid Lymphadenopathy: Ultrasonographic and CT Findings

PURPOSE: The purpose of this study was to evaluate the ultrasonographic and CT findings of various diseases that affect the intraparotid lymph node. MATERIALS AND METHODS: The subjects were 32 patients having various diseases involving the intraparotid lymph node. The final confirmed diagnoses were nonspecified benign inflammatory lymphadenopathy (n=20), metastasis (n=5), tuberculous lymphadenitis (n=4), and lymphoma (n=3). For the nonspecified benign inflammatory lymphadenopathy, there were multiple lesions in five patients and bilateral lesions in two patients, and a total of 26 lesions were included in this study. The pathologic proof of the diagnosis was made for 4 of 26 lesions, and by ultrasound follow-up on 22 of 26 lesions. All the patients underwent ultrasound. Color Doppler imaging was also performed in 19 patients and contrast-enhanced CT was also performed in 8 patients. All cases with metastasis, tuberculous lymphadenitis and lymphoma were pathologically confirmed and these patients were all examined with contrast-enhanced CT. RESULTS: For the nonspecified benign inflammatory lymphadenopathy, all the lesions were seen at the superficial lobe. All twenty six lesions were observed as well-defined ovoid or round hypoechoic nodules with posterior sonic enhancement on ultrasonography. A central echogenic hilum was seen in 12 of 26 inflammatory lymphadenopathies (46%), and a central hilar vascularity was noted in 13 of 19 inflammatory lymphadenopathies (68%) on color Doppler imaging. Contrast-enhanced CT showed well-defined nodules with homogeneous enhancement in most lesions. In 3 lesions, a central low density hilum was seen within a lymph node. In 12 cases with metastasis, tuberculous lymphadenitis and lymphoma, there were multiple lesions in 6 cases. CT revealed intraparotid masses with or without central necrosis and the associated multiple lymph node enlargements in the ipsilateral neck region, and their appearances were similar to that of parotid mass. CONCLUSION: Nonspecified benign inflammatory lymphadenopathy involving intraparotid lymph nodes often demonstrated characteristic ultrasonographic findings, including a central echogenic hilum on gray scale US and central hypervascularity on color Doppler ultrasonography. In the metastasic lesions, the tuberculous lymphadenitis and the lymphomas, the multiplicity of lesions and the associated enlarged lymph nodes in the ipsilateral neck region could be helpful in the differential diagnosis.

Castleman's Disease in the Upper Extremity: A Case Report

Castleman's disease is a rare lymphoproliferative disorder of uncertain etiology which most commonly occurs in the mediastinum. We describe a case of a benign Castleman 's disease of the hyaline vascular type affecting the upper extremity, an extremely rare site of the disease.

Radiologic Findings of lymphoproliferative Disorders of the Lung

Lymphoproliferative disorders of the lung consist of a spectrum of several entities from malignant lymphoma to variable non-lymphomatous lymphoproliferative disorders. While an entity may be histologically benign and can be cured without treatment or by surgical removal, malignancy may evolve, and aggressive treatment may thus be required. Radiographic and pathologic findings of an entity may overlap, but differential diagnosis of lymphoproliferative disorders of the lung is nonetheless important. In this paper we illustrate a variety of lymphoproliferative diseases of the lung that have been pathologically proven during the last ten years, and discuss their radiographic and pathologic characteristics.

Dynamic CT Findings of Bilateral Castleman Disease in the Neck: A Case Report

We present a case of hyaline vascular type Castleman disease involving the bilateral cervical lymph nodes. To our knowledge, no previous case of this localized form of the disease has been reported. Dynamic CT demonstrated a hypervascular pattern of enhancement, with central less enhanced areas that corresponded histologically to fibrosis. For the diagnosis of this uncommon lymph node disease, these findings might be helpful.