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Fine needle aspiration cytology in the diagnosis of Sjögren’s syndrome

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Pryczynicz A., Guzińska-Ustymowicz K., Wakulewska A., Ducher M., Lewczuk Ł., Kisielewski W., Ustymowicz A., Zioło M., Famulski W.
Progress in Health Sciences
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2013
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vol. 3
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issue 2
178-182
EN
Introduction: Sjögren’s syndrome is an autoimmune disease belonging to the group of collagenases. It is characterized by lymphocytic infiltration of the exocrine glands, leading to their impairment or complete dysfunction. The inflammatory process usually involves cells of the salivary or lacrimal glands. However, also other organs and systems can be affected. Purpose: The presentation of a Sjögren’s syndrome case. The pathologist’s role in the disease diagnosis. Case presentation: A 63-year-old female patient with the enlarged left parotid salivary gland and symptoms of xerostomia and xerophtalmia was referred for ultrasound imaging and fine-needle aspiration biopsy (FNAB). Ultrasonography revealed inhomogeneous echostructure of the salivary gland with multiple tiny, oval, hypoechoic areas, hyperechoic zones of fibrosis and enhanced vascularization of the gland. The pathological analysis of FNA showed a benign lymphoepithelial lesion, and Sjögren’s syndrome was suggested. Blood serum analysis found anti Ro-52 (SS-A), anti-La (SS-B) and anti-ANA antibodies at 1:1,000 titer. Sjögren’s syndrome was diagnosed based on accessory investigations and the clinical condition of the patient. Conclusions: The pathomorphological analysis of fine-needle aspiration biopsy of the salivary gland contributed to the diagnosis of Sjőgren’s syndrome in the patient.
2
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Labial salivary gland biopsy in the diagnosis of Sjögren’s syndrome

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Katarzyna Błochowiak K., Jerzy Sokalski J.
European Journal of Clinical and Experimental Medicine
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2019
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issue 2
162-168
EN
Introduction. Labial salivary gland biopsy is used for diagnosis of Sjögren’s syndrome (SS) and lymphoma accompanying SS. Aim. The aim of this study was to present the main techniques used for taking labial salivary gland biopsies in the diagnosis of SS with respect to their advantages, histologic criteria, validation, complications, and their usefulness for diagnostic procedures, monitoring disease progression, and treatment evaluation. Material and methods. This study is based on analysis of literature. Results. The microscopic confirmation of SS is based on the presence of focal lymphocytic sialadenitis (FLS) with a focus score ≥1 per 4 mm2 of glandular tissue. A lymphocytic focus is defined as a dense aggregate of 50 or more lymphocytes adjacent to normal-appearing mucous acini in salivary gland lobules that lacked ductal dilatation. Other histopathological features of SS are lymphoepithelial lesions and a relative decrease of <70% IgA + plasma cells. Labial salivary gland biopsy is characterized by high specificity, a positive predictive value, and an average sensitivity of 79% in SS. Conclusion. It can be also valuable in diagnosing B-cell mucosa-associated lymphoid tissue (MALT) lymphomas but it is not recommended for the monitoring of SS progression and the effectiveness of the treatment. Persistent lower lip hypoesthesia is the most severe complication of labial salivary gland biopsy.
3
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The spectrum of non-characteristic oral manifestations in COVID-19 – a scoping brief commentary

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Hüpsch-Marzec H., Dziedzic A., Skaba D., Tanasiewicz M.
Medycyna Pracy
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2021
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vol. 72
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issue 6
685-692
EN
Virus-induced oral abnormalities, occurring especially in severe COVID-19 cases of hospitalized patients, have various characteristics and clinical features being, either directly or indirectly, related to SARS-CoV-2 infection. Deregulation of the immune system as a result of SARS-CoV-2 infection may lead to the impairment of the normal defense pathway in the SARS-CoV-2 positive patients. This scoping mini-review is aimed to critically appraise the existing evidence concerning the potential link between COVID-19 condition and abnormal manifestations within oral cavity, affecting oral mucosa, salivary glands and sensory elements. COVID-induced oral mucosa manifestations, with various clinical aspects, are likely to occur as coinfections and secondary symptoms, as immune system imbalance is per se a causative factor of secondary manifestations. Oral mucosal lesions related to SARS-CoV-2 infection do not seem to demonstrate gender predilection, with the average reported age around 50 years of age. They include mainly white and erythematous plaques, ulcers, blisters, petechiae. The affected intraoral areas were mainly: tongue, palate, lips, gingiva, and buccal mucosa. The “aggressive” therapies utilized to treat COVID-19, including drug interactions may aggravate or initiate OMLs pathologies. Neglected oral hygiene or partial or complete abandonment of oral hygiene during intensive hospitalization constitutes an independent factor promoting a wide range of oral pathologies. In addition, stress factor indirectly impairs functioning of the immune system. Oral mucosa lesions occurring in COVID-19 cases present with a wide variation of non-characteristic features. These intraoral, soft tissues abnormalities seem to be reversible and transient. A potential impact of severe oral pathologies to systemic health resulting from SARS-CoV-2 infection, along with associated poor oral hygiene should not be ignored, predominantly in seriously ill patients hospitalized in intensive care units.
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