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Tuberculosis of the parotid gland: histology surprise.

Errami N, Benjelloun A, Tahtah N, Hemmaoui B, Jahidi A, Nakkabi I, Zalagh M, Benariba F - Pan Afr Med J (2015)

Bottom Line: The Parotid gland is rarely involved in tuberculosis, even in endemic countries.We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge.Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution.

View Article: PubMed Central - PubMed

Affiliation: Ear Nose and Throat unit, Mohammed V Military Hospital, Rabat, Morocco.

ABSTRACT
The Parotid gland is rarely involved in tuberculosis, even in endemic countries. We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge. Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution. We discuss both diagnostic and therapeutic modalities for this infection.

No MeSH data available.


Related in: MedlinePlus

Mass of the left parotid lodge
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Figure 0001: Mass of the left parotid lodge

Mentions: A 26 year-old woman with no medical history of personal or family tuberculosis was admitted for a left sub-mandibular swelling which had appeared 12 months earlier. It began small then gradually increased in volume without alteration of the general condition. Many broad-spectrum antibiotics were attempted without any improvement. Examination showed a 5 cm painless, elastic left parotid mass, adherent to the skin and deeper layers, with mild inflammation of the overlying skin but without fistula or facial paralysis (Figure 1). Moreover, we found ipsilateral sub-mandibular lymphadenopathies. The contralateral parotid region was unremarkable. Otoscopy was normal and oral cavity examination showed neither left tonsillar deviation nor purulent secretions from the left Stensen's duct. The MRI showed a 4.6 cm, irregular and heterogeneous tumoral process of the deep lobe of the left parotid gland with a T1 hyposignal and a T2 hypersignal, and heterogeneous enhancement after gadolinium injection (Figure 2). Fine needle aspiration cytology (FNAC) of the mass was inconclusive. We, therefore, decided an exploratory extrafacial parotidectomy. In preoperative, parotid tissue appeared necrotic and purulent by places (Figure 3). Frozen section showed tuberculous lesions in both parotid and sub-mandibular lymph nodes. We, therefore, restricted surgery to a left lower pole parotidectomy. A check-up looking for second location tuberculosis (clinical examination, chest X ray, sputum analysis) was negative. The tuberculin skin test was positive at 12 mm. A prolonged (9 months) four drug antituberculous regimen (H: isoniazid, E: ethambutol, R: rifampicin and Z: pyrazinamid) was then started according to our usual protocol: 2 RHZE/7 RH. The evolution was satisfactory with no relapse after six years.


Tuberculosis of the parotid gland: histology surprise.

Errami N, Benjelloun A, Tahtah N, Hemmaoui B, Jahidi A, Nakkabi I, Zalagh M, Benariba F - Pan Afr Med J (2015)

Mass of the left parotid lodge
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4491481&req=5

Figure 0001: Mass of the left parotid lodge
Mentions: A 26 year-old woman with no medical history of personal or family tuberculosis was admitted for a left sub-mandibular swelling which had appeared 12 months earlier. It began small then gradually increased in volume without alteration of the general condition. Many broad-spectrum antibiotics were attempted without any improvement. Examination showed a 5 cm painless, elastic left parotid mass, adherent to the skin and deeper layers, with mild inflammation of the overlying skin but without fistula or facial paralysis (Figure 1). Moreover, we found ipsilateral sub-mandibular lymphadenopathies. The contralateral parotid region was unremarkable. Otoscopy was normal and oral cavity examination showed neither left tonsillar deviation nor purulent secretions from the left Stensen's duct. The MRI showed a 4.6 cm, irregular and heterogeneous tumoral process of the deep lobe of the left parotid gland with a T1 hyposignal and a T2 hypersignal, and heterogeneous enhancement after gadolinium injection (Figure 2). Fine needle aspiration cytology (FNAC) of the mass was inconclusive. We, therefore, decided an exploratory extrafacial parotidectomy. In preoperative, parotid tissue appeared necrotic and purulent by places (Figure 3). Frozen section showed tuberculous lesions in both parotid and sub-mandibular lymph nodes. We, therefore, restricted surgery to a left lower pole parotidectomy. A check-up looking for second location tuberculosis (clinical examination, chest X ray, sputum analysis) was negative. The tuberculin skin test was positive at 12 mm. A prolonged (9 months) four drug antituberculous regimen (H: isoniazid, E: ethambutol, R: rifampicin and Z: pyrazinamid) was then started according to our usual protocol: 2 RHZE/7 RH. The evolution was satisfactory with no relapse after six years.

Bottom Line: The Parotid gland is rarely involved in tuberculosis, even in endemic countries.We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge.Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution.

View Article: PubMed Central - PubMed

Affiliation: Ear Nose and Throat unit, Mohammed V Military Hospital, Rabat, Morocco.

ABSTRACT
The Parotid gland is rarely involved in tuberculosis, even in endemic countries. We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge. Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution. We discuss both diagnostic and therapeutic modalities for this infection.

No MeSH data available.


Related in: MedlinePlus