{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:07:07Z","timestamp":1790140027959,"version":"4.0.1"},"reference-count":5,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005866","name":"Far Eastern Memorial Hospital","doi-asserted-by":"publisher","award":["FEMH-2025-C-027"],"award-info":[{"award-number":["FEMH-2025-C-027"]}],"id":[{"id":"10.13039\/501100005866","id-type":"DOI","asserted-by":"publisher"}]},{"award":["FEMH-2025-C-027"],"award-info":[{"award-number":["FEMH-2025-C-027"]}],"id":[{"id":"https:\/\/ror.org\/019tq3436","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Sj\u00f6gren\u2019s disease (SD) is a chronic autoimmune disease associated with an increased risk of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), particularly in the parotid glands. However, distinguishing benign SD-associated sialadenitis from early lymphoma remains a diagnostic challenge, especially when biopsy samples are limited. We report an elderly woman presenting with progressive bilateral parotid swelling accompanied by xerostomia and xerophthalmia. Serological testing revealed positive anti-SSA and anti-SSB antibodies, hypergammaglobulinemia, and hypocomplementemia, suggesting Sj\u00f6gren syndrome. Neck ultrasound demonstrated multiple hypoechoic nodules in both parotid glands. Ultrasound-guided core needle biopsy (US-CNB) revealed lymphoepithelial sialadenitis with mixed lymphocytic infiltration suggestive of SD. Subsequent computed tomography demonstrated necrotic lymphadenopathy in the right parapharyngeal space. Surgical excision of the right parotid tumor was therefore performed, and histopathology confirmed extranodal marginal zone B-cell lymphoma (MALT lymphoma). Staging PET-CT revealed multi-site involvement. Following chemotherapy, a complete metabolic response was achieved, and the patient remained in remission during 30 months of follow-up. Careful surveillance is essential in patients with SD due to the increased risk of lymphoma. Repeat biopsy or surgical excision should be considered when imaging and clinical findings are discordant with CNB results.<\/jats:p>","DOI":"10.3390\/diagnostics16183067","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:12:09Z","timestamp":1789999929000},"page":"3067","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sj\u00f6gren\u2019s Disease-Associated Parotid MALT Lymphoma: Diagnostic Pitfall of Ultrasound-Guided Core Needle Biopsy"],"prefix":"10.3390","volume":"16","author":[{"given":"Shiou-Yi","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Chen","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2772-0983","authenticated-orcid":false,"given":"Ping-Chia","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3393-9001","authenticated-orcid":false,"given":"Wu-Chia","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"},{"name":"Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8754-7516","authenticated-orcid":false,"given":"Chih-Ming","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Hsun","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5610-7080","authenticated-orcid":false,"given":"Andy Wei-Ge","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0837-1597","authenticated-orcid":false,"given":"Li-Jen","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"},{"name":"Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan"},{"name":"Department of Electrical Engineering, Yuan Ze University, Taoyuan 320315, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/art.39859","article-title":"2016 American College of Rheumatology\/European League Against Rheumatism Classification Criteria for Primary Sj\u00f6gren\u2019s Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts","volume":"69","author":"Shiboski","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1111\/odi.12526","article-title":"IgG4-related sialadenitis and Sj\u00f6gren\u2019s syndrome","volume":"23","author":"Fragoulis","year":"2017","journal-title":"Oral Dis."},{"key":"ref_3","unstructured":"Mahmoud, S. (2025). Evaluation of the Submandibular Gland. Surgery of the Salivary Glands: Diagnostic and Therapeutic Strategies, Springer."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e005560","DOI":"10.1136\/rmdopen-2025-005560","article-title":"Ultrasound-guided core needle biopsy of the parotid gland in Sj\u00f6gren\u2019s disease: A promising tool towards precision medicine","volume":"11","author":"Achten","year":"2025","journal-title":"RMD Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"112532","DOI":"10.1016\/j.ejrad.2025.112532","article-title":"Fine-needle aspiration or core needle biopsy? A meta-analysis of diagnostic accuracy and procedural outcomes in salivary gland tumors","volume":"194","author":"Kassem","year":"2026","journal-title":"Eur. J. Radiol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/18\/3067\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:54:31Z","timestamp":1790139271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/18\/3067"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":5,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diagnostics16183067"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16183067","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}