Biopsy of labial salivary glands and lacrimal glands in the diagnosis of Sjögren's syndrome.
OBJECTIVE
To determine the diagnostic value in Sjögren's syndrome (SS) of evaluating the presence of focal adenitis in labial salivary gland (LSG) and lacrimal gland (LG) biopsy specimens.


METHODS
We studied 105 cases with suspected SS and performed biopsies prospectively. The diagnostic criteria of Fox, et al were followed. The Chisholm-Mason grading standard and Greenspan focus score were used for evaluation.


RESULTS
Epimyoepithelial islands and severe lymphocyte infiltration with germinal centers were observed only in LG biopsy specimens (5.9 and 3.5%, respectively). The lymphocytic focus scores of LG (2.5 +/- 2.1/4 mm2) were significantly higher than those of LSG specimens (1.3 +/- 1.1/4 mm2) in 23 cases with both biopsy results (p < 0.05). Six of the 32 LSG biopsies were normal while their LG biopsies were significantly higher. Conversely, 5 of the 32 LG biopsies were aided by corresponding LSG biopsies, since in LG biopsies no glandular tissue was obtained. Evaluation of both specimens for the same patient was significantly more effective in diagnosing SS than using either specimen alone (p < 0.01).


CONCLUSIONS
LG biopsy specimens have a more evident histopathology than LSG biopsy specimens. We recommend that both LSG and LG biopsies be performed in patients with suspected SS to reduce false negative results and improve diagnostic accuracy.
Xu
K P
KP
Department of Ophthalmology and Oral Medicine, Tokyo Dental College, Chiba, Japan.
Katagiri
S
S
Takeuchi
T
T
Tsubota
K
K
D001706:Biopsy; D003710:Demography; D004848:Epithelium / Q000473:pathology; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D007765:Lacrimal Apparatus / Q000473:pathology*; D008046:Lip / Q000473:pathology*; D008679:Metaplasia / Q000473:pathology; D012469:Salivary Glands / Q000473:pathology*; D012699:Serology; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000473:pathology; D013666:Tears