[Salivary gland ultrasound or biopsy? : Comparison of methods based on case examples]. / Speicheldrüsenultraschall oder Biopsie? : Methoden im Vergleich anhand von Fallbeispielen.
Z Rheumatol
; 82(8): 654-665, 2023 Oct.
Article
in De
| MEDLINE
| ID: mdl-37782326
ABSTRACT
BACKGROUND:
Ultrasound examination of the salivary glands (SG) is a quick and noninvasive method to detect and semiquantitatively estimate typical changes in the large SG in Sjögren's syndrome (SS). The differential diagnosis of SS is difficult because several diseases and adverse effects of treatment have a similar clinical picture as SS with sicca syndrome and can even induce alterations in the SG (mimic diseases). Hence, for a long time an SG biopsy was regarded as the diagnostic procedure of choice, especially in SSA negative patients, whereas the significance of SD sonography is still controversially discussed.OBJECTIVE:
Comparison of typical and atypical changes for SS in the salivary glands in ultrasound and associated histological sections. MATERIAL ANDMETHODS:
This article describes six patient cases with antibody positive or negative SS with and without typical SS ultrasound patterns, SS-associated lymphoma, sarcoidosis and IgG4-associated disease. The findings of the sonographic examination of the parotid glands and the associated histology of the SD are explained and put into context.RESULTS:
The SSA antibody positive patients with SS show a typical sonographic pattern with hypoechoic foci, especially if the disease has been present for a long time. This pattern can help support the diagnosis of SS. The ultrasound patterns of the mimic diseases sometimes differ significantly from the typical patterns of pSS. The histological examination of the SG helps to corroborate the diagnosis but low histological focus scores, in particular, require a critical synopsis of the clinical, serological and imaging findings.CONCLUSION:
Both salivary gland ultrasound and the histological examination of SG biopsies are justified in the diagnostics and differential diagnosis of SS and sicca syndrome.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Sjogren's Syndrome
Limits:
Humans
Language:
De
Year:
2023
Type:
Article