Manifestations of parotid gland enlargement: radiographic, pathologic, and clinical correlations. Part I: The autoimmune pseudosialectasias.

Histologic, clinical, and radiographic presentations of the autoimmune salivary gland diseases are reviewed. The punctate and globular sialographic changes observed actually reflect penetration of contrast material through the uniquely diseased glandular ducts and not sialectasis, as was previously thought. "Pseudosialectasis" is suggested as a more accurate term. The progressive cavitary and destructive patterns seen on sialography appear to reflect complications of secondary infection rather than the specific pathology of these diseases. Conditions causing recurrent enlargement of the parotid gland or development of a multinodular gland include chronic sialadenitis, the sialoses, the granulomatous diseases, primary neoplasms, and metastatic tumors. Although they appear similar clinically, many of these diseases can be differentiated sialographically, and such a radiographic approach is presented.