Biopsies

[mathistracy]

I am scheduled for pre op Wednesday for a lymph node biopsy as well as a parotid gland biopsy. Has anyone had either of these performed?

[lupus-support1 Administrator]

I do wish you well for Wednesday. Please let us know how you fared.

With good wishes,

Ros

The Salivary gland biopsy can diagnose diseases such as sicca syndrome, Sjögren syndrome, a chronic autoimmune disorder in which the body attacks healthy tissue namely the salivary glands.

Autoimmune Disorders

Almost any autoimmune disorder can be associated with lymphadenopathy, but the most common associations are with rheumatoid arthritis, systemic lupus erythematosus (SLE), and Sjogren’s syndrome [11]. Lymphadenopathy may occur in as many as 75% of rheumatoid arthritis patients at some time during the illness. Although the enlarged nodes may be related to inflamed joints, generalized adenopathy can also occur, often when the disease is active [11, 12]. Pathology generally shows reactive lymphoid hyperplasia with interfollicular plasmacytosis [12]. Lymphadenopathy in SLE is also quite common, occurring in 25%–67% of patients [13], and occasionally representing the presenting symptom [14]. Lymph node pathology in this case generally shows a diffuse hyperplasia with scarce follicles [11].

Sjogren’s syndrome is characterized clinically by ocular and oral dryness, with lymphocytic infiltration of salivary and lacrimal glands and a polyclonal B cell activation [11]. Development of a lymphoproliferative disorder may be heralded by marked enlargement of the salivary glands or worsening lymphadenopathy [11]. Lymph node biopsies in Sjogren’s syndrome frequently show reactive adenitis or atypical lymphoid hyperplasia [15], although patients with Sjogren’s syndrome do have an estimated 44-fold increase in risk for the development of NHL [16]. These lymphomas are most commonly marginal zone lymphomas [17–19] and most commonly located in the salivary glands. Rapid enlargement of the salivary glands, with or without persistent lymphadenopathy, again mandates a lymph node biopsy.

11↵ Segal GH, Clough JD, Tubbs RR. Autoimmune and iatrogenic causes of lymphadenopathy. Semin Oncol 1993;20:611–626. Medline

12↵ Kojima M, Hosomura Y, Itoh H et al. Reactive proliferative lesions in lymph nodes from rheumatoid arthritis patients: a clinicopathological and immunohistological study. Acta Pathol Jpn 1990;40:249–254. Medline

13↵ Estes D, Christian CL. The natural history of systemic lupus erythematosus by prospective analysis. Medicine (Baltimore) 1971;50:85–95. Medline

14↵ Dubois EL, Tuffanelli DL. Clinical manifestations of systemic lupus erythematosus: computer analysis of 520 cases. JAMA 1964;190:104–111.

15↵ McCurley TL, Collins RD, Ball E et al. Nodal and extranodal lymphoproliferative disorders in Sjogren’s syndrome: a clinical and immunopathologic study. Hum Pathol 1990;21:482–492. CrossRefMedline

16↵ Kassan SS, Thomas TL, Moutsopoulos HM et al. Increased risk of lymphoma in sicca syndrome. Ann Intern Med 1978;89:888–892.

17↵ Voulgarelis M, Dafni UG, Isenberg DA et al. Malignant lymphoma in primary Sjogren’s syndrome: a multicenter, retrospective, clinical study by the European Concerted Action on Sjogren’s Syndrome. Arthritis Rheum 1999;42:1765–1772. CrossRefMedline

18 Tzioufas AG. B-cell lymphoproliferation in primary Sjogren’s syndrome. Clin Exp Rheumatol 1996;14(suppl 14):S65–S70.

19↵ Royer B, Cazals-Hatem D, Sibilia J et al. Lymphomas in patients with Sjogren’s syndrome are marginal zone B-cell neoplasms, arise in diverse extranodal and nodal sites, and are not associated with viruses. Blood 1997;90:766–775. Abstract/FREE Full Text

[Hellybell]

Hi all

Last October I had a radical lingual tonsillectomy and a large mass removed from base of my tongue and back of throat. My biopsy of lingual tonsils said I had mature B Cell Lymphoma and the mass (they lost most of it) was reactive lymphoid hyperplasia

Since then I have been suffering with multiple throat infections, reactive lymphoid hyperplasia on my tongue and base and up the back of my throat, I get sharp pains in left side of my neck, along my jawbone and into my collarbone, any suggestions?

I am steadily getting worse, my voice keeps changing, I am fatigued always, difficulty swallowing still and much more, any ideas would be greatly appreciated!!