Focal parotid necrosis in systemic lupus erythematosus - Case report and review of the literature

Systemic lupus erythematosus ISLE) is a disease that may affect a number of organ systems, particularly the joints, skin, kidneys, heart, lungs, and i mmune system. Salivary gland involvement is usually associated with Sjogren 's syndrome, in which lymphocytic acinar infiltrates predominate histologic ally. We present the case of a 29-year-old woman with SLE who developed bil ateral parotid enlargement with a unilateral focus of parotid necrosis that was consistent with a cystic mass on computerized tomography. A biopsy of this lesion was histologically similar to a cervical lymph node biopsy in t he same patient, with both specimens showing loss of architecture and foci of necrosis consisting of nuclear dust, histiocytes, and scattered plasma c ells without formation of granulomata or presence of multinucleated giant c ells; these findings are classic for SLE lymphadenopathy. We believe this t o be the first reported case of focal necrosis in the parotid gland directl y associated with SLE.