Post‐mortem prevalence of focal lymphocytic adenitis of the submandibular salivary gland

Waterhouse, J. P.; Doniach, I.

doi:10.1002/path.1700910107

Cited by 75 publications

(34 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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.…”

Section: Evaluation Of Salivary Gland Biopsiesmentioning

confidence: 94%

Sjögren's syndrome. Proposed criteria for classification

Fox¹,

Robinson²,

Curd³

et al. 1986

Arthritis & Rheumatism

617

230

View full text Add to dashboard Cite

The term “Sjögren's syndrome” (SS) is frequently used to describe the occurrence of keratocon‐junctivis sicca and xerostomia in association with an autoimmune disorder. However, well‐defined criteria for the classification of SS have not been established, and this diagnosis is being applied to a wide spectrum of conditions, ranging from clear “autoimmune” disease in some patients, to sicca complaints without evidence of a systemic immune process in elderly patients. Here, we review the clinical and laboratory features of patients referred for evaluation of sicca symptoms. In particular, we emphasize the need for care in choosing the site for minor salivary gland biopsy, and we describe the histologic features that aid in the evaluation of these biopsy specimens. In an attempt to identify a population of patients whose conditions might have a common etiopathogenesis and, thus, a common treatment program, we propose the following criteria for a diagnosis of SS: 1) objective evidence of keratoconjunctivis sicca, as documented by rose bengal or fluorescein dye staining; 2) objective evidence of diminished salivary gland flow; 3) minor salivary gland biopsy, obtained through normal mucosa, with the specimen containing at least 4 evaluable salivary gland lobules, and having an average of at least 2 foci/4 mm2; 4) evidence of a systemic autoimmune process, as manifested by the presence of autoantibodies, such as rheumatoid factor and/or anti‐nuclear antibody. The diagnosis of “definite SS” would be made when all 4 criteria are met; the diagnosis of “possible SS” would be made when 3 criteria are present. Specific exclusions for this diagnosis are preexisting lymphoma, graft‐versus‐host disease, sarcoidosis, and acquired immunodeficiency disease. These proposed criteria are more restrictive than are those currently used for diagnosing SS. Future multicenter trials will be required to determine whether these criteria are generally useful. Finally, we emphasize the rheumatologist's role in selecting safe, inexpensive methods of objectively monitoring sicca complaints (i.e., kerato‐conjunctivitis sicca and parotid salivary flow) and in evaluating the results of minor salivary gland biopsy.

show abstract

Section: Evaluation Of Salivary Gland Biopsiesmentioning

confidence: 94%

Sjögren's syndrome. Proposed criteria for classification

Fox¹,

Robinson²,

Curd³

et al. 1986

Arthritis & Rheumatism

617

230

View full text Add to dashboard Cite

show abstract

“…Waterhouse (1963) has shown that the changes observed in the submandibular gland in the postmortem subject reflect the degree of focal adenitis present in the parotid and lacrimal glands. Furthermore, Waterhouse and Doniach (1966) gland acini (Fig. 1).…”

mentioning

confidence: 97%

“…1). Such foci are commonly found in relation to small veins and at the edge of intralobular ducts (Waterhouse and Doniach, 1966).…”

mentioning

confidence: 99%

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

Chisholm¹,

Waterhouse²,

Mason³

1970

J Clin Pathol

Self Cite

113

View full text Add to dashboard Cite

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.

show abstract

“…The tissue sections were stained with hematoxylin and eosin (HE). FLI was divided according to the method of Waterhouse and Doniach [1966]: 0-1 focus per standard representative section = grade 0, 2-8 foci per standard representative section = grade I, 9^10 foci per standard representative section = grade II, over 40 foci per standard representative section = grade 111.…”

Section: Histology'mentioning

confidence: 99%