Both parotid glands are heterogenous with cystic regions consistent with the intermediate stage of Sjogren's disease. The submandibular glands are atrophic. No calcification identified within the parotid or submandibular glands.
There is diffuse enlargement of multiple lymph nodes within the neck. There is a level 1 lymph node measuring 2 cm. Enlarged left level 2/3 nodes measuring up to 2.5 cm. Enlarged right level 3 nodes measuring 2.5 cm.
The extent of lymphadenopathy extends into the down upper chest, with multiple small left infraclavicular nodes identified.
The pharynx and larynx have a normal appearance. The thyroid gland is unremarkable.
Conclusion:
- salivary gland changes are consistent with Sjogrens syndrome
- extensive lymph node enlargement within the and neck and axilla. Splenomegaly. This is suggestive of lymphomatous transformation
- the neck or left axillary lymph node would be amenable to ultrasound-guided biopsy