Importance of Cytology in Diagnosis of Sialadenosis-A Rare Entity

Abstract

Sialadenosis also known as sialosis is a non-inflammatory and non-cancerous enlargement of salivary glands particularly the parotid gland. It is commonly seen in age group of 40 to 70 years. It is an extremely uncommon cause for enlargement of the parotid gland. Sialadenosis is a systemic disease that is associated with a variety of systemic disorders which includes the endocrine system as in diabetes mellitus, pregnancy, hypothyroidism, acromegaly; dystrophic–metabolic disorders like malnutrition, avitaminosis, alcoholism, chronic liver diseases; neurogenic disorders like dysfunction of the vegetative nervous system and various drugs like antihypertensive agents, valproaic acid, isoprenaline, anti-thyroids. Out of these, diabetes and alcoholism are most common causes, management of sialosis is done by correcting the underlying cause. The present case is of a 50-year-old female patient having bilateral enlargement of parotids. The swellings were diffuse, soft, non-tender and gradually increasing in size from past three months. Past medical history revealed that patient was diabetic and was on irregular medication. Ultrasonography showed diffusely enlarged, hyperechoic salivary glands suggestive of benign salivary gland lesion; possibility of sialadenitis and sialadenosis was given and patient was advised Fine Needle Aspiration Cytology (FNAC). FNAC showed features of benign salivary gland lesion suggestive of sialadenosis. The sialomegaly was associated with diabetes mellitus and it disappeared after start of regular treatment. So, careful observation of cytological features along with clinical history can help in reaching a correct diagnosis and prevent unnecessary surgical intervention.

Keywords

• differential diagnosis
• enlargement
• fine needle aspiration cytology
• parotid gland