Minor salivary gland evaluation: Sjögren’s syndrome

Sarıoğlu, Sülen; Küçük, Ülkü; Cetin, P.; Sarı, İ̇smail; Birlik, Ahmet Merih

doi:10.3906/sag-1409-96

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…Furthermore, the distribution of the inflammatory cells in the gland may be uneven. For reduction of misdiagnosis resulting from the single tissue section a recommended modification is a multi-section and taking LSG at different depths from the same incision [31][32][33]. Moreover, LSGB can be valuable in diagnosing B-cell mucosa-associated lymphoid tissue (MALT) lymphomas, which can accompany SS.…”

Section: The Role Of Salivary Gland Biopsy In the Diagnosis Of MD And Ssmentioning

confidence: 99%

Mikulicz’s disease and Sjögren’s syndrome as the main autoimmune disorders involving salivary glands

Kamiński¹

2020

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Mikulicz's disease and Sjögren's syndrome involve salivary glands. They are characterised by lymphocytic infiltrations in affected exocrine glands leading to their swelling and dysfunction. Although they present similar clinical symptoms, currently they belong to different classifications and require different multidisciplinary treatments. This study presents and compares Sjögren's syndrome and Mikulicz's disease and reviews their main clinical, histopathological, and serologic criteria and the methods used in the diagnostic process. The most reliable diagnostic method is histopathologic examination of glandular tissue obtained by either minor or major salivary gland biopsies. Serologic criteria play an additional diagnostic role. The different radiological modalities allow the exclusion of other inflammatory and neoplastic processes that can mimic the initial stages of Mikulicz's disease and Sjögren's syndrome. Streszczenie Choroba Mikulicza i zespół Sjögrena zajmują gruczoły ślinowe. Charakteryzują się naciekami limfocytarnymi w zajętych gruczołach zewnątrzwydzielniczych, co prowadzi do ich obrzęku i dysfunkcji. Chociaż oba te schorzenia cechuje podobny obraz kliniczny, obecnie są odmiennie klasyfikowane i wymagają innego leczenia wielospecjalistycznego. W artykule przedstawiono chorobę Mikulicza oraz zespół Sjögrena i porównano je ze sobą. Omówiono ich główne kryteria kliniczne, histopatologiczne i serologiczne, a także metody stosowane w diagnostyce. Badanie histopatologiczne tkanki gruczołowej pobranej z małych lub dużych gruczołów ślinowych jest najpewniejszą metodą diagnostyczną. Badania serologiczne odgrywają dodatkową rolę. Różne metody radiologiczne pozwalają na wykluczenie procesów nowotworowych i zapalnych, które w początkowych fazach choroby mogą naśladować zespół Sjögrena i chorobę Mikulicza.

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Section: The Role Of Salivary Gland Biopsy In the Diagnosis Of MD And Ssmentioning

confidence: 99%

Mikulicz’s disease and Sjögren’s syndrome as the main autoimmune disorders involving salivary glands

Kamiński¹

2020

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“…Immunosuppressive drugs and steroids can also confuse histopathological results. Oral steroids and immunosuppressive drugs at the time of biopsy are factors potentially contributing to false-negative results of LSGB [4,19]. Problems in assessing the FS also arise when other histopathological patterns, such as nonspecific chronic sialadenitis or sclerosing chronic sialadenitis, are present.…”

Section: Labial Salivary Gland Biopsy In Diagnosing and Monitoring Sjmentioning

confidence: 99%

“…Considering this patchy distribution, a single tissue section may result in underdiagnosis. Multiple tissue sections at different tissue depths within the labial salivary gland may improve the accuracy of SS diagnosis by detecting specific features that may not have been detected in a single section [19].…”

Section: Labial Salivary Gland Biopsy In Diagnosing and Monitoring Sjmentioning

confidence: 99%

The unknown face of labial salivary glands. Labial salivary gland biopsy as a diagnostic tool

Kamiński¹,

Guzera²

2019

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Labial salivary gland biopsy (LSGB) is a minimally invasive and safe surgical procedure performed in the diagnosis and monitoring of selected diseases such as Sjögren's syndrome (SS), sarcoidosis, and amyloidosis. The aim of this study is to present the main possibilities and indications for the usefulness of LSGB in these diseases, their histopathological criteria, and the main advantages and limitations. Histopathological confirmation of SS is based on the presence of lymphocytic infiltrates, known as focal lymphocytic sialadenitis (FLS). FLS refers to the histopathological pattern of the presence of one or more foci in the biopsies, while the tissue surrounding the foci is composed mainly of unaffected parenchyma. A focus is defined as an aggregate of ≥ 50 lymphocytes, and the focus score (FS) is the total number of foci per 4 mm 2 of salivary gland tissue. FLS should be distinguished from other types of sialadenitis such as nonspecific chronic sialadenitis, sclerosing chronic sialadenitis, granulomatous inflammation, and lymphomas. Streszczenie Biopsja wargowych gruczołów ślinowych (LSGB) jest minimalnie inwazyjnym i bezpiecznym zabiegiem chirurgicznym wykorzystywanym w diagnostyce i monitorowaniu wybranych chorób, takich jak zespół Sjögrena (SS), sarkoidoza, amyloidoza. Celem pracy było przedstawienie głównych możliwości i wskazań do zastosowania LSGB, kryteriów histopatologicznych, głównych zalet i ograniczeń. Histopatologiczne potwierdzenie SS opiera się na stwierdzeniu obecności nacieków limfocytarnych znanych jako ogniskowe limfocytarne zapalenie gruczołów ślinowych (FLS). Nazwa FLS odnosi się histopatologicznie do obecności jednego lub więcej ognisk w biopsji, podczas gdy ognisko jest otoczone głównie przez niezmienioną tkankę miąższową. Ognisko jest definiowane jako skupisko 50 lub więcej limfocytów, a wynik jest liczbą ognisk przypadającą na 4 mm 2 tkanki gruczołowej. Ogniskowe limfocytarne zapalenie gruczołów ślinowych powinno być różnicowane z innymi typami zapalenia, takimi jak niespecyficzne zapalenie gruczołów ślinowych, twardniejące przewlekłe zapalenie gruczołów ślinowych, zapalenie ziarniniakowe i chłoniaki.

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“…Labial salivary gland injuries can result in mucous extravasation cysts. Some patients can report burning or tingling sensations, and functional deficits during the immediate postbiopsy period such as eating, sleeping, or speech difficulties [9][10][11][12].…”

Section: Surgical Technique and Possible Complications Of Lsgbmentioning

confidence: 99%

“…Focus score can change significantly at different tissue depths within the minor salivary glands. Multiple sections for LSGB increase the diagnostic value and are more representative than a single section [7,10] (Figure 3).…”

Section: Differentiation Of Focus Lymphocytic Sialadenitismentioning

confidence: 99%

Laryngological and Dental Manifestations of Sjögren’s Syndrome

Kamiński¹,

Błochowiak²

2019

Chronic Autoimmune Epithelitis - Sjogren's Syndrome and Other Autoimmune Diseases of the Exocrine Glands

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Sjögren's syndrome (SS) affects numerous different areas, and many specialists may be involved in the diagnosis and treatment of SS. Otolaryngological and dental manifestations, neurological impairment, and hearing loss may be the initial symptoms of SS. This chapter describes the most common otolaryngological and oral manifestations of SS, its pathomechanism and possible etiology. Dryness accompanying SS is associated with many clinical implications. The rate of dry mouth in SS ranged from 41% at initial diagnosis to 84% 10 years after diagnosis. An unstimulated salivary flow rate of 0.1 ml/min in sialometry gives a score of 1 to the weighted sum of 5 items according to the current EULAR/ACR criteria. The presence of mononuclear cell aggregates around the ducts and acini of salivary glands results in functional and structural alterations at the level of these glands and impairs their secretory function. The most common oral signs and symptoms are dental caries, tooth decay, fungal infections, traumatic oral lesions, dysphagia, dysgeusia, and inflammation of the salivary glands. Saliva in SS is characterized by the increased concentration of lactoferrin, potassium and cystatin C and the decreased concentration of amylase, carbonic anhydrase, mucins, histatines, IgA, statherins, proline-rich proteins, and the loss of salivary buffer properties. The lack of these physiological defense mechanisms increases the risk of opportunistic infections, mainly fungal infections by Candida albicans. Candidiasis accompanies angular cheilitis, simple cheilitis, and exfoliative cheilitis. The salivary glands of SS patients are characterized by chronic inflammation with the presence of lymphocytic infiltrates located around the striated ducts. These periductal foci may lead to the development of organized ectopic lymphoid structures resembling secondary lymphoid organs with segregated T-and B-cell areas, and high endothelial venules. These structures become an active center of immune response. The presence of foci in labial salivary glands is a hallmark of SS, and their histopathologic analysis is an important item in the diagnosis and classification. A biopsy can be taken from either the labial or the parotid salivary gland, but currently according to the diagnostic criteria, only labial salivary gland biopsy (LSGB) is recommended to confirm the diagnosis of SS. The authors present their own experience and recommendations in taking labial salivary gland biopsy, the main surgical approaches, and the main limitations for this diagnostic method and describe the possibilities and principles of histopathological examination in SS. The authors present the main ultrasonic signs of SS major salivary glands and perspectives of the usage of salivary gland ultrasonic examination in the diagnosis and monitoring of SS. The presented chapter also includes the most common laryngological manifestations associated with SS: nose dryness, crusting, Chronic Autoimmune Epithelitis-Sjogren's Syndrome and Other Autoimmune Diseases... 2 or atrophy of th...

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Minor salivary gland evaluation: Sjögren’s syndrome

Abstract: Assessment of 3 serial sections in MSGB has the potential to improve accuracy of SS diagnosis by detecting specific features that may not have been detected in a single section. We concluded that data about the PFS require further evaluation.

Cited by 4 publications

References 9 publications

Mikulicz’s disease and Sjögren’s syndrome as the main autoimmune disorders involving salivary glands

Mikulicz’s disease and Sjögren’s syndrome as the main autoimmune disorders involving salivary glands

The unknown face of labial salivary glands. Labial salivary gland biopsy as a diagnostic tool

Laryngological and Dental Manifestations of Sjögren’s Syndrome

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