Sonographic diagnosis for Mikulicz disease

Area of Science:

• Radiology
• Pathology
• Immunology

Background:

• Mikulicz disease (MD) is a rare chronic inflammatory condition.
• Distinguishing MD from Sjögren syndrome (SS) is crucial for appropriate management.
• New diagnostic criteria for MD necessitate updated imaging characterization.

Purpose of the Study:

• To investigate the diagnostic imaging features of Mikulicz disease (MD).
• To specifically evaluate sonographic characteristics of MD.
• To differentiate MD imaging findings from those of Sjögren syndrome (SS).

Main Methods:

• Analysis of sonographic and sialographic images from 9 MD patients.
• Comparison of imaging findings with clinical, histopathologic, and serologic data.
• Comparative analysis with imaging findings in patients with Sjögren syndrome (SS).

Main Results:

• MD exhibited bilateral, hypoechoic, hypervascular nodal areas in submandibular glands on sonography.
• Sialography revealed parenchymal defects in affected submandibular glands.
• Parotid glands showed minimal changes; CT/MRI were less clear for nodal areas, while gallium scintigraphy showed accumulation.

Conclusions:

• Mikulicz disease presents with characteristic bilateral submandibular gland nodal changes, distinct from Sjögren syndrome.
• Sonography is identified as the optimal imaging modality for detecting and monitoring these MD-specific changes.