title: CT features and pathologic characteristics of IgG4-related systemic disease of submandibular gland.
abstract: The submandibular gland is one of the most frequently affected salivary gland in IgG4-related systemic disease, usually demonstrate homogeneous attenuation on CT imaging as reported, but without much pathological comparison of many cases. This article is to investigate and analyze the typical CT findings and pathologic characteristics of IgG4-related systemic disease (IgG4-RSD) of submandibular gland. A retrospective analysis of the preoperative CT findings in patients with IgG4-RSD of submandibular glands who underwent surgical resection between January 2010 and February 2014 was performed. Twenty patients (16 women) were identified, with a mean age of 58.1±10.2 years. All patients presented with painless submandibular gland swelling. Diffuse gland enlargement, with clear margins and homogeneous density, was found on non-enhanced CT scans in all cases. There were no calcifications or stones within the involved glands. Based on contrast-enhanced CT appearance the patients could be divided into two groups: 11 cases showed homogeneous gland enhancement; and multiple hyperenhancing foci, with a crazy-paving pattern, were detected in 9 cases, which were in consistent with the pathologic findings. The maximum submandibular gland diameter on transverse images was significantly larger (P=0.008) in patients with crazy-paving appearance (32±4 mm) compared to patients with homogeneous enhancement (28±3 mm). It is concluded that the submandibular glands with IgG4-RSD can be characterized by either homogenous appearance or crazy-paving pattern on contrast-enhanced CT imaging.
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Ruie
authors.initials: R
authors.lastname: Feng
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Miao
authors.initials: M
authors.lastname: Duan
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Man
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Medical University of South Carolina Charleston, SC, USA.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Rumboldt
authors.affiliation: Department of Radiology, Peking Union Medical College Hospital Beijing, 100730, China.
authors.forename: Zhuhua
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001706:Biopsy; D003287:Contrast Media; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013363:Submandibular Gland / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology*; D013364:Submandibular Gland Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology
chemical_list: D003287:Contrast Media; D007074:Immunoglobulin G; D007472:Iohexol; C038192:iopromide
keywords: Computed tomography; IgG4-related systemic disease; submandibular gland