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Sialosis / Sialadenosis - Radiology

last modified on: Wed, 04/24/2024 - 10:54

Updated by Piper Wenzel, BS April 2024

return to: Salivary Swelling

see also: Sialosis or Sialadenosis of the Salivary Glands and Sialosis or sialadenosis Case example of surgical treatment

  • Diffuse, bilateral noninflammatory, nonneoplastic enlargement of the major salivary glands (Davis 2021)
  • Generally painless but may be tender (Ogle 2020)
  • Often occurs in the setting of endocrine disorders (diabetes, hypothyroidism), nutritional disorders (anorexia/bulimia, vitamin deficiencies), metabolic diosrders (obesity, cirrhosis), or drugs (antihypertensives, valproic acid) (Adhikari 2024, Ogle 2020)
  • 30-80% of people with alcoholic cirrhosis and 26-86% of people with alcoholic use disorder have been reported to have sialadenosis (Davis 2021)
  • Pathophysiology is thought to be related to autonomic neuropathy "associated with dysfunctional protein secretion and/or synthesis" resulting in "acinar enlargement and buildup of secretory granules" (Davis 2021)
  • Ultrasound generally shows a hyperechoic gland with no focal lesions (Davis 2021)
  • CT: initially shows diffuse glandular enlargement; fatty infiltration as condition becomes more chronic (Davis 2021)
  • Sialography may be useful for later-stage diagnosis; may show thin ductal system due to compression from swelling, termed "leafless tree pattern" (Davis 2021)
  • Histopathology shows acinar cell hypertrophy and granular appearance of cytoplasm; advanced disease shows widespread replacement of acini with fatty tissue (Davis 2021)
  • Treatment involves management of underlying condition (Ogle 2020)

References

Adhikari R, Soni A. Submandibular Sialadenitis and Sialadenosis. 2022 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32965882.

Davis AB, Hoffman HT. Management Options for Sialadenosis. Otolaryngol Clin North Am. 2021 Jun;54(3):605-611. doi: 10.1016/j.otc.2021.02.005. PMID: 34024487.

Ogle OE. Salivary Gland Diseases. Dent Clin North Am. 2020 Jan;64(1):87-104. doi: 10.1016/j.cden.2019.08.007. Epub 2019 Oct 10. PMID: 31735235.