
What Does The Following MRI Of Throat Suggest?

The study shows abnormalsignal and mild enlargement of the left submandibular gland, with
this gland appearing hypointense on T1 and hyperintense on STIR images. Contrast
enhanced study shows abnormalenhancement of the gland with preserved architecture and
without distortion or splaying of the intra-glandular ducts. The right submandibular gland
appears normal. There is heterogeneous signal and subtle heterogeneous enhancement
within bilateral parotid glands.
The nasopharynx, oropharynx and oral cavity, hypopharynx & larynx reveal no obvious
discrete mass. The rest of the soft tissuespaces of the neck are unremarkable.
Small normal sized lymph nodes are seen at levels 2& 1 bilaterally. Subcentimeter nodes
are also noted at level 5 on bothsides.
Both lobes of thyroid are also normal in size and signalintensity. The carotid vessels and
jugular veins reveal normal flowvoids.
Mandible and maxilla are normal in signalintensity.
As below:
Detailed Answer:
Hi,
Thank you for your query.
1. If this mild enlargement of the left submandibular salivary gland is recent (not chronic) then it is most likely to be a sialadenitis. This will require antibiotics such as Clindamycin that achieve high concentration in saliva.
2. A stone in the left submandibular duct should be ruled out (especially if there is a history of repeated chronic episodes). What were the CT findings? A Sialogram will help.
3. Since the MRI findings in both the Parotid salivary glands suggests multiple salivary gland involvement, get the following tests done:
a. Autoimmune work-up.
b. Haemogram Blood Sugar Level (BSL), Thyroid Function tests (TFTs), Liver Function Tests (LFTs), Vitamin B12 levels, Serum electrolytes.
4. Further treatment will depend upon the symptoms and the results of the above tests. You may upload the test results here.
I hope I have answered your query. If you have any further questions I will be available to answer them.
Regards.

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