Other causes of inflammation – Salivary gland disease

Granulomatous disease

1. Sarcoidosis

Uncommon chronic multisystem disease, unknown cause

Epidemiology: Adult females of African origin


  • Granuloma formation in:
    • Lungs lymph nodes (particularly hilar nodes)
    • Salivary glands
    • Oral sites
  • Systematic features:
    • Erythema nodosum
    • Lymphadenopathy
    • Lung involvement
  • Oral features:
    • Enlarged salivary glands
    • Xerostomia
    • Gingival hyperplasia
    • Labial swelling

NB: Heerfordt’s syndrome (salivary and lacrimal swelling, facial palsy and uveitis) is rare


2. TB

  • Primary TB of the salivary glands:
    • Uncommon, usually unilateral, parotid most common affected
    • Believed to arise from spread of a focus of infection in tonsils
  • Secondary TB – may involve the salivary glands but tends to involve the SMG

3. Cat Scratch Disease

  • Does not involve the salivary glands directly, but involves the periparotid and
    submandibular triangle lymph nodes
  • May involve SG by contiguous spread
  • Bacteria is Bartonella Henselae(G-R)



True cysts of the parotid account for 2-5% of all parotid lesions

  1. Congenital:
  • Type 1 – Branchial arch cysts
  • Type 2 – Cysts are a duplication anomaly of the membranous and cartilaginous EAC
  1. Acquired:
  • Mucus extravasation vs. retention
  • Traumatic
  • Benign epithelial lesions
  • Association with tumors:
    • Pleomorphic adenoma
    • Adenoid Cystic Carcinoma
    • Mucoepidermoid Carcinoma
    • Warthin’s Tumor


  • Aka: pneumosialadenitis, wind parotitis, pneumatocele glandulae parotis
  • In the absence of gas-producing bacterial parotitis, gas in the parotid duct or gland is assumed to be due to the reflux of pressurized air from the mouth into Stenson’s duct.
  • May occur with episodes of increased intrabuccal pressure – glass blowers, trumpet players
  • Crepitations on palpation of gland
  • Swelling may resolve in minutes to hours, in some cases, days.
  • US and CT show air in the duct and gland
  • Antibiotics to prevent superimposed infection

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