Diagnostic quality of Labial gland biopsies in the diagnosis of Sjögrens syndrome in EKHUFT

Abstract

Introduction: Biopsies of the Labial gland are invasive, key to establishing a definitive histological diagnosis in Sjögrens syndrome. Insufficient sampling and inaccurate reporting risks unnecessary morbidity. Inspite of this no consensus on the diagnostic criteria currently exists. Following consultation with the East Kent Hospitals University Foundation Trust (EKHUFT) head and neck lead histopathologist, a standard was devised where 6 or more minor salivary gland lobules were required to be deemed of sufficient diagnostic quality, and a focus score of 1 or more (1 focus score is 1mm2with more than 50 lymphocytes) as diagnostic of Sjögrens syndrome. Between 11/12/2011-28/10/2014 an initial retrospective audit of our trust (population of 759,000) established that biopsies and reporting were of insufficient diagnostic quality, with many failing to comment on the focus score or number of lobules.