Parotid gland involvement in sarcoidosis: Sonographic features

Teymoortash, Afshin; Werner, Jochen A.

doi:10.1002/jcu.20593

Cited by 18 publications

(11 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found a Hočevar score above the control range in approximately 19% of our sample, and in 37% when using a cutoff score of 15, as suggested in some studies . A case series described US findings of the parotid gland of 6 patients with histologically proven sarcoidosis of the parotid gland with sonographic features ranging from nodal enlargement to diffuse or partial involvement of the parotid gland, with various degrees of echogenicity and vascularity . However, we did not detect any differences in lymph nodes or vascularity among our cohorts, and we could not distinguish the glandular appearance of the sarcoidosis subjects with abnormal salivary glands from those with Sjögren's syndrome.…”

Section: Discussionsupporting

confidence: 52%

“…Another investigator, blinded to the underlying diagnosis and clinical evaluation, analyzed the US video clip images for salivary gland US score (SGUS) using the Hočevar protocol (parenchymal echogenicity, homogeneity, hypoechoic areas, hyperechoic foci, and border visibility) , Doppler signal, hyperechoic septae, and lymph node characteristics. Intraglandular lymph nodes were evaluated for number, shape, size, group configuration, and pattern of Doppler flow .…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Ultrasound Features of Major Salivary Glands in Sarcoidosis, Amyloidosis, and Sjögren's Syndrome

Law

Jafarzadeh

Govender

et al. 2020

Arthritis Care & Research

View full text Add to dashboard Cite

Objective While salivary gland ultrasound (SGU) has gained prominence for evaluating Sjögren's syndrome, little information exists on SGU appearance of sarcoidosis and amyloidosis, potential mimics of Sjögren's syndrome. Our goal in this study was to estimate the diagnostic accuracy of major SGU features in differentiating Sjögren's syndrome from sarcoidosis, amyloidosis, and controls. Methods We enrolled consecutive adult ambulatory patients with a clinical diagnosis of Sjögren's syndrome fulfilling the 2016 American College of Rheumatology (ACR) classification criteria; we also enrolled patients with a clinical diagnosis of sarcoidosis or systemic immunoglobulin light chain (AL) amyloidosis, with histologic confirmation from any tissue, and rheumatology outpatients without diagnoses affecting salivary glands. Subjects underwent major SGU using the Hočevar protocol, with resulting video clips reviewed blind to clinical diagnosis. Results Sjögren's syndrome SGU scores were greater than in patients from the other groups, but there were no distinguishing salivary gland features from AL amyloidosis or sarcoidosis. None of the patients in the control group scored higher than 17, a cutoff previously suggested for Sjögren's syndrome, but 27% of patients with AL amyloidosis and 19% with sarcoidosis scored higher than 17. Adding Hočevar SGU scores of ≥17 to the 2016 ACR/European League Against Rheumatism criteria in a parallel scheme increased the sensitivity for Sjögren's syndrome from 87% to 98%, while combining the 2 criteria in series increased specificity from 81% to 98%. Conclusion Sjögren's syndrome, sarcoidosis, and AL amyloidosis share common SGU features that can help distinguish these conditions from patients without systemic rheumatologic disease. Clinicians should carefully consider these potential mimics when interpreting salivary gland US results.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Methodsmentioning

confidence: 99%

Comparison of Ultrasound Features of Major Salivary Glands in Sarcoidosis, Amyloidosis, and Sjögren's Syndrome

Law

Jafarzadeh

Govender

et al. 2020

Arthritis Care & Research

View full text Add to dashboard Cite

show abstract

“…MALT lymphoma should be excluded by open biopsy when enlarged intraparotideal lymph nodes are diagnosed in SS (Fig. 3) [19]. It has been estimated that MALT lymphoma originates in 510% of primary SS [1].…”

Section: Discussionmentioning

confidence: 99%

Rheumatic disorders affecting the head and neck: underestimated diseases

et al. 2011

View full text Add to dashboard Cite

The majority of rheumatic diseases of the H&N can be related to SS, granulomatosis with polyangiitis and sarcoidosis. However, the lack of specific symptoms and the clinical variability of H&N manifestation may contribute to a prolonged time to diagnosis. Our retrospective study points out the variability of symptoms and suggests a diagnostic pathway to reduce the cases of undetected H&N affection in rheumatic disorders.

show abstract

“…However, Teymoortash, et al [9].found that ultrasound findings had poor diagnostic specificity for sarcoidosis. While there are pathognomonic findings on certain imaging and histologic studies, a reliable modality for parotid assessment is yet to be determined.…”

Section: Diagnosismentioning

confidence: 97%

Sarcoidosis of the Head and Neck

Badhey

Kadakia

Carrau

et al. 2014

Head and Neck Pathol

View full text Add to dashboard Cite

Sarcoidosis is a complex disorder that often times involves the head and neck. Despite the presence of strong clinical evidence, tissue diagnosis and imaging is needed for confirmation of the disease. Although typically managed medically, when found in the sinonasal tract or intracranially, it may necessitate the intervention of a rhinologist-skull base surgeon. This article seeks to provide a comprehensive review of head and neck sarcoidosis, as this fascinating disorder often poses a diagnostic and therapeutic challenge. A brief discussion of surgical treatment for pituitary lesions is also provided. Articles from 1997 to 2013 were selected and reviewed by three researchers utilizing the most recent literature regarding sarcoidosis in the head and neck. PubMed searches were conducted using search terms such as "sarcoidosis", "neurosarcoid", and "extra-pulmonary sarcoid", among many others. A large collection of articles was generated and reviewed by the team of authors, and appropriate information was extracted to compose a thorough and expansive review of the subject. 10-15 % of patients with sarcoidosis have head and neck manifestations. Sinonasal and pituitary sarcoidosis presents a diagnostic challenge owing to its non-specific symptoms. Although systemic steroid therapy is often the first time treatment, endoscopic surgery is commonly used to treat advanced pituitary sarcoidosis refractory to medical management. As tissue diagnosis and imaging is key, a multi-disciplinary team approach is advantageous. Our study collates the available literature on head and neck sarcoidosis to provide a comprehensive review of the subject. This provides helpful information to guide all practitioners involved in the care of these challenging patients, namely pathologists, radiologists, otolaryngologists, and skull base surgeons, in the workup and management of head and neck sarcoidosis.

show abstract

Parotid gland involvement in sarcoidosis: Sonographic features

Abstract: Because of the lack of specificity of US findings in sarcoidosis involvement of the parotid gland, sarcoidosis should be considered in the differential diagnosis of parotid gland lesions in the proper clinical setting.

Cited by 18 publications

References 7 publications

Comparison of Ultrasound Features of Major Salivary Glands in Sarcoidosis, Amyloidosis, and Sjögren's Syndrome

Comparison of Ultrasound Features of Major Salivary Glands in Sarcoidosis, Amyloidosis, and Sjögren's Syndrome

Rheumatic disorders affecting the head and neck: underestimated diseases

Sarcoidosis of the Head and Neck

Contact Info

Product

Resources

About