Prevalence and clinical significance of lymphocytic foci in minor salivary glands of healthy volunteers

Abstract

Objective. To determine the prevalence and severity of focal lymphocytic sialadenitis in minor salivary glands of healthy, asymptomatic individuals, in whom Sjö gren's syndrome (SS) has been excluded. Methods. Charts of 54 healthy volunteers who had salivary gland biopsies at the National Institutes of Health from January 1992 to August 1998 were reviewed. The healthy volunteers served as control subjects in various studies of salivary dysfunction. Significant medical conditions including SS were excluded. A biopsy with a focus score (FS) >1 was regarded as positive. Descriptive statistics were used to summarize the population's characteristics. Results. The frequency of focal lymphocytic infiltration in the healthy volunteers was about 15% (8 of 54). None of these individuals had subjective xerostomia or dry eyes. The positive FS ranged from 2 to 6. FS did not correlate with age, smoking, serologic findings, or salivary flow in these patients. Conclusion. Lymphocytic infiltration in minor salivary glands is not uncommon among individuals without a history of salivary gland dysfunction. This finding is in agreement with the result of a previous autopsy survey study, indicating that focal sialadenitis may occur in the absence of SS.

Sjögren Syndrome or Sjögren Disease? The Histological and Immunological Bias Caused by the 2002 Criteria

“…Making an invasive technique mandatory simply to fulfill classification criteria, whose results will not modify the clinical management of patients, may be questioned ethically [14]. In addition, various studies have described significant limitations in the diagnostic utility of minor salivary gland biopsy [15][16][17][18][19], which makes it somewhat difficult to accept it as a mandatory criterion. In contrast, histopathological study of salivary glands should be considered as mandatory in those patients in whom other causes of sicca syndrome are suspected (such as sarcoidosis, HIV infection, or lymphoma [20,21]).…”

A Conspicuous Role For B Cells In Sjögren’s Syndrome

“…The distribution of lymphocyte subsets in the blood does not necessarily reflect their disposal at the sites of inflammation, all the more because lymphocyte infiltrates are detectable in the SG of around 15% of healthy individuals [48]. In the patients, this contains substantial numbers of plasma cells (PC) and B cells.…”

The oral component of Sjögren’s syndrome: Pass the scalpel and check the water

“…Lymphocytic foci suggestive of SS occur in 10% to 15% of "normal" individuals or postmortem samples without obvious symptoms of SS [13,14]. The major clinical issues raised by these findings include the following: 1) the pathologic diagnosis needs to evaluated in the context of the clinical symptoms; 2) do these "asymptomatic" patients progress to SS, regress to a normal state, or remain stable; and 3) do these patients have similar biologic markers in their saliva/ minor salivary glands (ie, interleukin-6, matrix metalloproteinases, tumor necrosis factor) or aberrant cell surface expression of inflammatory markers (ie, human leukocyte antigen-DR, cytotoxic T lymphocyte antigen-4, CD1a, and integrins) as patients with SS?…”