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This study aimed to investigate the relationship between the elastic modulus and the histological components of parotid adenolymphoma by using real-time shear wave elastography.A total of 157 patients, histologically confirmed as having parotid adenolymphoma, were enrolled in the study. The maximum and the mean elastic modulus of the parotid mass were measured by using preoperative shear wave elastography. Parotid adenolymphoma was histopathologically subdivided into different types based on the relative proportion of stromal to cellular components.The maximal elasticity of parotid adenolymphoma ranged from 20.67 to 160.90 kPa, and the mean elasticity was 83.18 ± 39.15 kPa. The maximal elasticity of the 3 types of parotid adenolymphoma was 34.21 to 155.20, 20.67 to 104.20, and 45.89 to 160.90 kPa, respectively. The mean elasticity of the 3 types of parotid adenolymphoma was 89.16 ± 40.62, 63.24 ± 28.07, and 111.10 ± 37.85 kPa, respectively. The difference in the maximal elasticity among 3 groups was significant (P < 0.01). There was no significant difference in maximal elasticity of type II and type III as compared with type I adenolymphoma (P > 0.05). The maximal elasticity of type III adenolymphoma was significantly higher than that of type II (P < 0.05, t = 3.12).Shear wave elastography depicts parotid adenolymphoma with a variable appearance because of the relative proportions of stromal to cellular contents in the mass.