AB0816 UPDATED DATA ON SAFETY AND PATIENT TOLERABILITY OF ULTRASOUND-GUIDED CORE NEEDLE BIOPSY OF MAJOR SALIVARY GLANDS IN PATIENTS AFFECTED BY SJÖGREN’S SYNDROME AT INCREASED RISK FOR LYMPHOMA
Authors: A. Zabotti, V. Manfrè, I. Giovannini, S. Longhino, E. Pegolo, M. Lorenzon, S. De Vita, L. Quartuccio
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Ultrasound-guided core needle biopsy (US-guided CNB) of major salivary glands represents an innovative diagnostic approach in primary Sjögren's syndrome (pSS) and related lymphoproliferative complications. This procedure has proven to be safe and well tolerated, with good diagnostic accuracy (1-3). <h3>Objectives:</h3> to report our updated data on safety, tolerability and diagnostic accuracy of US-guided CNB of major salivary glands on a wider cohort of pSS patients at increased risk for lymphoma. <h3>Methods:</h3> from September 2019 to October 2023, we included patients with a clinical diagnosis or suspicion of pSS and increased risk for lymphoma. All patients underwent US-guided CNB of major salivary glands, and subsequently monitored for eventual complications (transient if lasting &lt;12 weeks; persistent if ≥12 weeks) at 1, 2 and 12 weeks, through clinical evaluation and a written questionnaire on post-procedural complication and pain Visual Analogue Scale 0-10 (VAS 0-10). <h3>Results:</h3> US-guided CNB was performed on 57 major salivary glands (8 submandibular glands, 49 parotid glands) in 55 patients. In 22/57 cases no swelling was present at the time of biopsy. During follow-up (mean 26,75 months, SD ±15,4), only 1/57 case of persistent complication and 23/57 cases of transient complications were reported. The only persistent complication was represented by mild auricle paresthesia in the afference territory of great auricular nerve; the same involvement was described in other 2 cases as transient. Of note, no involvement of facial nerve was ever reported. Complications were reported in 10/22 cases with no glandular enlargement at the time of biopsy; in 14/35 cases with glandular enlargement at the time of biopsy, with no statistical difference between the 2 groups (<i>p</i> value 0.7). Mean intraprocedural VAS pain was 1,96 (SD ±2,87); post procedural VAS pain was 0,77 (SD ±1,87). Furthermore, tissue samples were adequate for diagnostic purposes in 54/57 cases (94,7%), allowing also pSS differential diagnosis in 5/57 cases (3 sarcoidosis, 1 IgG4 related disease, 1 chronic sclerosing sialadenitis). Mean gland surface area of histological samples was 26,56 mm<sup>2</sup> (SD ±12,35) All updated and detailed results are summarized in the attached Table 1. <h3>Conclusion:</h3> Expanding upon our previous group of cases enabled us to affirm and reinforce the growing significance of US-guided CNB in pSS patients at higher risk for glandular lymphoma. Notably, this procedure is well-tolerated, safe and exhibits a high level of diagnostic accuracy. Among our cohort, there haven't been any recorded cases of facial nerve injury following the biopsy procedure. However, there is a possibility of mild and mostly temporary sensory auricular impairment in the afference area of great auricular nerve. <h3>REFERENCES:</h3> [1] Giovannini I et al., RMD Open, 2022; [2] Zabotti et al., Clin Exp Rheumatol, 2022; [3] Zabotti et al., Rheumatology, 2021. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>