Farhan Ahmed Majeed, Muhammad Ahmed, Sohail Aslam, Muhammad Ali.
Parotid gland tuberculosis an unusual presentation.
Pak Armed Forces Med J Jan ;58(3):346-7.

A 68 years old female presented with right side swelling on her face. Her complaint was pain while opening the mouth and progressive increase in size of swelling for last one year. She did not give any history of weight loss, cough, fever, chest pain and night sweats. Local examination revealed a bosselated swelling with overlying prominent veins.Size of swelling was almost equal to table tennis ball. There was no fistula or scar over it (figure). Palpation revealed mobile firm swelling 4 cm x 5 cm in size, non compressible without fluctuation. Intraoral examination was normal. Systemic examination did not reveal any abnormality. Laboratory profile was unremarkable except erythrocyte sedimentation rate which was 45 mm fall at the end of 1st hour. Chest X ray was normal. Fine needle aspiration revealed hemorrhagic aspirate with possibility of sialadenitis. Keeping in mind the benign growth of parotid gland she was planned for superficial parotidectomy which was performed under general anesthesia. Operative sp ecimen revealed gray white tissue of salivary gland measuring 3.8 cm x 4.5 cm in size. Microscopic section showed granulomas made up of epithelioid cells and occasional giant cells around caseous type of necrosis. Scattered abscesses were also seen. There was no evidence of malignancy. Opinion was chronic caseating granulomatuous inflammation of salivary gland consistent with tuberculosis. Post operatively she recovered uneventfully and was started on four drugs anti tuberculous treatment with regular follow up

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