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- Title
Ultrasound-Guided Biopsy of Suspected Salivary Gland Lymphoma in Sjögren's Syndrome.
- Authors
Baer, Alan N.; Grader‐Beck, Thomas; Antiochos, Brendan; Birnbaum, Julius; Fradin, Joel M.; Grader-Beck, Thomas
- Abstract
<bold>Objective: </bold>To evaluate the safety and utility of core needle biopsy (CNB) for diagnosis of salivary gland lymphoma in Sjögren's syndrome (SS).<bold>Methods: </bold>We analyzed data from consecutive SS patients who underwent ultrasound-guided major salivary gland CNB for lymphoma diagnosis and determined whether CNB yielded an actionable diagnosis without need for further intervention.<bold>Results: </bold>CNBs were performed in 24 patients to evaluate discrete parotid (n = 6) or submandibular (n = 2) gland masses or diffuse enlargement (n = 16; 15 parotid). One patient had 3 CNBs of the same mass. Of the 26 CNBs, 24 included flow cytometry, using CNB and/or fine needle aspirate material, and 14 targeted sonographically identified focal lesions. No patient reported complications. In the 23 patients with 1 CNB, final diagnoses were marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT; n = 6), atypical lymphoid infiltration (n = 3), benign lymphoepithelial sialadenitis (n = 9), normal gland tissue (n = 4), and lymphoepithelial cyst (n = 1). In the patient with serial CNBs, the initial one without flow cytometry was benign, but the next 2 showed atypical lymphoid infiltration. Monoclonal lymphoid infiltration was detected in 12 patients: 6 with MALT lymphoma, 3 were benign, and 3 with atypical lymphoid infiltration. Of the latter 3, 1 was treated with rituximab and 2 with expectant observation. The diagnosis changed from atypical lymphoid infiltration to MALT lymphoma in 1 patient following biopsy of inguinal adenopathy 6 months post-CNB. CNB provided actionable results and avoided open excisional biopsies in all cases.<bold>Conclusion: </bold>CNB is safe and useful in the evaluation of suspected salivary gland lymphoma in SS.
- Subjects
CORE needle biopsy; LYMPHOMA diagnosis; SJOGREN'S syndrome; SALIVARY gland disease diagnosis; PAROTID glands; SALIVARY gland tumors; RESEARCH; BIOPSY; ULTRASONIC imaging; PREDICTIVE tests; SUBMANDIBULAR gland; RESEARCH methodology; DIFFERENTIAL diagnosis; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; LYMPHOMAS; PAROTID gland tumors; NEEDLE biopsy
- Publication
Arthritis Care & Research, 2021, Vol 73, Issue 6, p849
- ISSN
2151-464X
- Publication type
journal article
- DOI
10.1002/acr.24203