Sialolithiasis is a common disease of the salivary glands that usually affects the submandibular gland. Histological changes, such as infiltration of inflammatory cells, atrophy or degeneration of acini, and fibrosis and metaplasia of ductal epithelium, are found in most cases, but fatty degeneration is rare. We report a case of sialolithiasis with severe fatty degeneration of the submandibular gland. In this case, fatty degeneration affected 70% of the submandibular gland. Moreover, fatty degeneration was found in each lobule and was not diffuse. The fatty degeneration was attributed to disturbed lipid metabolism related to anoxia, caused by local circulatory disorder related to severe inflammatory cell infiltration.
