Minor Salivary Glands Morphology in Xerostomia Patients

Is minor salivary gland biopsy more than a diagnostic tool in primary Sjo¨gren׳s syndrome? Association between clinical, histopathological, and molecular features: A retrospective study

“…The Tarpley score highlights only the absence (score 0) or the presence (scores 1-4) of foci in 4 mm 2 of glandular tissue, with the higher scores identifying glands with many foci and consequent progressive derangement of glandular tissue [7]. Finally, in order to assess and quantify the presence of inflammatory cells, some authors proposed an inflammatory severity score including (i) normal MSGs (score 1), (ii) MSGs with different amounts of inflammatory cells (scores 2-4), and (iii) the presence of 1 or more foci in 4 mm 2 (score 5) [8][9][10]. The main limitations of these classical score systems is to be confined to the diagnostic setting, and H&E staining allows only to quantify the inflammatory infiltrate and foci number, without giving information concerning qualitative features of the infiltrate.…”

“…For histological evaluation, H&E-stained sections were assessed as follows: (i) the histological pattern (normal, NSCS, or FLS) [5]; (ii) the Chisholm and Mason grading system (grades 0-4) [6]; (iii) the Tarpley score (scores 0-4) [7]; (iv) a grading for the severity of inflammatory infiltrate (grades 1-5) [9,10]; and (v) the focus score, assessing the number of foci/4 mm 2 (a focus is defined as an aggregate including at least 50 mononuclear cells) [8]. A biopsy was considered GC positive (GC þ ) if displaying at least one focus with lymphoid-like organization within normal MSG tissue.…”

“…In addition to FLS, different morphologic patterns of chronic inflammation commonly occur in MSG biopsy specimens: non-specific chronic sialadenitis (NSCS) and sclerosing chronic sialadenitis (SCS) [5]. Different histological scores have been employed to describe glandular involvement during pSS [6][7][8][9][10], and as far as MSGs histology is concerned, its diagnostic role is widely accepted and currently considered the "gold standard." Indeed, MSG biopsy is considered 1 of the 4 objective criteria of American-European Consensus Group's classification and 1 of the 3 objective criteria of American College of Rheumatology's classification for pSS [11,12].…”

Prevalence of Sjögren's syndrome in Brazilian patients infected with human T‐cell lymphotropic virus

“…While it is not uncommon to find inflammatory foci in the minor salivary glands of patients with xerostomia , a minor salivary gland biopsy finding of chronic inflammatory infiltrate with a lower intensity and different inflammatory cell population from typical SS does not rule out the hypothesis that the lymphoproliferation resulting from HTLV infection is involved in impairment of salivary gland function, but enhances the hypothesis that these alterations do not characterize true SS.…”

Prevalência da Síndrome de Sjögren em infectados pelo HTLV em São Paulo

“…Apesar de não ser incomum que pacientes simplesmente xerostômicos apresentem focos inflamatórios nas glândulas salivares menores (Liquidato et al, 2006), o intenso infiltrado inflamatório crônico, típico da SS, constatado nas cinco biópsias de glândula salivar menor realizadas, não afasta a hipótese de que a linfoproliferação decorrente da infecção pelo HTLV esteja envolvida no comprometimento funcional dessas glândulas.…”