Submandibular masses

Echogenic line is the Intraglandular DUct
H - myelohyoid; D - Belly of Diagastric
s:- Submandibular gland


small White arrow -Whartons Duct; Large white arrow, mylohyoid muscle


P, parotid gland; White arrow, Küttner lymph node; R, retromandibular vein; S, submandibular gland


There is a non-obstructing intraductal calculus within Wharton's duct casting an acoustic shadow (large white arrow), together with sludge. S, submandibular gland


submandibular abscess --. There is an ill-defined intraglandular hypoechoic mass and adjacent enlarged reactive lymph node (white arrow). Under ultrasound guidance pus was aspirated and subsequent culture grew Staphylococcus aureus. S, submandibular gland.

tuberculous abscess. There is a complex mass (callipers) in the submandibular gland with a central necrotic abscess cavity. Excision confirmed involvement of the gland with
Mycobacterium tuberculosis.


chronic sialadenitis secondary to stone disease. S, atrophic, hypoechoic, irregular gland. Note the associated intraglandular calculus (callipers).



Küttner tumour. There is a well-defined, hypoechoic mass in the submandibular gland, which could be mistaken, clinically and sonographically for a tumour. Diagnosis of chronic inflammation was confirmed by core biopsy and subsequent excision. Incresed Doppler

sarcoid granulomata



Sjögren's syndrome. The gland is diffusely enlarged and of heterogeneous echotexture. Note the hypoechoic foci within the gland representing early sialectatic chang
numerous prominent cystic spaces typical of florid sialectasis in Sjögren's syndrome. A similar appearance can occur in HIV infection.


submandibular gland pleomorphic adenoma. This lesion appears rounded, well defined and hypoechoic with distal acoustic enhancement present.


Oncocytoma




intraglandular adenoid cystic carcinoma. This appears as an ill-defined, hypoechoic and inhomogeneous mass.



mucoepidermoid carcinoma (large white arrow). Sonographically the features shown are similar to the adenoid cystic carcinoma in Note that in this case there is also extraglandular extension of tumour with invasion of the subcutaneous tissues and skin (small white arrows).



lymphoma of the submandibular gland

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Pretty much the whole article:=
British Journal of Radiology (2005) 78, 362-369