MEETING No. 44, - JULY 6th, 2002 AT THE
MANTUA HOSPITAL

Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Case 6


"PAROTID MASS"
R. GIARDINI - Sondrio Hospital
(pict. by dr. Giardini)

Clinical history: a 43y.o.man has an asymptomatic, left parotid mass since 4 years.
Recently the mass has grown and there is functional deficit of the mandible.
At the clinical examination there is a 5cm mass at the left temporomandibular joint. X-Ray, CT scan, US and NMR show a mass of the mandibular joint with osteolysis of the left mandibular condilum; the parotid is not involved. Part of the mandible is removed with reconstruction with titanium prosthesis.
Macroscopical description: well-defined, capsulated, elastic and translucent mass with alternate reddish and pearly areas, which involves the mandibular condilum.
Microscopical description: the lesion consists of dense fibrous and adipose tissue with numerous follicle-like lymphoid nodule (pict. 1), intermingled with groups of histiocytes and multinucleated giant cells;the fibrous tissue (pict. 2) sometimes is in fascicles (pict. 3).
In the connective tissue many aggregates of hemosiderin-laden macrophages are also present; the connective tissue surrounds multiple deposits (pict. 4) of amorphous material, which contains birifrangent, basophilic, calcified, crystal structures (pict. 5); other areas show chondroid –like features (pict. 6) with deposition of similar calcified, basophilic material (pict. 7).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7

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