Discussion of Panda sign
- The panda sign has been classically described as indicating Sarcoidosis
- Bilateral inflammatory involvement of the parotid and lacrimal glands results in Gallium-67 citrate uptake and production of the panda sign.
- The presence of perihilar adenopathy adds the lambda distribution of increased uptake in the chest, which at times has been included in the description of the panda distribution.
- The panda sign is not specific for sarcoidosis, although it is one of few disorders that affect the salivary and lacrimal glands symmetrically.
- Since 67Ga citrate accumulates in areas of inflammation and malignancy, the differential diagnosis for the symmetric bilateral accumulation in the lacrimal and salivary glands includes lymphoma (after irradiation), Sjögren syndrome, and acquired immunodeficiency syndrome.
 Imaging Findings for Panda sign
- When the normal accumulation of the radionuclide in the nasopharynx is combined with increased symmetric accumulation in the parotid and lacrimal glands, the image shows a striking similarity to the mottled coloring of the giant panda.
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 References for Panda sign
- Karen A. Kurdziel. [The Panda Sign.] Radiology 2000 215: 884-885.