Unusual case

[Thomas Razmus]

The image adjacent to the right mandibular angle may be the ghost image of the structure imaged on the left side.

Confidentiality Notice: This e-mail message, including any attachments, is
for the sole use of the intended recipient(s) and may contain confidential
and privileged information. Any unauthorized review, use, disclosure or
distribution is prohibited. If you are not the intended recipient, please
contact the sender by reply e-mail and destroy all copies of the original
message.

>>> lccarter at VCU.EDU 05/07/03 08:53AM >>>
Dr. Halse,
Is it certain that the CT exam found the radiopacity to be "in" the
inferior portion of the parotid gland and not adjacent to it? Would you be
able to attach representative slices of the CT? There appears to be a
similar process adjacent to the right angle of the mandible on the
panoramic radiograph. The appearance on the pan is consistent with
bilateral calcified lymph nodes. In that case, you would want to consider
whether the patient had had any pre-existing condition which might lead to
the development of calcified nodes, such as granulomatous disorders (TB,
sarcoidosis, cat scratch disease, deep fungal infections...), prior
lymphoma especially if treated with radiation and so on. A calcified node
per se would not require treatment but you would want to establish the
etiology and treat any underlying conditions if still active.
Laurie Carter


Laurie Carter, D.D.S., Ph.D.
Associate Professor and Director, Oral and Maxillofacial Radiology
Virginia Commonwealth University School of Dentistry
315 Lyons Bldg., 520 N. 12th St., P.O. Box 980566
Richmond, Virginia 23298
(804)828-1778, (804)828-6234 FAX
lccarter at vcu.edu




Agnar Halse <Agnar.Halse at ODONT.UIB.NO>
Sent by: Oral Radiology Discussion Group <ORADLIST at listserv.ucla.edu>
05/07/2003 03:37 PM
Please respond to Oral Radiology Discussion Group


        To:     ORADLIST at listserv.ucla.edu
        cc:
        Subject:


I need some expert comments on an unusual case. I was consulted by dr.
B.Grung - oral surgeion in Stavanger,Norway - who in turn had been
consulted by an orthodontist.

The pan - also lateral ceph - showed a radiopapue structure posterior to
the left angulus in a 13 years old girl. Retrospectively, it was seen also
two years earlier in an pan, no changes during this period. No
PA-projection available.

Clinical examination and patient history not much helpful. Norwegian in
many generations, never lived abroad, nothing in the  family.

To dr. Grung I commented on three possible conditions. Calcification in
the
tonsillar area - in the parotid gland - lymph nodes. But - as I also
commented - these options do not fit very well. I suggested to him a
possible CT examination.

By CT the dense structure was found to be in the most inferior part of the
parotid gland, nothing else in the area.

After discussion, the decision has been observation.

I send as attechment to images with different format, hoping that one at
least will function on your computer.

Agnar Halse