to expect a radiologist to distinguish between a lymph node and a salivary gland on a CT scan?

[boredagain]

Any doctors out there who can help me out?
DD had a large (5cm) lump diagnosed as cervical lymphadenopathy on a CT scan. Excision biopsy revealed it to be a blocked salivary gland. Surely a fluid filled SG can be distinguished from a solid LN on a CT. Should I challenge this, as it might not have been excised if it was a salivary gland.

Do you know which salivary gland it was? Hope DD is ok, not sure what you mean by challenge, do you mean you think it's negligence?

Did they have a ultrasound first ?

Good point, no ultrasound was done, just straight into a CT as they were saying it might be a lymphoma. I will bring this up. DD is fine, still has a lump but is going down. Not sure which salivary gland it was. is being referred to an ENT specialist..... I think that what is bothering me about this is that no-one thought of it and the CT should have picked it up. They should be told that we are not happy so they are more stringent in future. I just want to get my facts right.Dont get me wrong I am relieved its not a lymphoma but went through hell, so would have appreciated an earlier diagnosis.

Sometimes the salivary glands get overlooked. Inmy experience, people have seen their GP twice with pain that I've then diagnosed as a salivary gland stone.
You should let them know your thoughts as it may lead to a review of how cases like these are managed. Perhaps input from a maxillofacial radiologist would have been a good idea. Good news though that it wasn't a lymphoma.

Good luck.

I had to go to the dental hospital to get my salivary gland stone x rayed and diagnosed.
It was over 10 years ago, conventional scan and x ray revealed something there but not enough definition to say what, given my symptoms the diagnosis was leaning toward a stone blocking the salivary gland, which was chronically infected

Not unusual at all; CT will often distinguish, but no imaging modality is 100% accurate, and urgent excision biopsy is more important than repeated scanning. USS will also not distinguish reliably. A very large lump like that always needs a tissue diagnosis; any imaging can only give an indication of the likely diagnosis. It is very unlikely that "no-one thought of it"; it would be a typical differential diagnosis for a lump in the neck; but in cases like this the focus has to be the potentially serious diagnosis, and the only way to know is with tissue.

Agree with Iwantanotherbaby. Your DD needed excison of the lump to confirm diagnosis. CT is almost never accurate enough to preclude tissue biopsy in this sort of situation.

Thank you, folks! I can relax. As you say I am very relieved