CT features and analysis for misdiagnosis of parotid tuberculosis

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• 作者：Shambhu Kumar Sah^a ; ¹ ; ^{mrsks2007@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Chun Zeng^a ; ¹ ; ^{zengchun19840305@163.com" class="auth_mail" title="E-mail the corresponding author} ; Xian Li^b ; ^{932471230@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Xiaoqing Shi^a ; ^{364506987@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Tej Kumar Shrestha^a ; ^{drtejshrestha@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; You You Guo^a ; ^{1272378153@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Ping Yin^a ; ^{yinping915@163.com" class="auth_mail" title="E-mail the corresponding author} ; Jingjie Wang^a ; ^{345151097@qq.com" class="auth_mail" title="E-mail the corresponding author} ; Yongmei Li^a ; ^{lymzhang70@aliyun.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Parotid gland ; Tuberculosis ; Lymph node ; CT ; Pathology
• 刊名：Clinical Imaging
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：40
• 期：4
• 页码：810-815
• 全文大小：874 K

文摘

To analyze the computed tomography (CT) features and the reasons for misdiagnosis of parotid tuberculosis (TB).

Methods

CT features of 13 cases of parotid TB identified more than a 10-year period (2005–2015) were retrospectively analyzed. The CT features were analyzed for nature, range, and extent of the various pathological patterns.

Results

Because of the nonspecific CT features, 10 of 13 cases were misdiagnosed as benign and malignant tumors of parotid gland and received surgery. Ten cases of lymph nodal TB, one case of parenchymal TB, and two cases of mixed (concurrence of lymph nodal and parenchymal types) TB were found in the parotid gland. On contrast-enhanced CT scan, two cases showed homogeneous enhancement and eight cases showed ring enhancement (including five cases with thin-walled ring enhancement, two cases with flower-ring enhancement, and one case with thick-walled and eccentric ring enhancement); diffuse enhancement was seen in the one case of parenchymal type; the two cases of mixed type showed diffuse enhancement of parotid gland and ring enhancement of lymph node. Thickened skin around the parotid gland was seen in eight cases, including sinus tract between the lesion and skin in two cases. Ipsilateral cervical lymphadenopathy was found in 10 patients and bilateral was found in 3 patients.

Conclusions

Nonspecific CT features of parotid TB closely relate with pathological changes. Recognition and understanding the spectrum of CT features of parotid TB is helpful for differential diagnosis, but the definitive diagnosis still depends on laboratory and pathological examination.