The diagnostic utility of submandibular gland sonography and labial salivary gland biopsy in IgG4-related dacryoadenitis and sialadenitis: Its potential application to the diagnostic criteria

Sakamoto, M.; Moriyama, Masafumi; Shimizu, Masakata; Chinju, Akira; Mochizuki, Keita; Munemura, Ryusuke; Ohyama, Keiko; Mitsui, Takashi; Ogata, Kenichi; Ohta, Miho; Yamauchi, Masaki; Ishiguro, Nozomu; Matsumura, Mayu; Ohyama, Yukiko; Kiyoshima, Tamotsu; Nakamura, Seiji

doi:10.1080/14397595.2019.1576271

Cited by 12 publications

(7 citation statements)

References 18 publications

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“…Submandibular gland sonography is a useful imaging modality for its diagnosis because it detects characteristic nodal/reticular changes [3]. Doppler imaging of the salivary glands shows high vascularity, which is also a hallmark of Mikulicz's disease [3,4].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional ultrasonographic imaging of Mikulicz’s disease

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Three-dimensional ultrasonographic imaging of Mikulicz’s disease

et al. 2021

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“…A further limit could be represented by the absence of an imaging exam performed in our cohort. In a recent paper, Sakamoto et al [17] showed how salivary gland biopsy has low sensitivity for the diagnosis of IgG4-SA, showing favourable results with ultrasound in identifying IgG4-SA.…”

Section: Study Limitationsmentioning

confidence: 99%

Routine IgG4 staining in minor salivary gland biopsy in a cohort of Italian Caucasian patients suffering from xerostomia

Conticini¹,

D’Alessandro²,

Bardelli³

et al. 2022

Reumatologia

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Objectives: IgG4-related disease is a potentially systemic disease mimicking and overlapping with different autoimmune diseases, such as primary Sjögren's syndrome (pSS). The involvement of salivary glands, previously called Mikulicz's disease, has been reclassified as IgG4-related sialadenitis (SA). The aim of this study was to assess the prevalence of IgG4-SA in a cohort of Italian Caucasian patients presenting with xerostomia and to evaluate the eventual overlap between IgG4-SA and pSS. Material and methods: We included 154 patients -15 males and 139 females, mean age 54.18 ±14.24 years, who underwent minor salivary gland biopsy between March and December 2019 for xerostomia. Histopathology was evaluated using Chisholm-Mason (CM) and focus score (FS) for pSS and immunohistochemical study with IgG4 staining for IgG4-SA were performed. Serum autoantibodies (anti-SSa/RoAb, anti-SSB/LaAb, antinuclear antibodies, rheumatoid factor) were also assessed. Results: In 69 patients (44.8%) FS 0 was found, while FS ≥ 1 was presented in 85 (55.2%). Chisholm-Mason score < 3 and CM ≥ 3 was found in 73 (47.4%) and 81 (52.6%) cases, respectively. IgG4/high-power field level was 20 in 3 pSS patients (1.9%), but none of them had an IgG4/IgG ratio ≥ 40, as well as tissue fibrosis with storiform pattern, obliterative vasculitis, and tissue eosinophilia. The diagnosis of pSS, was confirmed in 92 patients (59.74%). No patient was definitively diagnosed with an IgG4-related disease. Conclusions: In the case of xerostomia, the evaluation of the histopathological specimen for IgG4 should not be routinely performed, at least in an Italian-based Caucasian population. Moreover, immunohistochemistry should not be requested in the case of a negative result of biopsy for pSS.

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“…More than 30-40% of the patients are diagnosed as having an IgG4-related disease present with sialadenitis [167][168][169]. The value of ultrasound was investigated in reports published in recent years with characteristic findings described [76,163,[169][170][171][172][173]. IgG4-associated sialadenitis may be considered as a "chameleon" concerning its variability of US findings.…”

Section: Igg4-associated Involvement Of Salivary Glandsmentioning

confidence: 99%

“…If US is used in IgG4-related sialadenitis, it is a very useful tool for suspecting this disease, but the final diagnosis can only be made based on clinical and serological findings and on gland biopsy [168,173]. Due to the variable appearance in US, the DD includes the whole spectrum of subacute or chronic sialadenitis with sialodochitis.…”

Section: Igg4-associated Involvement Of Salivary Glandsmentioning

confidence: 99%

Ultrasound in Inflammatory and Obstructive Salivary Gland Diseases: Own Experiences and a Review of the Literature

Koch

Sievert

Iro

et al. 2021

JCM

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Background: Ultrasound is established as a diagnostic tool in salivary glands for obstructive diseases such as sialolithiasis and tumors. Concerning inflammatory diseases and in non-sialolithiasis-caused obstruction, much fewer data are available. In recent years, technical development has allowed a better assessment of the gland parenchyma, and knowledge about intraductal pathologies has increased considerably, which has provided new insights and a new interpretation of ultrasound findings. Objectives: To provide a comprehensive review of the literature that includes our own experiences and to point out the state of the art in ultrasound in the diagnostics of inflammatory and obstructive salivary gland diseases, taking adequate techniques and recent technical developments into consideration. Data sources and study eligibility criteria: A systematic literature search was performed in Pubmed using various specific key words. Results: According to the literature results, including our own experiences, ultrasound is of value in up to >90% of cases presenting with inflammatory and/or obstructive diseases. Technical developments (e.g., elastography) and the application of modified ultrasound techniques (e.g., transoral ultrasound) have contributed to these results. Today, ultrasound is considered a first-line diagnostic tool in these diseases. However, in some inflammatory diseases, the final diagnosis can be made only after inclusion of the anamnesis, clinical symptoms, serologic blood tests, or histopathologic investigation. Conclusions: Ultrasound can be considered as a first-line diagnostic tool in obstructive and inflammatory salivary gland diseases. In obstructive diseases, it may be sufficient for diagnostics in >90% of cases. In inflammatory diseases, ultrasound is at least an excellent screening method and can be used to establish the diagnosis in cases of an early suspicion. In all diseases ultrasound can contribute to better management and can be used for monitoring during follow-up.

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The diagnostic utility of submandibular gland sonography and labial salivary gland biopsy in IgG4-related dacryoadenitis and sialadenitis: Its potential application to the diagnostic criteria

Cited by 12 publications

References 18 publications

Three-dimensional ultrasonographic imaging of Mikulicz’s disease

Three-dimensional ultrasonographic imaging of Mikulicz’s disease

Routine IgG4 staining in minor salivary gland biopsy in a cohort of Italian Caucasian patients suffering from xerostomia

Ultrasound in Inflammatory and Obstructive Salivary Gland Diseases: Own Experiences and a Review of the Literature

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