Salivary glands

Author: Sally Tanakchi, M.B.Ch.B. (see Authors page)
Editor: F. Zahra Aly, M.D., Ph.D.

Revised: 29 October 2015, last major update October 2015

Copyright: (c) 2002-2015,, Inc.

PubMed Search: Sialolithiasis [title]
Cite this page: Sialolithiasis. website. Accessed January 21st, 2018.
Definition / general
  • Stones (calculi) within salivary ducts are most common within the submandibular gland, probably due to production of saliva more saturated with calcium, more mucous content and the duct being long and tortuous
  • Calculi are composed of mixtures of different calcium phosphates (hydroxyapatite, carbonate apatite)
  • Nidus of formation is organic material such as bacteria, mucous and desquamated epithelial cells on which the calcium salts are precipitated due to supersaturation and deficit of crystallization inhibitors
  • Presents with pain and swelling at meal time
  • No association between sialoliths and either nephrolithiasis or cholelithiasis, suggesting difference in risk factors and pathogenesis
  • Plain Xray films miss 15% of calculi due to insufficient calcification
  • Recommend sialogram and ultrasound scan
Case reports
  • Surgical removal of calculus or gland
  • Disintegration of calculi with shock wave lithotripsy
Clinical images
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Asymptomatic nodule

Gross images
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Removal of sialolith from Wharton duct

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Removed sialoliths

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Microscopic (histologic) description
  • Dilated ducts with squamous metaplasia or calculi
  • Variable chronic inflammation, destruction of acini and fibrosis (sialadenitis)
Microscopic (histologic) images
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Lamellated calculi

Cytology images
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Image from Nature journal
Benign duct with obstructive lesion