Histological criteria of Sjögren's syndrome in scleroderma

33 patients with scleroderma, xerostomia and xerophthalmia underwent biopsy of 3 to 5 labial salivary glands. Histological and ultrastructural study were systematically performed on the salivary gland specimen. In 27 patients, sclerosis was the main feature: it was an active fibrosis, with numerous secreting fibroblasts and degranulating mast cells. This fibrosis was located around capillaries and excretory ducts. It surrounded the acini, progressively destroying them. Lymphocytes were present but not very numerous. They were not grouped around the ducts but scattered in the fibrosis. 5 patients had similar fibrotic lesions but they also had numerous lymphocytes grouped in focus around excretory ducts as in primary Sjögren's syndrome. It is concluded that in scleroderma, xerostomia and xerophthalmia can be related either to a pure sclerotic process or to a 'common' secondary Sjögren's syndrome.