title: The tortoiseshell pattern in one or both sides of the submandibular glands in mucosa-associated lymphoid tissue lymphoma is related to chromosomal aberrations and the disease extent.
abstract: OBJECTIVE
  Lesions of mucosa-associated lymphoid tissue (MALT) lymphoma in the submandibular glands are localized or a part of systemic involvement in association with chromosomal aberrations. This series was undertaken to investigate the sonographic features of MALT lymphoma in the submandibular glands and their relationships with chromosomal aberrations and the disease extent.
  
  
  METHODS
  A total of 5 patients with MALT lymphoma without Sjögren syndrome in the submandibular glands were enrolled in this series. Patients underwent sonography of the submandibular glands with a high-resolution transducer before surgical biopsy of the main lesion. Sonographic characteristics of the lesions were described for their location, presence of a posterior echo, texture, and presence of an internal echo.
  
  
  RESULTS
  Sonography in all cases showed hypoechoic and solid masses with increased posterior echo enhancement. There was an arrangement of hypoechoic small compartments demarcated by hyperechoic contour lines, which had a tortoiseshell pattern. This pattern was classified into 2 types according to its location: a lesion in the right or left side and lesions in both sides of the submandibular glands, found in 3 and 2 patients, respectively. The latter 2 cases had chromosomal aberrations of t(11;18)(q23;q23) and t(12;18)(q22;q21), respectively, and were revealed as secondary organ involvement.
  
  
  CONCLUSIONS
  The sonographic appearance of MALT lymphoma in the submandibular glands was characterized by the tortoiseshell pattern in both primary and secondary lesions. Detection of this pattern in both sides of the submandibular glands can be an indicator of chromosomal aberrations and systematic involvement of the disease.
authors.affiliation: Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. sa@is.icc.u-tokai.ac.jp
authors.forename: Satomi
authors.initials: S
authors.lastname: Asai
authors.forename: Kenji
authors.initials: K
authors.lastname: Okami
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakamura
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Ohta
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ogase
authors.forename: Guilan
authors.initials: G
authors.lastname: Jin
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Matsushita
authors.forename: Hayato
authors.initials: H
authors.lastname: Miyachi
mesh_terms: D000368:Aged; D002869:Chromosome Aberrations; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000000981:diagnostic imaging* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013365:Submandibular Gland Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics*; D014463:Ultrasonography