The nose, minor salivary glands, and sarcoidosis

Fifty-nine patients referred to the ear, nose, and throat clinic for random minor salivary gland (MSG) biopsy were studied. After a careful head and neck examination, a random MSG biopsy and a random inferior turbinate or specific nasal lesion biopsy was done. Of 30 patients with bilateral hilar lymphadenopathy (BHL), 12 of 26 who were thought to have sarcoidosis had abnormal findings on MSG biopsy. Of 29 patients without BHL, none of the six who were later believed to have sarcoidosis had abnormal findings on MSG biopsy. The other 23 patients without BHL and who later were believed findings on MSG biopsy. A careful history, physical examination, and chest roentgenogram should precede referral for random MSG biopsy. Patients without BHL and without other evidence for systemic sarcoidosis do not benefit from random MSG biopsies. This is especially true because of the relative nonspecificity of the finding of a noncaseating granuloma.