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Ranula Radiology

last modified on: Mon, 05/06/2024 - 08:57

Updated by Piper Wenzel, BS May 2024

see also: Plunging Ranula

  • Simple ranula: retention cyst of the sublingual space (Smith et al. 2021)
  • Plunging/diving ranula: occurs when a ranula ruptures out of the sublingual space and into the submandibular space (Smith et al. 2021)
  • Trauma or obstruction of the sublingual salivary gland results in saliva collection (Smith et al. 2021)
  • Presents as painless, fluctuant, mobile mass, blue in color (Bowers et al. 2021)
  • Incidence of 0.2 in 1000, most often presents between second and third decade, with 2:1 ratio of males to females (Bowers et al. 2021; Liman et al. 2021)
  • Fine needle aspiration cytology findings: high amlyase, histiocytes, no epithelial cells (Bowers et al. 2021)
  • Typically homogenous and cystic in appearance (Smith et al. 2021)
  • Plunging/diving ranulas show "tail sign": communication between collapsed sublingual and submandibular space (comet-shaped) (Liman et al. 2021)
  • On CT: low-density, unilocular lesion, subtle ring enhancement, florid enhancement if infected
  • On MR: low signal on T1; very high signal on T2; T1 post-contrast shows wall enhancement and high signal if infection present


Liman ARUA, Tuang GJ, Mansor M. Plunging Ranula. Ear Nose Throat J. 2021 Dec;100(10_suppl):1004S-1005S. doi: 10.1177/0145561320927828. Epub 2020 Jun 11. PMID: 32525702.

Bowers EMR, Schaitkin B. Management of Mucoceles, Sialoceles, and Ranulas. Otolaryngol Clin North Am. 2021 Jun;54(3):543-551. doi: 10.1016/j.otc.2021.03.002. PMID: 34024482.

Smith SM, Thelen JC, Bhatt AA, Kessler AT. Facial swelling for the emergency radiologist-typical and atypical causes. Emerg Radiol. 2021 Feb;28(1):177-183. doi: 10.1007/s10140-020-01809-x. Epub 2020 Jun 19. Erratum in: Emerg Radiol. 2020 Jun 30;: PMID: 32556655.