BIOPSY OF LABIAL SALIVARY-GLANDS AND LACRIMAL GLANDS IN THE DIAGNOSISOF SJOGRENS-SYNDROME

Objective, To determine the diagnostic value in Sjogren's syndrome (SS ) of evaluating the presence of focal adenitis in labial salivary glan d (LSG) and lacrimal gland (LG) biopsy specimens Methods, We studied 1 05 cases with suspected SS and performed biopsies prospectively. The d iagnostic criteria of Fox, et al were followed, The Chisholm-Mason gra ding standard and Greenspan focus score were used for evaluation. Resu lts, Epimyoepithelial islands and severe lymphocyte infiltration with germinal centers were observed only in LG biopsy specimens (5.9 and 3. 5%, respectively). The lymphocytic focus scores of LG (2.5 +/- 2.1/4 m m(2)) were significantly higher than those of LSG specimens (1.3 +/- 1 .1/4 mm(2)) in 23 cases with both biopsy results (p < 0.05), Six of th e 32 LSG biopsies were normal while their LG biopsies were significant ly higher. Conversely, 5 of the 32 LG biopsies were aided by correspon ding LSG biopsies, since in LG biopsies no glandular tissue was obtain ed, Evaluation of both specimens for the same patient was significantl y more effective in diagnosing SS than using either specimen alone (p < 0.01), Conclusion, LG biopsy specimens have a more evident histopath ology than LSG biopsy specimens. We recommend that both LSG and LG bio psies be performed in patients with suspected SS to reduce false negat ive results and improve diagnostic accuracy.