© 2016 The Korean Academy of Medical Sciences.
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pISSN 1011-8934 eISSN 1598-6357
Isolated Parotid Gland Sarcoidosis Mimicking Parotid Tumor
Dong Hoon Lee,1 Jo Heon Kim,2 and Joon Kyoo Lee1
1Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea;
2Department of Pathology, Chonnam National University Medical School & Chonnam National University Hwasun Hospital, Hwasun, Korea http://dx.doi.org/10.3346/jkms.2016.31.4.644 • J Korean Med Sci 2016; 31: 644-645
A 49-year-old female presented to our department with right infra-auricular swelling present for more than 3 weeks. The pa- tient’s medical history was not remarkable. The patient had no fever, cough, stridor, dyspnea, shortness of breath, rash, and dryness of mouth or eyes, weight loss, convulsions, or previous hospital admissions. The family history was unremarkable.
Physical examination revealed a solitary, firm, non-tender, mo- bile, and approximately 2-cm sized mass of the right parotid gland. The overlying skin was normal in appearance without erythema or induration. The patient had no cranial nerve defi- cits and no cervical lymphadenopathy. Computed tomography (CT) scan of the neck demonstrated about 2.2 × 2.1 × 2.2 cm heterogeneously enhancing mass in the right parotid gland (Fig.
1A). Fine-needle aspiration cytology (FNAC) under ultrasound showed chronic granulomatous inflammation. Based on these observations, the preoperative diagnosis was a right-side parot- id tumor.
We performed the superficial parotidectomy with preserving
facial nerve through a standard ‘lazy S’ cervico-mastoid preau- ricular surgical incision. The post-operative course was unevent- ful. The histopathological analysis of the parotid mass demon- strated non-necrotizing granulomatous inflammation sugges- tive of sarcoidosis (Fig. 1B). Staining of the excised tissues was negative for acid-fast bacilli, and special stains for mycobacteria and fungus revealed no microorganisms. We consulted a pul- monologist and ophthalmologist. Ophthalmologic examina- tions and radiologic examinations (chest and abdomen CT) re- vealed no evidence of lung sarcoidosis. The final diagnosis made was parotid gland sarcoidosis. The patient has been regularly followed up usually every 6 months with ophthalmologic and radiologic examinations to check for occurrence of sarcoidosis.
Ethics statement
The authors obtained approval from the institutional review board of Chonnam National University Hwasun Hospital (CN UHH-2016-005).
IMAGES IN THIS ISSUE
Otorhinolaryngology
Fig. 1. Supportive findings for diagnosis of the patient. (A) Neck CT scans demonstrate a 2.2 × 2.1 × 2.2 cm heterogeneously enhancing mass (arrow) in the right parotid gland.
(B) Histological examination of the specimen reveals non-necrotizing coalescing granulomas, composed of epithelioid cells and scattered multinucleated giant cells (arrow). The multinucleated giant cells are of Langhans type. Mature lymphoplasma cells form a concentric rim around the granuloma. Granulomatous inflammation irregularly infiltrates normal salivary parenchyma and peri-parotid soft tissue (Hematoxylin and eosin stained, × 100).
A B
Lee DH, et al. • Isolated Parotid Gland Sarcoidosis
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http://dx.doi.org/10.3346/jkms.2016.31.4.644
DISCLOSURE
The authors have no potential conflicts of interest to disclose.
AUTHOR CONTRIBUTION
Study concept and design: Lee DH. Data collection and analy- sis: Kim JH. Drafting of manuscript and critical revision: Lee DH, Lee JK. Revision: Kim JH. Approval of final version of man- uscript: all authors.
ORCID
Dong Hoon Lee http://orcid.org/0000-0001-9288-5368 Jo Heon Kim http://orcid.org/0000-0002-2207-6693 Joon Kyoo Lee http://orcid.org/0000-0002-7542-9616
Address for Correspondence:
Joon Kyoo Lee, MD
Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do 58128, Korea E-mail: [email protected]
