Table 2. Categorization of sonographic patterns that form the main diagnoses in parotid glands; proposal for a new classification system.

Diagnosis	Pattern of features
Normal parotid	Homogeneous and isoechoic
	Occasional normal intraparotid lymph nodes
Lymphocytic aggregations	Heterogeneous appearance
	“Coarse” echotexture
	Diffuse mainly small hypoechoic or anechoic areas interspersed within normal isoechoic areas
	Moderate to ill-defined margins
	Size usually less than 5 mm
	Not associated with posterior acoustic enhancement
	Subgroups
	Internal echogenic foci
	May be microcalcifications
	Intraparotid lymphadenopathy
Lymphoepithelial cysts	Heterogeneous appearance
	Prominent round hypoechoic area
	Well-circumscribed margins
	Size usually > 5 mm, up to several cm
	Internal septa
	Posterior acoustic enhancement
	Subgroups
	Internal echogenic foci
	May be microcalcifications
	Intraparotid lymphadenopathy
Fatty infiltration	Whole gland hypoechoic, with posterior attenuation
	Subgroup
	Intraparotid lymphadenopathy
Lymphadenopathy	Oval-shaped hypoechoic areas or nodules
	Echogenic hilum with hilar blood flow seen on colour Doppler