Solution: The US identifies a calcified structure in the right submandibular region with an associated hypoechoic mass. It is not exactly clear what this represents on the US, but it is obvious that it is separate from the parotid gland and does not have the normal appearance of a submandibular gland. The differential would be a necrotic lymph node, inflamed submandibular gland with stone in duct, or a primary salivary gland tumor. The findings on the CT are more specific. The stone is well seen with associated dilatation of the submandibular gland salivary duct and then increased density of the submandibular gland is suggestive of chronic inflammation. Considerations for treatment would include observation, antibiotics and surgery.