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Sonographic Appearance of the Submandibular Glands in Patients With Immunoglobulin G4‐Related Disease
Author(s) -
Asai Satomi,
Okami Kenji,
Nakamura Naoya,
Shiraishi Shuichi,
Yamashita Tomohiro,
Anar Damdinsuren,
Matsushita Hiromichi,
Miyachi Hayato
Publication year - 2012
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2012.31.3.489
Subject(s) - medicine , pathology , igg4 related disease , submandibular gland , differential diagnosis , lymph , antibody , disease , immunology
Swelling of the salivary glands is often an initial sign of immunoglobulin G4 (IgG4)‐related disease or IgG4‐related sclerosing/autoimmune disease. We encountered 2 patients with IgG4‐related disease who showed swollen submandibular glands with a unique characteristic sonographic pattern. Bilateral submandibular glands of both patients were enlarged with a smooth contour. The internal echo texture indicated multiple hypoechoic foci scattered against a heterogeneous background, which characteristically appeared with a mottled or irregular netlike appearance. A histopathologic examination of a resected section showed multiple foci of dense infiltrated lymphoplasmacytic cells and lymph follicles encircled by fibrous bands. A mottled appearance in the sonographic findings of the submandibular glands suggests the characteristic of IgG4‐related disease and can be helpful in the differential diagnosis at the initial manifestation.