Value of minor salivary gland biopsy in diagnosing Sjögren's syndrome.

Abstract

Minor salivary gland biopsy is suggested for diagnosing Sjögren's syndrome in patients with clinical signs of sicca syndrome. This biopsy is mainly examined on the basis of the semiquantitative morphologic criteria without taking into account the detection of characteristic myoepithelial sialadenitis (MESA). The role of minor salivary gland biopsy in the diagnosis of Sjögren's syndrome as a possible detection method for MESA was examined in a retrospective study. Minor salivary gland biopsies were obtained from 32 patients between 1986 and 1996. Twenty-two patients fulfilled the criteria for primary and 10 patients for secondary Sjögren's syndrome based on the catalogue of the European Study Group on Diagnostic Criteria for Sjögren's Syndrome. The histopathologic assessment was based on the histomorphologic MESA criteria, that is, parenchymatrophy, interstitial lymphocytic cell infiltration, and myoepithelial cell islands. The histopathologic assessment revealed normal minor salivary glands in 37.5% of the cases and chronic sialadenitis in 59.4% of the patients. Only one female patient (3.1%) had changes characteristic of MESA. Minor salivary gland biospy is therefore an unsuitable method for detecting MESA if the pathomorphologic correlative of MESA is used to confirm the diagnosis of Sjögren's syndrome.