the first important discussion regarding sialosis in dental reports was mentioned 35 years ago and since then little has been published . sailadenosis refers to noninflammatory , often recurrent enlargement of the salivary glands , most frequently , the parotids . it is usually associated with various underlying disorders that include diabetes , alcoholism , malnutrition , anorexia nervosa , bulimia , etc . , the management of sialadenosis depends upon identification of the underlying cause that must then be corrected . a 45-year - old female came with a swelling at the left preauricular region measuring 3 cm  3 cm . ultrasonography showed single , well - circumscribed swelling measuring 3 cm  3 cm in the left preauricular region which was suggestive of benign salivary gland lesion . fine needle aspiration cytology showed moderately cellular smears having acinar epithelial cells arranged in clusters , papillae , and glandular pattern as well as scattered singly [ figure 1a ] . individual cells were round , having round uniform nuclei and a moderate amount of cytoplasm [ figure 1b ] . in areas ( a ) photomicrograph showing moderately cellular smears having acinar epithelial cells arranged in clusters , papillae , glandular pattern , and scattered singly ( b ) individual cells were round , having round uniform nuclei , and a moderate amount of cytoplasm ( c ) in areas mild cellular enlargement , nucleomegaly , and hyperchromasia were noted . sialadenosis is a recurrent , noninflammatory , nonneoplastic enlargement of salivary glands usually associated with an underlying systemic disorder . pape et al . reported in his series of cases , four cases of unilateral sialadenosis . sialadenosis usually occurs in association with a variety of conditions including diabetes mellitus , alcoholism , endocrine disorders , pregnancy , drugs , bulimia , eating disorders , idiopathic , ect . clinically , it presents as soft , often bilateral , usually painless , and recurrent swelling of the parotid gland . fine needle aspiration yields cellular smears having acinar epithelial cells adherent to thin fibrovascular stroma . mainly large numbers of naked nuclei of epithelial cell origin were seen in the background . a similar condition that can mimic sialadenosis is low grade acinic cell tumor particularly on cytology . atypical nuclear features were more prominent in acinic cell tumors as compared to sialadenosis . in our case , the distinguishing cellular feature for acinic cell carcinoma includes large nuclei , grainy eosinophilic cytoplasm , and neoplastic cells are arranged singly or in small clusters . in addition , usually there is an absence of other normal salivary gland structures such as duct epithelium and interstitial adipose tissue . these are important features useful for differentiating acinic cell carcinoma from sialadenosis and normal salivary gland enlargement . the diagnosis of silaladenosis must exclude inflammatory causes of salivary gland swelling , particularly sjogren 's syndrome , human immunodeficiency virus ( hiv ) infection , sarcoidosis , and lymphoepithelial diseases by relevant investigations . other condition of sialadenitis will be excluded as it contains inflammatory cells on the background . the treatment of sialadenosis is unsatisfactory but it should be aimed at the correction of the underlying disorder . we are presenting this case for its rarity and its important differentiation on cytology smears from other parotid lesions . in the work - up of salivary gland swelling , it is important to recognize on cytological evaluation of these underestimated entities which do not necessarily require surgical treatment and can be treated with an underlying systemic cause .
a diffuse , chronic , usually bilateral , noninflammatory , nonneoplastic enlargement of major salivary glands is termed as sialosis or sialadenosis . 
 it is an extremely uncommon cause for enlargement of the parotid gland . 
 we hereby present a case of a 45-year - old female patient having a swelling at the left preauricular region . 
 the swelling was gradually increasing in size since 6 months . on clinical examination , 
 the swelling was 3 cm  3 cm , mobile , and nontender . on ultrasonography , it was suggestive of benign parotid lesion or parotitis with cervical lymphadenopathy . on fine needle aspiration cytology , it was suggestive of sialadenosis . 
 this is an extremely rare salivary gland lesion with specific cellular features . 
 it is very important to distinguish sialadenosis from other causes of enlargement of the parotid gland as treatment modality differs .