The diagnostic significance of findings in salivary gland biopsies was evaluated in 4 groups.
Group I (32 cases): control (normal female)
Group II (22 cases): sialaporia (10-20ml/10 min by gum-test)
Group III (21 cases): “probable” Sjögren's syndrome.
Group IV (55 cases): “definite” Sjögren's syndrome.
The diagnosis of Sjögren's syndrome was based on criteria established by the Ministry of Health and Welfares Sjögren's syndrome Committee.
The results were as follows:
1. Changes in duct epithelium (destruction and/or proliferation of the duct epithelial cells, formation of epimyoepithelial island-like structures) were observed tobe more prominent in group ET than in other groups.
2. Changes in intralobular duct epithelium were more severe in group IV than in other groups.
3. The incidence of periductal foci (an aggregate of 100 or more lymphoid cells and histiocytes) in d labial salivary glands was 72.7% in group IV, higher than the other groups. Diffuse lymphoid cell infiltrations were observed to be prominent in group IV.
4. The incidence of cases demonstrating one or more periductal foci (an aggregate of 50 or more lymphoid cells) per lobule was noted to be highest in group IV.
5. The periductal foci recognized in groups III and IV were composed mainly of lymphocytes.
6. Changes in glands (interstitial fibrosis, atrophy, destruction and disappearance of acinal parenchyma) were more severe in group IV than in other groups.
7. Although salivary gland biopsies are an important addition to available diagnostic procedures for Sjögren's syndrome, this method may not be entirely adequate to confirm the diagnosis of this disease.