Salivary glands: IgG4-related sialadenitis: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Salivary glands: IgG4-related sialadenitis

Sample item

A 60-year-old man has bilateral firm, painless submandibular gland enlargement with raised serum IgG4 and a lymphoplasmacytic infiltrate with storiform fibrosis on biopsy. What is the diagnosis and treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Kuttner tumour (IgG4-related sclerosing sialadenitis), treated with corticosteroids

Chronic sclerosing sialadenitis of the submandibular gland (Kuttner tumour) is an IgG4-related disease, with a mass-like firm enlargement, elevated IgG4 levels and storiform fibrosis. It responds well to corticosteroids. It can mimic a neoplasm.

Option by option

  • A. Warthin tumour, treated with enucleation

    Warthin tumour is a parotid tumour in older male smokers.

  • B. Kuttner tumour (IgG4-related sclerosing sialadenitis), treated with corticosteroids (correct)

    Correct. IgG4 disease responds to steroids.

  • C. Sjogren syndrome, treated with methotrexate

    Sjogren syndrome shows anti-Ro or anti-La antibodies and a focal lymphocytic sialadenitis.

  • D. Mucoepidermoid carcinoma, treated with surgery and radiotherapy

    Mucoepidermoid carcinoma is a malignant tumour and rarely bilateral.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Kuttner tumour (IgG4-related sclerosing sialadenitis), treated with corticosteroids. Chronic sclerosing sialadenitis of the submandibular gland (Kuttner tumour) is an IgG4-related disease, with a mass-like firm enlargement, elevated IgG4 levels and storiform fibrosis.

Why is "Warthin tumour, treated with enucleation" not the answer?

Warthin tumour is a parotid tumour in older male smokers.

Why is "Sjogren syndrome, treated with methotrexate" not the answer?

Sjogren syndrome shows anti-Ro or anti-La antibodies and a focal lymphocytic sialadenitis.

Why is "Mucoepidermoid carcinoma, treated with surgery and radiotherapy" not the answer?

Mucoepidermoid carcinoma is a malignant tumour and rarely bilateral.

What concept does this question test?

It tests Salivary glands: IgG4-related sialadenitis in ENT. It responds well to corticosteroids. It can mimic a neoplasm.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Salivary glands: IgG4-related sialadenitis?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.