What are the characteristic findings of minor salivary gland biopsy in Sjögren syndrome?

Updated: Mar 05, 2021
  • Author: Sriya K Ranatunga, MD, MPH; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Although pathologists use different classification systems, the characteristic findings of minor salivary gland biopsy in a person with Sjögren syndrome include the following (see the image below) [74] :

  • The biopsy shows focal aggregates of at least 50 lymphocytes, and, to a lesser extent, plasma cells and macrophages

  • More than 1 focal aggregate is seen per 4 mm2

  • T cells, predominantly CD4+ cells, are present, unlike the predominance of CD8+ T cells seen in the salivary gland biopsy samples from patients with DILS associated with HIV disease

  • Normal acini are replaced by lymphocytes

  • Focal aggregates are seen in almost all glands

  • Ten percent of the lymphocytes are CD5+ B cells that produce IgM and IgG antibodies, often with a monoclonal or oligoclonal pattern

  • Large foci are present, possibly showing germinal centers

  • Epimyoepithelial islands are uncommon in the minor salivary gland but can be seen in the major salivary glands

    Photomicrograph of a lip biopsy specimen showing t Photomicrograph of a lip biopsy specimen showing two lymphocytic foci adjacent to normal-appearing mucinous acini typical of minor salivary gland abnormalities in Sjögren syndrome.

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