Vol.95 No.6 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 6 June 2002
Bilateral Enlargement of the Submandibular Glands
-Clinical and Pathological Appearance-
Toshio Yoshihara
(Tokyo Women's Medical University)
Diseases showing bilateral enlargement of the submandibular glands were evaluated with respect to their clinical and histological features. It is well known that sialolithiasis is one of the most common diseases causing submandibular gland enlargement. Pleomorphic adenoma is also a common tumor of submandibular gland origin. These diseases usually cause unilateral swelling of the gland. This report describes several diseases affecting both glands, as follows: mumps, sialodochitis fibrinosa, Küttner's tumor, Mikulicz syndrome, sialadenosis, sialolithiasis, malignant lymphoma and amyloidosis. Sialodochitis fibrinosa is charaterized by white jelly-like material obtained from Wharton's duct containing numerous eosinophils. Most cases of sialadenosis show parotid gland swellings, however, those associated with anorexia nervosa cause swellings predominantly in the submandibular gland. Malignant lymphoma is a rare tumor arising in the parotid and/or submandibular glands. Our cases resembled Küttner's tumor or sialadenosis on palpation of the glands. Patients with amyloidosis were initially suspected of having Küttner's tumor because very few patients visiting ENT clinics have bilateral gland swelllings caused by amyloidosis. Therefore, the differential diagnosis of bilateral submandibular enlargement is often difficult. In accordance with each case, careful examinations are needed using ultrasonograms, sialograms, RI scintigrams, CT scans, MRI and blood tests. When necessary, we add FNA or open biopsy.
Key words : submandibular gland, sialodochitis fibrinosa, Küttner's tumor, sialadenosis, amyloidosis