Lymphoma of the parotid gland in Sjogren's syndrome.
We evaluated a 60-year-old woman who had experienced an insidious and slowly progressive development of dry eyes and dry mouth. She exhibited no evidence of underlying rheumatoid arthritis. Clinically, a soft-tissue mass was identified in the parotid area. Computed tomography (CT) at the level of the parotid glands showed a nodular appearance of both parotid glands, indicating dilation of the acini (figure, A). Also noted was a low-density soft-tissue mass in the right parotid gland that measured approximately 3 cm at its greater dimension (figure, B); this lesion was histologically proven to be a lymphoma.
The pathophysiology of lymphoma in Sjogren's syndrome remains unknown. To date, there is no argument favoring a viral infection or deregulation of a unique oncogene or antioncogene. (2) CT and magnetic resonance imaging can demonstrate findings consistent with Sjogren's syndrome. In such cases, the parotid glands have a punctate or nodular appearance that represents globular collections. These findings, however, are nonspecific; they are also seen in chronic sialadenitis and granulomatous diseases. (4)
(1.) Talal N. Sjogren's syndrome In: Schumacher HR, Jr., ed. Primer on the Rheumatic Diseases. 9th ed. Atlanta: Arthritis Foundation, 1988:136-8.
(2.) Mariette X. [Gougerot-Sjogren syndrome. Risk of lymphoma]. Presse Med 1999;28:1214-18.
(3.) Voulgarelis M, Moutsopoulos HM. Lymphoproliferation in autoimmunity and Siogren's syndrome. Curr Rheumatol Rep 2003;5:317-23.
(4.) Som PM, Brandwein MS. Salivary glands: Anatomy and pathology. In: Som PM, Curtin HD, eds. Head and Neck Imaging. 4th ed., vol. 2, St. Louis: Mosby, 2003:2005-133.
>From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans.