PDF: Diagnostic evaluation of serial sections of labial salivary gland biopsies in Sjögren’s syndrome

Sjögren’s syndrome (SS) is a chronic inflammatory disease with unknown onset and progress mechanisms, which diffusely involves exocrine glands, and which clinically presents distinctive dysfunctional signs defined as "sicca syndrome".

The disease mainly affects middle-aged women in a 10:1 ratio.

No individual SS clinical or laboratory tests exist so far; therefore, the diagnosis is based on the combined evaluation of multiple clinical, serological, functional and morphological parameters, as originally proposed by a group of researchers supported by the European Community, and recently revised by the American-European Consensus Group.

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The detection of chronic inflammatory infiltrates containing >50 lymphocytes (lymphocytic focus) per 4 mm2 tissue in minor salivary gland biopsies (MSGB) is the diagnostic morphological parameter of SS.

Based on the presence and number of lymphocytic foci, Daniels and Greenspan formulated a focus score (FS) ranging from 0 to >2, whose diagnostic specificity and sensitivity to SS is detectable in grades >1 and >2.