“Does CT definitley confirm parotid mass?”
I felt a lump under my ear and got an ultrasound. The report said it was a 1.9 cm solid, hypoechoic, well circumscribed mass. My ENT felt it and said it was a parotid tumor. I got a CT and they said it was the parotid as well. When I got the FNA which I am still waiting on the results, the radiologist said he wasn't sure what it was- maybe a lymph node. My question is if CT said it was a parotid mass - not a lymph node is that with certainty- I am getting confused because ultrasound is not clearly saying parotid. I am scared it is a lymph node and could be something worse. Also my ENT said he does not think it is malignant- does CT give a good indication of this which is why he was so confident?
15 Answers
yes
Wait for the biopsy result. That your answer. Lymph nodes can sometimes be easily recognized and sometimes not so easily recognized depending on whether there is infection or malignancy.
An MRI with contrast should sort out the question of an intra parotid mass versus adjacent lymph node.
The biopsy is the most definitive. The imaging studies, i.e. CT and ultrasound, are merely looking. The biopsy will give you an answer.
It is sometimes difficult to determine if a "mass" in arising from the parotid or next to the parotid and pushing on it. Your biopsy will answer that question.
Susmitha Reddy
Radiologist
Sometimes it can be difficult to answer that question definitely on CT or ultrasound. Sometimes you can predict by palpation or by imaging but FNA should be more definitive.
Stephen W. Kulbaba
Radiologist
It's difficult to answer with any certainty. In addition to the parotid gland, lymph nodes are also present in the parotid space. Typically with a CT scan it should be evident if it's gland or node, however if there happens to be inflammation or a particularly large mass it's possible to mistake one for the other. I'm also uncertain on what basis the radiologist who performed the FNA suggested it may be a lymph node, whether he was or had viewed images at the time or was speculating based on location and palpation when he said it. I hesitate to comment because it's difficult to guess without seeing the images.
As for whether CT would give you any indication of whether it's malignant, CT in and of itself may not give you that information unless you had a PET CT, which is a type of CT done with radioactive "dye". Although histopatholgoy results from FNA can at times be equivocal, it probably represents the best test so far to identify what the mass may be and could clear up any question of whether it was parotid or lymph node in origin.
As for whether CT would give you any indication of whether it's malignant, CT in and of itself may not give you that information unless you had a PET CT, which is a type of CT done with radioactive "dye". Although histopatholgoy results from FNA can at times be equivocal, it probably represents the best test so far to identify what the mass may be and could clear up any question of whether it was parotid or lymph node in origin.
the parotid gland is the one salivary gland that encapsulates "late", and therefore can envelop adjacent lymph nodes. Thus, lesions within the parotid capsule proper can be either parotid or lymphatic origin, thus a "parotid mass" isn't necessarily of parotid origin. An enlarged lymph node is usually just a manifestation of your immune system reacting to something in the neighborhood (infection, inflammation, etc.). And if it is a parotid tumor, most are benign (when dealing with the salivary glands, the smaller glands tend to have more aggressive lesions, while the largest- the Parotid- tends to have benign tumors.
hope this helps, dlh
hope this helps, dlh
Nothing is 100% certain. Benign and malignant is suggested by study based on findings. Even histopathology is not 100%, but it is the defining analysis. Whether lesion is in parotid or adjacent can at times be difficult, but it is definitely in vicinity and that will correlate with FNA. Also, imaging will help define whether lesion is contained and whether or not there are other lesions, very important.
Thank you for your outreach and I hope you find a good outcome with your issue. Developmentally, the parotid has internal lymph nodes, whereas the submandibular gland does not. With that being said enlarged lymph nodes (either benign or malignant) typically are more numerous. With regard to a tumor, the most common parotid mass is a benign mixed tumor (aka pleomorphic adenoma), account for 80% of parotid tumors. CT does give a very good indication of this. Overlapping features of parotid space masses can make imaging diagnosis difficult, however, 1. benign much much more common than malignant 2. primary salivary gland malignancies usually not subtle...typically very aggressive appearing.
The FNA will give you your answer and were I a betting man, I'd say 1. likely benign and 2. likely a benign mixed tumor.
I hope this helps and all the best.
The FNA will give you your answer and were I a betting man, I'd say 1. likely benign and 2. likely a benign mixed tumor.
I hope this helps and all the best.
CT is not perfect and can misread masses as lymph nodes and lymph nodes as masses depending on the morphology of the node or mass. I would not be so concerned about it being a lymph node as they can be commonly seen in the parotid. Waiting on the path results would be prudent to definitely determine what it is. Most cases turn out to be nothing so I wouldn't be concerned until you have to be.
Dr Cox
Dr Cox
The FNA biopsy was done to answer the question you asked.
There are intraparotid lymph nodes that can get enlarged if the parotid gland is infected. A parotid mass could be a malignancy. A mass can be a lymph node or a malignancy. Lymph nodes are not worrisome unless they are very large due to lymphoma, another form of malignancy. Another type of malignant mass like pleoprphic adenoma is more worrisome. Wait until you get the biopsy results back. Hopefully, that will be definitive and then you can rest easy if it is just a regular or inflamed lymph node. If it's anything else, then you can begin to do more research on the type of malignancy it is. Just a word of caution, FNA can sometimes not collect enough cells and you may need to have a biopsy done with a larger needle. Hopefully, that won't be the case.
CT would be more accurate in localizing the mass to determine whether it is in the parotid or right next to it. Ultrasound could be less specific.
If it is in the parotid, the majority of parotid tumors are benign.
If it's outside of the parotid, it could be a lymph node.
Bottom line is the FNA biopsy you had. That will give the definitive answer.
Neck masses can be tricky to figure out where they originate from on CT or ultrasound. They are mainly used as tools to initially see if the mass is solid or a cyst, and also to look for other possible masses or other abnormalities that might help figure out what it could be and to decide if biopsy is required.
Hope this helps!
Dr. Boker
If it is in the parotid, the majority of parotid tumors are benign.
If it's outside of the parotid, it could be a lymph node.
Bottom line is the FNA biopsy you had. That will give the definitive answer.
Neck masses can be tricky to figure out where they originate from on CT or ultrasound. They are mainly used as tools to initially see if the mass is solid or a cyst, and also to look for other possible masses or other abnormalities that might help figure out what it could be and to decide if biopsy is required.
Hope this helps!
Dr. Boker
Get an MRI with contrast.
