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Branchial Cyst Anomaly in a Newborn

Functioning salivary gland tissue can be displayed by radionuclide scanning because of absorption and concentration by ductal epithelium of the salivary tissue. Parotid tumors can be demonstrated because the differential uptake of radioactivity within the tumor is different from adjacent normal salivary gland tissue. A localized area of increased uptake is nearly always an indication of a Warthin's tumor (papillary cystadenoma lymphomatosum) or an oncocytoma. Cat-scratch disease, a benign lymphadenitis, can appear as preauricular lymph nodes. Chronic infection may result in a persistent preauricular mass adjacent to parotid tissue. We report on a 60-year-old woman who had a 2.5 cm firm mass that clinically appeared as a parotid tumor. A technetium scan resulted in the discovery of a "hot nodule." Permanent histopathology after parotidectomy was consistent with catscratch disease; no other salivary pathosis was noted. The salivary scan and pathosis of cat-scratch disease are discussed and illustrated.