Lymphocytic sialadenitis in the major and minor glands: a correlation in postmortem subjects

Abstract

In the present investigation, the prevalence offocallymphocytic adenitis in the submandibular salivary gland was observed in a series of 116 postmortem subjects after suitable exclusions had been made. Focal lymphocytic adenitis could not be demonstrated in the labial salivary glands. The degree of lymphocyticinfiltrationin the labial salivary glands is positively correlated with the level of focal lymphocytic adenitis in the submandibular glands in the same subject. Lymphocytic foci and lymphocytic infiltrations found under these circumstances are probably related. This finding provides conceptual support for the examination, by biopsy, of the labial glands in patients suspected of Sjögren's syndrome.

Labial salivary gland biopsy in sjögren's syndrome

“…Although some lymphocytic foci are seen in most normal parotid and submandibular glands (13,15,16), postmortem studies on a total of 279 LSG specimens from persons who had no history of CTD confirmed that, when appropriate exclusionary criteria are applied (see Patients and Methods), focal sialadenitis is not found in LSGs unless a CTD is present (12,14,32,33,38). However, postmortem LSG specimens commonly exhibit inflammatory cell infiltration associated with acinar atrophy.…”

“…Using a semiquantitative method to grade the inflammation, they found that more than I focus of lymphocytes per 4-mm2 gland section was seen only in patients with SS and was not present in control postmortem specimens. Further studies showed a positive correlation in pattern and extent of inflammation between LSGs and submandibular glands from 116 postmortem subjects (33), and histopathologic agreement between LSGs and parotid glands from 12 patients with SS (34).…”

Cerebrospinal Fluid Findings in Neurological Diseases Associated with Sjögren's Syndrome

“…Xerostomia was considered when the weight difference of the sponge before and after chewing was less than 3.5 g. We defined both antiSjögren antibodies (SSA [Ro] and SSB [La]) and antibodies against α-Fodrin (IgA and IgG) each for them-self and also in combination of both as comparable positive detection of autoimmune antibodies in Sjögren's syndrome [20,21] . Focal lymphocytic sialadenitis was defined positive with a focus score ≥ 1 (number of lymphocytic foci containing more than 50 lymphocytes per 4 mm 2 ) [22] . Our patients were categorized into separate groups depending on whether Sjögren's syndrome was diagnosed alone or in association with other autoimmune diseases.…”

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“…Biopsies obtained from $3 patients who have had xerostomia symptoms for nhany years also exhibit these changes, which suggests that salivary glands are a site of continued autoimd u n e activity, rather than a site that "burns out" and forms fibrotic scar tissue (10). In contrast, fibrotic and cmtracted-appearing salivary gland lobules have been found frequently in elderly subjects with sicca symptoms (33,34), in whom the lymphoid cells were diffusely scattered throughout the lobule, and dilated ducts were filled with inspissated mucus.…”