Advanced Thyroid and Parathyroid Ultrasound by Mira Milas Susan J. Mandel & Jill E. Langer

Author:Mira Milas, Susan J. Mandel & Jill E. Langer
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Table 23.1 Ultrasound characteristics of various salivary gland pathology

Echogenecity

Heterogeneity

Shape

Vascularity

Pleomorphic adenoma

Hypoechoic

Homogeneous

Lobular

Peripheral

Warthin tumor

Hypoechoic

Heterogeneous

Round or ovoid

Hypovascular

Salivary malignancy

Hypoechoic

Heterogeneous

Irregular

Hypervascular

Sjogren’s

Mixed

Heterogeneous

Diffuse

Hypervascular

23.10 Benign Tumors

The most common benign tumors of the salivary glands are pleomorphic adenoma and Warthin’s tumors . The most common parotid tumor is the pleomorphic adenoma [32]. This lesion is most often located in the superficial lobe of the parotid. Ultrasound demonstrates homogeneously hypoechoic, rounded lesions that are regular in appearance with well-defined borders [Video 23.5; Fig. 23.15] [33]. The tumor capsule may be visualized as a thin, hyperechoic line around the mass [34]. Pleomorphic adenomas are also frequently lobulated and do not typically have cystic components [35]. Though generally benign tumors are relatively hypovascular, a peripheral vascularization pattern may be seen with Doppler mode [22, 34]. Occasionally, calcifications may be visualized as brightly hyperechoic areas within the mass [36]. Bright posterior enhancement, a brightly hyperechoic area posterior to a hypoechoic or anechoic structure, is often seen with this benign lesion [Fig. 23.16] [34, 36]. Recurrent pleomorphic adenoma in a postoperative surgical bed may be multicentric and nodular .

Fig. 23.15Ultrasound of a parotid mass shows a round, well-defined, hypoechoic, solid lesion with vascularity, in keeping with a pleomorphic adenoma

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