Salivary histopathology in diagnosis of Sjögren's syndrome

Although the etiology of Sjögren's syndrome (SS) remains unknown, the histopathologic examination of affected organs provides tissue diagnosis, a way to assess severity, and clues to pathogenesis. A common feature in organs affected by SS is lymphocytic infiltration, which presumably causes the functional changes and the diverse clinical features associated with this disease. So far, the salivary glands are the best studied organs in SS. Biopsy of major salivary glands is not a clinically convenient nor a very effective way to diagnose SS and can have serious sequelae. For these reasons, the minor salivary glands in SS have been studied for the last 20 years and used in diagnosing the salivary component of SS for more than 10 years. However, minor gland specimens can present different patterns of inflammation, and in diagnosing SS it is critical to distinguish between these patterns. Furthermore, a minor gland biopsy specimen must be taken from clinically normal-appearing mucosa and must contain sufficient glandular tissue for assessment.