PMC6257896_01
Panoramic radiography revealing radiopaque mass in the region of the left mandibular body.
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Panoramic radiography showed a dense radiopaque mass in the region corresponding to the left submandibular gland (Figure 1).
Cone beam computed tomography showing the dimensions of sialoliths. (a) Coronal view. (b) Axial view. (c) 3D reconstruction. (d) Sagittal view.
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The CBCT showed a hyperdense image of 24.35 mm x 9.35 mm (Figure 2).
Ultrasonograph of the left submandibular gland showing (a) total dimensions of the gland, (b, c) sialolith and its size, and (d) dilatation of the duct.
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Three-dimensional segmentation for the calculation of the sialolith's volume by using the InVesalius software.
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CBCT image shows the area corresponding to the sialolith, which was manually segmented (Figure 4).
Fragment of tissue collected, with the lobular portion next the scalpel corresponding to the sialolith's area.
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A fragment of soft tissue measuring 70 mm x 28 mm x 17 mm having irregular surface, elongated shape, blackened colour, and fibrous consistency was collected (Figure 5).
H&E histological sections of fragments of salivary gland lobules centrally showing excretory duct containing granular basophilic material and mineralised areas with a concentric deposition pattern compatible with sialolith, sialolithiasis, and intercalated duct lesion.
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fig6
In the focal area, one could also observe the presence of exogenous material of yellowish colour and refractive aspect, exhibiting strange body reaction characterised by the presence of multinucleated giant cells (Figure 6).