A Case Report of Sjögren's Syndrome with the Formation of the Lymph Follicles in the Parotid Gland

Abstract

Sjogren's syndrome is characterized clinically by xerostomia, keratoconjunctivitis sicca and rheumatoid arthritis.A 52 year old female developed weakness and enlargement of the parotid glands in 1969 when a parotid gland biopsy was done, revealing a moderate periductal lymphocytic infiltration moderately.In 1972, the small joints of her hand and toes started to become progressively deformed. In 1976, she was finally diagnosed as having rheumatoid arthritis and had surgery on her deformed right hand. In 1978, in a parotid gland biopsy we found a complete formation of lymph follicles with germinal centers which mimicked Hashimoto's thyroiditis, pathologically.Sicca syndrome alone such as xerostomia and keratoconjunctivitis sicca should be separated and termed as Sjogrens disease and only when rheumatoid arthritis or other collagen diseases are included in this disease, should the term Sjogren's syndrome be used.The diagnosis of Sjogren's disease should be made only when a parotid gland biopsy shows the appearance of lymph follicles with germinal centers or massive lymphocytic infiltration.