IM 3-37 Woman with dry mouth

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IM 3-37 Woman with dry mouth

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DrVirgo
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06/19/07 - 12:17 PM

A 38 year old woman visits the clinic because of oral tendrness and soreness in her jaw for the past 2 months. She admits that swallowing food has become more painful. SHe notices that her mouth is chronically dry and that drinking lots of fluids seems to reduce the pain. She has normal appetite but reports that she has lost 5 lb and is eating less because of the pain upon swallowing most foods. Physical exam reveals parched lips, dry oral mucous membranes, and bilaterally enlarged parotid glands with a firm, smooth texture. Needle biobsy of the salivary gland tissue reveals a dense, lymphocitic infiltrate with oss of many glands. Residual glands have prominent intraductal celular proliferation. Which of the following si the most likely diagnosis in this patient?

A. Mucoepidermoid carcinoma
B. Pleomorphic adenoma
C. Sarcoidosis
D. Sjorgren Syndrome
E. Squamous cell cancer
F. Warthin tumor

What gives it away?

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CocaCola
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06/19/07 - 12:21 PM

d - sjorgrens

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sprint123
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06/19/07 - 01:13 PM

Lymphocytic infiltration of the salivary glands!

yasmeen
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06/19/07 - 01:24 PM

sjogren synd

Ivonne
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06/19/07 - 01:32 PM

D. Sjogren Syndrome

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Mahwish Mushtaq
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06/19/07 - 06:29 PM

It's D

prathapdoctor
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06/19/07 - 09:18 PM

yes, its D.

DrVirgo
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06/20/07 - 06:59 AM

D is right.

It should be easy, but:
This question threw me off because I know SS is dry mouth AND dry eyes, but they didn't mention anything about her eyes!!!
Can we still assume its SS??? HOW? what gave it away???

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DrVirgo
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06/22/07 - 11:06 AM

Still wondering about this one. anyone? any ideas?

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Justice
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06/22/07 - 11:56 AM

#10

DrVirgo wrote:
D is right.

It should be easy, but:
This question threw me off because I know SS is dry mouth AND dry eyes, but they didn't mention anything about her eyes!!!
Can we still assume its SS??? HOW? what gave it away???

Well, if they do not mention about that, the only reason - to make you frustrated... And it looks like they reached that point ... Lymph infiltrate tells what you would be looking for instead... (D) grin

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dr in trouble
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06/23/07 - 12:33 AM

#11

it is sjogren syndrome

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