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Lumps and swellings of the salivary glands 1
Published on February 28, 2017 35 min
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I'm professor John Langdon. I was professor of Maxillofacial surgery at King's College London until I retired a few years ago.
I'm going to be talking to you about swellings and lumps that arise in the salivary glands. I think the best way is to go through the normal pathological sieve as you can see on this slide.
We'll start off with the developmental anomalies. Within the context of lumps and swellings, there are two to consider. One is aberrant tissue, it's very, very important to realize that from time to time you get enclaves of salivary gland tissue trapped in the lymph nodes in the neck. Now these can cause great confusion, when you're examining necks and you find lymphadenopathy, particularly in a patient with the history of malignant disease because, of course, you think it's metastatic lymphadenopathy. Whereas, it can on occasion not commonly, but it can on occasion be normal entrapped salivary gland tissues, so that's an important point on differential diagnosis. The other important thing to be aware of it is the accessory ducts with their associated accessory salivary gland lobes.
This is an old-fashioned conventional parotid sialogram. And if you look up the left hand image, look out the horizontal part of the main duct halfway along the horizontal duct, you will see it going often northwards a tributary and accessory duct which leads to an accessory lobe parotid salivary gland. Now I have seen these present with tumors. And, of course, if you get a tumor in that sight, it presences a lump in the cheek, quite far forwards on the face, not in the position you would classically expect a parotid gland swelling. Again, it's important to be aware of this.