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Submandibular Gland Sialadenitis
Richard H. Wiggins, III, MD, CIIP, FSIIM
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Submandibular gland (SMG) sialadenitis
            • Definitions

              • Inflammation of SMG of any cause
              • Acute sialadenitis: Usually with duct calculus
                • Most often Staphylococcus aureus infection
                • Others: Streptococcus viridans, Haemophilus influenzae, & Escherichia coli
              • Chronic sialadenitis: Recurrent SMG inflammation with reduced saliva flow
                • Stasis of secretions, calculi; swelling without acute infection
              • Secondary SMG sialadenitis: Ductal obstruction from floor of mouth squamous cell carcinoma
                • Enlarged, swollen SMG often mistaken for malignant node
              • Sialolithiasis: Concretions within SMG ductal system
                • Salivary stagnation, precipitation of calcium salts ± epithelial injury along duct leading to sialoliths
              • Autoimmune sialadenitis: Sjögren syndrome
              • Chronic sclerosing sialadenitis: Küttner tumor
                • Fibrosis & inflammation with IgG4-related systemic disease; SMG > > parotid
              • Sialadenosis: Noninflammatory SMG swelling
                • Causes include: Diabetes, cirrhosis, hypothyroidism

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Reporting Tips

                                              Selected References

                                              1. Abdel Razek AA et al: Imaging of sialadenitis. Neuroradiol J. 1971400916682752, 2017
                                              2. Putra J et al: Küttner Tumor: IgG4-Related Disease of the Submandibular Gland. Head Neck Pathol. 10(4):530-532, 2016
                                              3. Trujillo O et al: Rapid recurrent sialolithiasis: Altered stone composition and potential factors for recurrence. Laryngoscope. ePub, 2016
                                              4. Culver EL et al: Immunoglobulin G4 related chronic sclerosing sialadenitis. J Laryngol Otol. 129(3):226-31, 2015
                                              5. Pace CG et al: Sialadenitis Without Sialolithiasis Treated by Sialendoscopy. J Oral Maxillofac Surg. 73(9):1748-52, 2015
                                              6. Harrison JD et al: IgG4-related sialadenitis is rare: histopathological investigation of 129 cases of chronic submandibular sialadenitis. Histopathology. 63(1):96-102, 2013
                                              7. Pandarakalam C et al: Chronic sclerosing sialadenitis or Küttner's tumor associated with a giant sialolith: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 115(4):e38-40, 2013
                                              8. Geyer JT et al: Chronic sclerosing sialadenitis (Kuttner tumor) is an IgG4-associated disease. Am J Surg Pathol. 34(2):202-10, 2010
                                              9. Yu C et al: Endoscopic Observation and Strategic Management of Obstructive Submandibular Sialadenitis. J Oral Maxillofac Surg. Epub ahead of print, 2010
                                              10. Ardekian L et al: Obstructive sialadenitis of submandibular gland due to foreign body successfully treated by sialoendoscopic intervention. J Oral Maxillofac Surg. 67(6):1337-9, 2009
                                              11. Stone JH et al: Case records of the Massachusetts General Hospital. Case 24-2009. A 26-year-old woman with painful swelling of the neck. N Engl J Med. 361(5):511-8, 2009
                                              12. Yu CQ et al: Selective management of obstructive submandibular sialadenitis. Br J Oral Maxillofac Surg. 46(1):46-9, 2008
                                              13. Williams JB et al: Images in emergency medicine. Acute submandibular sialadenitis with infected sialocele. Ann Emerg Med. 50(1):13, 24, 2007
                                              14. Singh SA et al: Suppurative submandibular sialadenitis in a preterm infant. Int J Pediatr Otorhinolaryngol. 68(5):593-5, 2004
                                              15. Garavello W et al: The intriguing association between prematurity and neonatal isolated submandibular suppurative sialadenitis. Int J Pediatr Otorhinolaryngol. 62(1):41-4, 2002
                                              16. Kalinowski M et al: Comparative study of MR sialography and digital subtraction sialography for benign salivary gland disorders. AJNR Am J Neuroradiol. 23(9):1485-92, 2002
                                              17. Tiemann M et al: Chronic sclerosing sialadenitis of the submandibular gland is mainly due to a T lymphocyte immune reaction. Mod Pathol. 15(8):845-52, 2002
                                              18. Ching AS et al: Comparison of the sonographic features of acalculous and calculous submandibular sialadenitis. J Clin Ultrasound. 29(6):332-8, 2001
                                              19. Davies MG et al: Linear cutaneous lupus erythematosus in association with ipsilateral submandibular myoepithelial sialadenitis. Clin Exp Dermatol. 26(1):56-8, 2001
                                              20. Bova R et al: Neonatal submandibular sialadenitis progressing to submandibular gland abscess. Int J Pediatr Otorhinolaryngol. 53(1):73-5, 2000
                                              21. Williams HK et al: Chronic sclerosing sialadenitis of the submandibular and parotid glands: a report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 89(6):720-3, 2000
                                              22. Sekine S et al: Chronic sclerosing sialadenitis of the submandibular gland associated with idiopathic retroperitoneal fibrosis. Pathol Int. 49(7):663-7, 1999
                                              23. Tighe JV et al: Relation of preoperative sialographic findings with histopathological diagnosis in cases of obstructive sialadenitis of the parotid and submandibular glands: retrospective study. Br J Oral Maxillofac Surg. 37(4):290-3, 1999
                                              24. Harrison JD et al: Chronic submandibular sialadenitis: ultrastructure and phosphatase histochemistry. Ultrastruct Pathol. 22(6):431-7, 1998
                                              25. Ungkanont K et al: Neonatal suppurative submandibular sialadenitis: a rare clinical entity. Int J Pediatr Otorhinolaryngol. 43(2):141-5, 1998
                                              26. Harrison JD et al: Role of microliths in the aetiology of chronic submandibular sialadenitis: a clinicopathological investigation of 154 cases. Histopathology. 31(3):237-51, 1997
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Submandibular gland (SMG) sialadenitis
                                                        • Definitions

                                                          • Inflammation of SMG of any cause
                                                          • Acute sialadenitis: Usually with duct calculus
                                                            • Most often Staphylococcus aureus infection
                                                            • Others: Streptococcus viridans, Haemophilus influenzae, & Escherichia coli
                                                          • Chronic sialadenitis: Recurrent SMG inflammation with reduced saliva flow
                                                            • Stasis of secretions, calculi; swelling without acute infection
                                                          • Secondary SMG sialadenitis: Ductal obstruction from floor of mouth squamous cell carcinoma
                                                            • Enlarged, swollen SMG often mistaken for malignant node
                                                          • Sialolithiasis: Concretions within SMG ductal system
                                                            • Salivary stagnation, precipitation of calcium salts ± epithelial injury along duct leading to sialoliths
                                                          • Autoimmune sialadenitis: Sjögren syndrome
                                                          • Chronic sclerosing sialadenitis: Küttner tumor
                                                            • Fibrosis & inflammation with IgG4-related systemic disease; SMG > > parotid
                                                          • Sialadenosis: Noninflammatory SMG swelling
                                                            • Causes include: Diabetes, cirrhosis, hypothyroidism

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Other Modality Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Abdel Razek AA et al: Imaging of sialadenitis. Neuroradiol J. 1971400916682752, 2017
                                                                                          2. Putra J et al: Küttner Tumor: IgG4-Related Disease of the Submandibular Gland. Head Neck Pathol. 10(4):530-532, 2016
                                                                                          3. Trujillo O et al: Rapid recurrent sialolithiasis: Altered stone composition and potential factors for recurrence. Laryngoscope. ePub, 2016
                                                                                          4. Culver EL et al: Immunoglobulin G4 related chronic sclerosing sialadenitis. J Laryngol Otol. 129(3):226-31, 2015
                                                                                          5. Pace CG et al: Sialadenitis Without Sialolithiasis Treated by Sialendoscopy. J Oral Maxillofac Surg. 73(9):1748-52, 2015
                                                                                          6. Harrison JD et al: IgG4-related sialadenitis is rare: histopathological investigation of 129 cases of chronic submandibular sialadenitis. Histopathology. 63(1):96-102, 2013
                                                                                          7. Pandarakalam C et al: Chronic sclerosing sialadenitis or Küttner's tumor associated with a giant sialolith: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 115(4):e38-40, 2013
                                                                                          8. Geyer JT et al: Chronic sclerosing sialadenitis (Kuttner tumor) is an IgG4-associated disease. Am J Surg Pathol. 34(2):202-10, 2010
                                                                                          9. Yu C et al: Endoscopic Observation and Strategic Management of Obstructive Submandibular Sialadenitis. J Oral Maxillofac Surg. Epub ahead of print, 2010
                                                                                          10. Ardekian L et al: Obstructive sialadenitis of submandibular gland due to foreign body successfully treated by sialoendoscopic intervention. J Oral Maxillofac Surg. 67(6):1337-9, 2009
                                                                                          11. Stone JH et al: Case records of the Massachusetts General Hospital. Case 24-2009. A 26-year-old woman with painful swelling of the neck. N Engl J Med. 361(5):511-8, 2009
                                                                                          12. Yu CQ et al: Selective management of obstructive submandibular sialadenitis. Br J Oral Maxillofac Surg. 46(1):46-9, 2008
                                                                                          13. Williams JB et al: Images in emergency medicine. Acute submandibular sialadenitis with infected sialocele. Ann Emerg Med. 50(1):13, 24, 2007
                                                                                          14. Singh SA et al: Suppurative submandibular sialadenitis in a preterm infant. Int J Pediatr Otorhinolaryngol. 68(5):593-5, 2004
                                                                                          15. Garavello W et al: The intriguing association between prematurity and neonatal isolated submandibular suppurative sialadenitis. Int J Pediatr Otorhinolaryngol. 62(1):41-4, 2002
                                                                                          16. Kalinowski M et al: Comparative study of MR sialography and digital subtraction sialography for benign salivary gland disorders. AJNR Am J Neuroradiol. 23(9):1485-92, 2002
                                                                                          17. Tiemann M et al: Chronic sclerosing sialadenitis of the submandibular gland is mainly due to a T lymphocyte immune reaction. Mod Pathol. 15(8):845-52, 2002
                                                                                          18. Ching AS et al: Comparison of the sonographic features of acalculous and calculous submandibular sialadenitis. J Clin Ultrasound. 29(6):332-8, 2001
                                                                                          19. Davies MG et al: Linear cutaneous lupus erythematosus in association with ipsilateral submandibular myoepithelial sialadenitis. Clin Exp Dermatol. 26(1):56-8, 2001
                                                                                          20. Bova R et al: Neonatal submandibular sialadenitis progressing to submandibular gland abscess. Int J Pediatr Otorhinolaryngol. 53(1):73-5, 2000
                                                                                          21. Williams HK et al: Chronic sclerosing sialadenitis of the submandibular and parotid glands: a report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 89(6):720-3, 2000
                                                                                          22. Sekine S et al: Chronic sclerosing sialadenitis of the submandibular gland associated with idiopathic retroperitoneal fibrosis. Pathol Int. 49(7):663-7, 1999
                                                                                          23. Tighe JV et al: Relation of preoperative sialographic findings with histopathological diagnosis in cases of obstructive sialadenitis of the parotid and submandibular glands: retrospective study. Br J Oral Maxillofac Surg. 37(4):290-3, 1999
                                                                                          24. Harrison JD et al: Chronic submandibular sialadenitis: ultrastructure and phosphatase histochemistry. Ultrastruct Pathol. 22(6):431-7, 1998
                                                                                          25. Ungkanont K et al: Neonatal suppurative submandibular sialadenitis: a rare clinical entity. Int J Pediatr Otorhinolaryngol. 43(2):141-5, 1998
                                                                                          26. Harrison JD et al: Role of microliths in the aetiology of chronic submandibular sialadenitis: a clinicopathological investigation of 154 cases. Histopathology. 31(3):237-51, 1997