title: Sonographic appearance of the submandibular glands in patients with immunoglobulin G4-related disease.
abstract: 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.
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: Shuichi
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Damdinsuren
authors.initials: D
authors.lastname: Anar
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Matsushita
authors.forename: Hayato
authors.initials: H
authors.lastname: Miyachi
mesh_terms: D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000000981:diagnostic imaging* / Q000276:immunology*; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D013363:Submandibular Gland / Q000000981:diagnostic imaging*; D013364:Submandibular Gland Diseases / Q000000981:diagnostic imaging* / Q000276:immunology*; D018615:Ultrasonography, Doppler, Color
chemical_list: D007074:Immunoglobulin G