A comparison of clinical, pathological and radiological findings with magnetic resonance imaging studies of lymphomas in patients with Sjögren's syndrome.

In the past few years a variety of papers on magnetic resonance imaging (MRI) of the salivary glands have been published, mainly focusing on the evaluation of salivary gland tumors. More recently, non-tumorous lesions have also been examined with this imaging technique. In Sjögren's syndrome (SS) a characteristic inhomogeneous pattern with a "honeycomb-like" appearance of the parotid gland tissue has been shown in the T2-weighted sequence. This study shows MRI findings in four cases of intraglandular lymphoma occurring in patients with SS. Four patients with suspected lymphomas were examined with MRI, following which all lesions were either biopsied or removed. This enabled us to correlate clinical, radiological and pathological findings. Results indicate that MRI is a useful imaging tool in the detection of intraglandular lymphatic infiltrates, although it is not possible to distinguish morphologically between a localized lymphatic infiltrate and an early stage malignant lymphoma. Nevertheless, MRI is considered to be a valuable non-invasive method for deciding whether or not to perform a biopsy. Due to the excellent soft tissue differentiation obtained, it is also helpful for the surgeon to plan and perform a successful biopsy with minimal risk to the facial nerve.