Parotid gland: US findings in Sjögren syndrome. Work in progress

To determine the value of sonography of the parotid gland in patients with Sjögren syndrome, six consecutive cases were retrospectively reviewed in which clinical findings indicated Sjögren syndrome. All patients were women. Two patients were found at sonography to have normal parotid glands. Four patients had multiple cystic changes in the parotid glands bilaterally. Each of these four patients had a clinical diagnosis of Sjögren syndrome. One of the four underwent sialography, which demonstrated characteristic sialectasia. Pathologic examination of an excised gland in one of the patients with Sjögren syndrome demonstrated typical benign lymphoepithelial aggregates, which cause obstruction and progressive ductal dilatation. While parotid enlargement in these patients may be due to salivary tumor, lymphoma, or sarcoidosis--all of which appear as solid lesions at sonography--this study suggests that bilateral cystic changes may be the rule in uncomplicated cases of Sjögren syndrome.