Auris·Nasus·Larynx (Tokyo) 19,271-273 (1992) TUBERCULOSIS OF THE PAROTID SALIVARY GLAND Mehmet ATAMAN, M.D., Btilent SOZERi, M.D., Tuncay Oz<;:ELiK, M.D., and Gokhan GEDiKOGLU, M.D.* Departments of Otolaryngology and *Pathology, Hacettepe University School of Medicine, Ankara, Turkey An interesting and rare case of tuberculosis involving a parotid gland is discussed. Although pulmonary tuberculosis is not uncommon in Turkey, primary parotid gland involvement is rare. The patient was treated by parotidectomy and antituberculous chemotherapy. Tuberculosis of the parotid gland was first described in 1896 by De Paoli. Less than 200 cases have been reported since that time and only 38 in the English literature. 1 This lesion accounts for approximately 2.5 to 10% of parotid patholo- gy, both sexes being affected equally. It occurs most commonly between the second and fifth decade, being exceptional in infants. CASE REPORT A 56-year-old female was admitted to the Otolaryngology Department of the Hacettepe University Hospital with a large painless swelling of the right parotid. On examination the swelling occupied the entire superficial lobe and extended below and behind the angle of the jaw. It was painless and firm to palpation. There were also two upper cervical lymph nodes which were two centimeters in diameter. Chest X-ray revealed that there was no pathologic condition. The total white cell count was within normal limits. E.S.R. was 16mm in the first hour (Westergren). A sialogram of the right parotid showed there was an external pressure to the gland. A superficial parotidectomy, extended to include pre- and post-auricular lymph nodes, was carried out. The salivary gland was adherent to adjacent structures. Histological examination of the specimen showed a raised grayish area 2 em in diameter within the superficial lobe. The specimen was infiltrated with epithelioid cells, Langhans giant cells, and focal areas of caseation. The lymph nodes also showed multiple caseating granulomata (Fig. 1). Acid-fast bacilli were found in a salivary specimen from the right parotid duct. Received for publication January 21, 1992 271