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Is there any value in nonspecific inflammation seen on a salivary gland biopsy for making a clinical diagnosis of Sjogren’s disease in a seronegative patient with sicca symptoms (ie. chronic sialoadenitis with focus score 0)?

Is biopsy criteria (focal infiltrate of 50+ lymphocytes) absolutely necessary to consider a clinical diagnosis of Sjogren's?
2 Answers
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Rheumatology · Boston University School of Medicine
Answered on · Updated on

Unfortunately, nonspecific inflammation is unhelpful. In patients classified as having Sjogren's, the minor salivary gland biopsy will have a focus score of 0 in about 20% (Sharma et al., PMID 31092717). So you cannot rule out Sjogren's with a negative/non-specific biopsy. To meet the 2016 ACR/EULAR...

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Rheumatology · University of Kansas Medical Center
Answered on · Updated on

A helpful way to interpret minor salivary gland biopsy is the SICCA-derived approach (Daniels et al., 2011), which separates immune activity from chronic damage. The main histologic categories are:

  1. Focal lymphocytic sialadenitis (FLS): discrete clusters of >=50 lymphocytes in relatively preserved l...

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