44

FNAC parotid mass M 24 y.o.

Wegener's granuloma

The lesion is in?ammatory, with acute in?ammatory cells including eosinophils. Occasional multinucleate giant cells noted. Salivary gland
epithelium trapped within the exudate, show squamous metaplasia in some areas. Not a neoplasm.

Wegener's Granulomatosis is a vasculitis of uncertain aetiology. Affected patients usually present with disease of the respiratory and renal
tracts. Classic symptoms and clinical ?ndings, together with serology titres positive for anti- neutrophil cytolplasmic antibody against
proteinase 3 con?rm the diagnosis. Wegener's Granulomatosis can occasionally involve other organs, but solitary parotid gland disease is
uncommon. Patients generally also have systemic disease

Patient may present with an isolated parotid abscess and only subsequently develop nasal, paranasal sinus and respiratory symptoms.

Parotid gland swelling may be the initial presenting symptom of Wegener's granulomatosis. It can be confused with infectious or malignant diseases of the gland.--