AB0831 SALIVARY GLAND ULTRASONOGRAPHY SCREENING FOR PRIMARY SJOGREN SYNDROME-RELATED LYMPHOMA
Authors: M. M. Tamas, A. Brozba, B. F. Agli, I. Felea, M. Lenghel, L. Damian, S. P. Simon, C. Pamfil, I. Filipescu, L. Muntean, S. Rednic
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Predictive factors for lymphoma in primary Sjogren syndrome (pSS) include clinical, serological, histopathological, and imaging characteristics [1]. Salivary gland ultrasonography (SGUS) is used as a promising novel tool for the diagnosis of pSS [2]. Moreover, the recent identification of potential ultrasonographic predictive factors for salivary gland (SG) lymphoma might assist in selection of patients suitable for US-guided core needle biopsy [2]. <h3>Objectives:</h3> The present study aimed to describe clinical, serological, and imaging features in patients with pSS and SG lymphoma and to evaluate potential associations between SGUS abnormalities and the traditional risk factors for lymphoma development. <h3>Methods:</h3> Patients diagnosed with pSS, according to the EULAR/ACR Criteria for the Classification of Primary Sjögren Syndrome, and SG lymphoma between 2019-2023 in a tertiary Rheumatology department were selected. Clinical and laboratory parameters, US, and MRI SG reported characteristics were retrieved from patients' records at the time of their last visit. US results were reported by experienced sonographers including the OMERACT score of the SG. <h3>Results:</h3> A total of 8 patients were included (F:M=7:1, mean age 54.8±10.5 years, mean disease duration 9.3±7.7 years). All patients were diagnosed with non-Hodgkin lymphoma. Lymphadenopathy was present in 5 (62.5%), parotid gland swelling in 7 (87.5%), and purpura in 1 (12.5%) patient. Autoantibodies were frequently found: rheumatoid factor in 6 (75%), anti-Ro in 7 (87.5%), hypocomplementemia in 4 (50%) of patients, while 3 (37.5%) presented hiper-gammaglobulinemia. Time since pSS onset was &lt;5 years in 4 (50%), between 5-10 years in 1 (12.5%), or &gt;10 years in 3 (37.5%) and did not correlate to the age at diagnosis. US OMERACT score 2 or 3 was identified in most patients. All patients presented SGUS abnormalities, with focal or diffuse pattern. Well-defined, hypoechoic focal lesions with posterior enhancement were the most frequently described US features, in 7 (87.5%) of patients. MRI was performed in 5 (62.5%) of patients. The most common characteristics of patients MRIs were heterogeneous intraglandular lesions with multinodular appearance, contrast-enhanced with rapid wash-out, and restrictive lesions on diffusion sequences. <h3>Conclusion:</h3> Clinical and serological predictors for lymphoma were variably present in patients with pSS and SG lymphoma. On the contrary, SGUS abnormalities were uniformly present and when available, MRI results aligned with the US findings. SGUS and MRI may serve as non-invasive tools for identification of patients at risk for lymphoma development. While results are not indicative of the specific lymphoma type, they can be valuable in guiding the selection of patients for salivary gland core biopsy. <h3>REFERENCES:</h3> [1] Alunno A, Leone MC, Giacomelli R, Gerli R, Carubbi F. Lymphoma and Lymphomagenesis in Primary Sjögren's Syndrome. Front Med (Lausanne). 2018;5:102. [2] Lorenzon M, Tulipano Di Franco F, Zabotti A, et al. Sonographic features of lymphoma of the major salivary glands diagnosed with ultrasound-guided core needle biopsy in Sjögren's syndrome. Clin Exp Rheumatol. 202;39 Suppl 133(6):175-183. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>