Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, Sao Paulo State University (UNESP), Araraquara, São Paulo, Brazil.
Oral Pathology, Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (FORP/USP), Ribeirão Preto, SP, 14040-904, Brazil.
Rheumatol Int. 2022 Aug;42(8):1411-1421. doi: 10.1007/s00296-021-04949-6. Epub 2021 Jul 20.
Focal lymphocytic sialadenitis (FLS), an important diagnostic criterion for Sjögren's syndrome (SS) diagnosis, can also be observed when assessing minor salivary gland (mSG) biopsies from healthy asymptomatic individuals (non-SS patients). Fifty cases of primary SS (pSS group) and 31 cases of oral reactive lesions (non-SS non-sicca group) containing also typical FLS features, were assessed by morphological and immunohistochemical (CD10, CD23 and Bcl-6) analysis, aiming at the detection of GCs. All pSS cases showed FLS with focus score (FS) ≥ 1. In the non-SS non-sicca group, 12, 10 and 9 cases showed FLS with FS ≥ 1, FLS with FS < 1 and FLS associated with chronic sclerosing sialadenitis with FS < 1, respectively. The morphological analysis revealed similar frequency of GCs in pSS (20%) and non-SS non-sicca group (19%). The area (p = 0.052) and largest diameter (p = 0.245) of GCs were higher in pSS than non-SS non-sicca group. The FS and number of foci were significantly higher in pSS than non-SS non-sicca group with FS < 1. Immunohistochemistry confirmed all morphological findings (GCs showing CD23 and Bcl-6 positivity, with variable CD10 expression) and additionally in 3 and 1 cases of the pSS and non-SS non-sicca group, respectively. Moreover, another 6 and 2 cases of the pSS and non-SS non-sicca group with FS ≥ 1, respectively, showed positivity only for CD23. FLS can also be observed when assessing oral reactive lesions, which showed similar frequency of GCs with those found in pSS patients. Further studies, including functional analysis of lymphocytic populations and GCs in FLS, are encouraged.
局灶性淋巴细胞性唾液腺炎（FLS）是干燥综合征（SS）诊断的重要标准，在评估健康无症状个体（非 SS 患者）的小唾液腺（mSG）活检时也可以观察到。评估了 50 例原发性 SS（pSS 组）和 31 例包含典型 FLS 特征的口腔反应性病变（非 SS 非干燥组），通过形态学和免疫组织化学（CD10、CD23 和 Bcl-6）分析，旨在检测 GC。所有 pSS 病例均显示 FLS 焦点评分（FS）≥1。在非 SS 非干燥组中，12、10 和 9 例分别显示 FS≥1 的 FLS、FS<1 的 FLS 和 FS<1 的伴慢性硬化性唾液腺炎的 FLS。形态学分析显示 pSS（20%）和非 SS 非干燥组（19%）的 GC 频率相似。pSS 组 GC 的面积（p=0.052）和最大直径（p=0.245）高于非 SS 非干燥组。与 FS<1 的非 SS 非干燥组相比，pSS 组的 FS 和焦点数量明显更高。免疫组织化学证实了所有形态学发现（GC 显示 CD23 和 Bcl-6 阳性，CD10 表达可变），另外在 pSS 和非 SS 非干燥组中分别有 3 例和 1 例。此外，pSS 和非 SS 非干燥组中另外 6 例和 2 例 FS≥1 的病例仅显示 CD23 阳性。在评估口腔反应性病变时也可以观察到 FLS，其 GC 频率与 pSS 患者相似。鼓励进一步研究，包括 FLS 中淋巴细胞群和 GC 的功能分析。
