AB0454 CHARACTERISTIC ULTRASOUND FEATURES OF SALIVARY GLAND LYMPHOMA IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME

Background: Lymphoma was one of the most severe complications of primary Sjogren’s syndrome (pSS). Lymphomas often developed in organs where pSS is active, such as salivary glands. The enlargement of salivary glands is considered a predictive factor in previous studies. It is clarified that salivary gland ultrasound can visually and clearly demonstrate the parenchyma structure, which is a feasible method for SS diagnosis. However, there are no specific ultrasound features of salivary gland lymphoma and no early ultrasonic alarming system have been reported. Objectives: To descript the characteristic ultrasound features and assess ultrasonic alarming value of salivary gland lymphoma in patients with pSS. Methods: We followed a cohort of 63 patients with pSS from March 2017 to September 2019 and salivary gland ultrasound was performed every three months. All patients were examined by grey-scale and color Doppler ultrasound (US). The size, echostructure and vascularity of salivary glands were analyzed. US-guided core-needle biopsy (US-CNB) was used for the diagnosis of salivary gland lymphoma. Results: In 63 patients with pSS, parotid enlargement occurred in 11 patients and none of them had submandibular gland enlargement. During the follow-up, 2 patients with parotid enlargement demonstrated recovery of size and echostructure improved. The remaining 9 patients had permanent parotid swelling and echostructure unchanged. US-CNB was performed in these 9 patients and histological and immunohistochemical findings of the cores suggested parotid lymphoma. Compared with other patients, these 9 patients revealed marked, permanent parotid enlargement of the unilateral or bilateral or asymmetric parotid. The parotid lymphoma ultrasonography was characterized by multiple, relatively large, well-demarcated hypoechoic (>6mm) with increased vascularity. Conclusion: Ultrasonographic assessment of salivary gland helped to alarm the occurrence of lymphoma in pSS patients. Marked, permanent and asymmetric parotid enlargement with multiple, relatively large, well-demarcated hypoechoic in echostructure seemed to be characteristic for parotid lymphoma in pSS patients. References: [1]Theander E, Henriksson G, Ljungberg O, Mandl T, Manthorpe R, Jacobsson LT. Lymphoma and other malignancies in primary Sjogren’s syndrome: a cohort study on cancer incidence and lymphoma predictors. Ann Rheum Dis. 2006;65(6):796-803. [2]Nocturne G, Mariette X. Sjogren’s Syndrome-associated lymphomas: an update on pathogenesis and management. Br J Haematol. 2015;168(3):317-27. [3]Alunno A, Leone MC, Giacomelli R, Gerli R, Carubbi F. Lymphoma and lymphomagenesis in primary Sjogren’s syndrome. Front Med (Lausanne). 2018;5:102. [4]Orita Y, Sato Y, Kimura N, Marunaka H, Tachibana T, Yamashita Y, et al. Characteristic ultrasound features of mucosa-associated lymphoid tissue lymphoma of the salivary and thyroid gland. Acta Otolaryngol. 2014;134(1):93-9. Disclosure of Interests: None declared