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
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.