Diagnosis of major salivary gland tuberculosis: experience of eight cases and review of the literature.
CONCLUSIONS
Tuberculosis of the salivary gland is mostly a medically curable disease entity but early diagnosis is very important to ensure complete remission. In cases with a high index of suspicion, reliable diagnostic methods such as polymerase chain reaction (PCR) should always be considered before surgical intervention to enable differential diagnosis of a salivary gland tumor.


OBJECTIVE
To investigate the clinical characteristics of major salivary gland tuberculosis and to review the literature relating to its diagnosis.


METHODS
Eight patients diagnosed as having major salivary gland tuberculosis between 1994 and 2004 were treated at one of three tertiary referral centers. Medical records, including imaging findings and the results of microbiological tests, Mycobacterium tuberculosis PCR and histopathology, were retrospectively retrieved and the literature was reviewed.


RESULTS
The parotid and submandibular glands were involved in 5 (62.5%) and 3 cases (37.5%), respectively. Neck CT demonstrated typical findings of salivary gland tuberculosis in 3 patients (37.5%). Fine-needle aspiration cytology revealed chronic inflammation in 6/7 patients (85.7%), 2 of whom (33.3%) showed caseous necrosis, strongly suggesting tuberculosis. Five of the 8 patients (62.5%) required resection of the affected gland and 3 (37.5%) received open biopsy. PCR was performed in half of the cases and was affirmative in every case. No significant differences were found between the surgically resected and non-resected groups in terms of treatment results or morbidity. All patients received anti-tuberculous chemotherapy for 8-12 months, with no disease recurrence.
Kim
Young Ho
YH
Department of Otolaryngology, Head and Neck Surgery, Seoul Municipal Boramae Hospital, Seoul, South Korea. yhkiment@yahoo.co.kr
Jeong
Woo-Jin
WJ
Jung
Kwang-Yoon
KY
Sung
Myung-Whun
MW
Kim
Kwang Hyun
KH
Kim
Chong Sun
CS
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D010306:Parotid Gland / Q000187:drug effects / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012466:Salivary Gland Diseases / Q000188:drug therapy / Q000382:microbiology*; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents; D004269:DNA, Bacterial