الموقع الرسمي للدكتور أحمد رفاعي

  • الرئيسية
  • محاضراتي - فيديو
  • محاضراتي - بور بوينت
  • case of the week
  • أعمال من تصويري
  • أعمال من رسوماتي
  • قصص قصيرة
  • اتصل بنا

Case No : 9

2/14/2013

2 Comments

 
Picture










Differential diagnosis:

·        Benign lymphoepithelial lesions – HIV ( BLL-HIV)
·        Bilateral Warthin tumor
·        Sjogren syndrome
·        lymphoma
 Clue for the diagnosis:
·        Benign lymphoepithelial lesions – HIV ( BLL-HIV)
-         HIV +ve patient
-        Multiple cystic and solid masses enlarging both parotid glands usually associated with tonsilar hyperplasia & cervical reactive adenopathy
-         Thin rim enhacement of cystic lesions
-         5% of HIV+ve patients develop BLL of parotids  
·        Bilateral Warthin tumor:
-         Masses are  painless, slowly growing.
-         90% of patients are smokers
-         Mean  age = 60 years.
-         Most commonly within parotid tail superficial to angle of mandible.
 -         Parenchymal inhomogeneity is characterestic.
  
·        Sjogren syndrome
 -         Chronic systemic autoimmune exocrinopathy that causes salivary and lacrimal gland tissue destruction.
 -         
         * 1ry SJS – dry eyes , dry mouth ,  no collagen vascular disease.
-           * 2ry SJS – dry eyes , dry mouth , with collagen vascular disease, most commonly rheumatoid arthritis.
-         CT shows bilateral enlarged parotids with multiple cystic and solid intraparotid lesions with or without intraglandular calcification.
 ·        lymphoma
-         Clinically: chronic systemic NHL already apparent.
-         Usually bilateral solid masses in both parotids.
 Diagnosis:
 ·        
Benign lymphoepithelial lesions – HIV (
BLL-HIV)



2 Comments