Parotid gland ultrasonography in Sjögren's syndrome, with histopathologic correlation

(A) Longitudinal axis view of right parotid gland in a patient with sicca symptoms who did not fulfill criteria for Sjögren's syndrome. Note the overall homogeneity of the echotexture of the glandular parenchyma. This was interpreted as a normal study.
(B) Longitudinal axis view of right parotid gland in a patient with Sjögren's syndrome. Note the numerous hypoechoic rounded areas (arrow), some of which are bounded by hyperechogenic linear bands. There are also numerous punctate hyperechogenic foci (dashed arrow), representing punctate areas of calcification within the glandular parenchyma.
(C) Core needle biopsy of the parotid gland of patient whose ultrasound is shown in panel B, showing benign lymphoepithelial sialadenitis. There is a dense lymphocytic infiltrate with lymphoepithelial lesions (arrowhead). Residual glandular acini are evident (thick arrow).