Lymphoepithelial sialadenitis of minor salivary glands no Sjögren Syndrome related

Abstract Objective.—To determine the prevalence of diffuse infiltrative lymphocytosis syndrome (DILS) in the minor salivary glands of 30 African Cameroonian adults with the acquired immunodeficiency syndrome (AIDS). Design.—Salivary gland tissue was analyzed using a modified classification system that was developed to aid the diagnosis of Sjögren syndrome. The advantages and disadvantages of this approach are discussed. Materials and Methods.—Formalin-fixed, paraffin-embedded, hematoxylin-eosin–stained biopsy sections were prepared for 30 patients with AIDS, 26 healthy individuals who declined human immunodeficiency virus (HIV) testing, and 4 seronegative healthy controls. Tissues were immunostained for CD4/CD8+ lymphocytes and cytomegalovirus (CMV), and transmission electron microscopy was performed to locate viral particles. Patients were tested for HIV-1 and HIV-2 by the HIV/Chek System 3 or CAMSTIX-HIV-1 and HIV-2 assay. Results.—Severe salivary ductal atypia (96%) was the feature most strongly associated with AIDS, and the lymphocytic focus score was the second histologic feature most strongly correlated with AIDS. Forty-eight percent of patients with HIV-1 infection had more than 1 lymphocytic focus in a minor salivary gland. These lymphocytes were primarily CD8+. We report, to the best of our knowledge, the first case of multinucleated salivary duct epithelial cells in minor salivary glands also containing enveloped virus particles. All cases were negative for CMV. Conclusions.—The prevalence of DILS in West Africans with AIDS appears higher than the prevalence reported in whites from the United States and Europe and in blacks from the United States, a group that has been reported to have a greater incidence of DILS than whites. This discrepancy may be related to differences in patient selection criteria. The determination of lymphocytic focus score, as used in the diagnosis of Sjögren syndrome, with the adjunct of ductal atypia is useful for assessing DILS. The impact of patient selection, drug therapy, and parasites on salivary gland pathology is discussed.

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Salivary Glands Ultrasonography as a Diagnostic Aid in Sjögren Syndrome: A Prospective Pilot Investigation

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2021.03.007 ◽

2021 ◽

Author(s):

Alaa F. Bukhari ◽

Arwa Farag ◽

Athena Papas ◽

Rumpa Ganguly ◽

Hugo Campos ◽

...

Keyword(s):

Salivary Glands ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Diagnostic Aid ◽

Pilot Investigation

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AB0936 Usefulness of Salivary Glands Ultrasonography in The Diagnosis of Sjögren Syndrome

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.5499 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 1221.2-1221

Author(s):

B. Paredes ◽

E. De Miguel ◽

G. Bonilla ◽

A. Pieren ◽

C. Plasencia ◽

...

Keyword(s):

Salivary Glands ◽

Sjögren Syndrome ◽

Sjogren Syndrome

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Role of Fractalkine in the Pathogenesis of Primary Sjögren Syndrome: Increased Serum Levels of Fractalkine, Its Expression in Labial Salivary Glands, and the Association with Clinical Manifestations

The Journal of Rheumatology ◽

10.3899/jrheum.130892 ◽

2014 ◽

Vol 41 (12) ◽

pp. 2425-2438 ◽

Cited By ~ 7

Author(s):

Jae Ho Lee ◽

Seung-Ki Kwok ◽

Seung Min Jung ◽

Jennifer Lee ◽

Jae-Seon Lee ◽

...

Keyword(s):

Epithelial Cells ◽

Confocal Microscopy ◽

Salivary Glands ◽

Proinflammatory Cytokines ◽

Sjögren Syndrome ◽

Control Group ◽

Sjogren Syndrome ◽

Clinical Effects ◽

Extraglandular Manifestations ◽

Primary Sjögren Syndrome

Objective.To investigate the expression of fractalkine and identify the clinical effects of fractalkine and its receptor (CX3CR1) in patients with primary Sjögren syndrome (pSS).Methods.Serum fractalkine levels were determined by ELISA. Immunohistochemical staining was done to compare the expression of fractalkine and CX3CR1 between salivary glands (SG) of patients with SS and controls. The cells to be merged with fractalkine were evaluated by confocal microscopy. Type of CX3CR1-expressing cells among infiltrating lymphocytes in SG was analyzed by confocal microscopy. Further, associations among fractalkine, proinflammatory cytokines, and clinical profiles were investigated.Results.Serum fractalkine levels in patients with pSS were higher than those in the control group (p = 0.026). SG expression of fractalkine and its receptor was upregulated in patients with pSS compared to that in the controls by immunohistochemistry. Higher histological grade was associated with more fractalkine-positive cells per total epithelial cells. Epithelial cells were the main fractalkine-expressing cell type in the SG. Serum fractalkine levels were significantly correlated with proinflammatory cytokines levels (interleukin 17: r = 0.685, p = 0.029; tumor necrosis factor-α: r = 0.444, p = 0.003), antinuclear antibody (r = 0.349, p = 0.022), and immunoglobulin G levels (r = 0.325, p = 0.044). Serum fractalkine levels in patients with extraglandular manifestations of pSS were significantly higher than in those without extraglandular manifestations (p = 0.026).Conclusion.Fractalkine and CX3CR1 may play a role in the pathogenesis of pSS, including extraglandular manifestations.

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IS THERE AN EARLY ULTRASONOGRAPHIC PATTERN IN SALIVARY GLANDS IN BOTH PRIMARY AND SECONDARY SJÖGREN SYNDROME?

Romanian Journal of Rheumatology ◽

10.37897/rjr.2017.1.6 ◽

2017 ◽

Vol 26 (1) ◽

pp. 30-37

Author(s):

Vasilia Iorgoveanu ◽

◽

Violeta Bojinca ◽

Madalina Gheorghe ◽

Diana Mazilu ◽

...

Keyword(s):

Parotid Gland ◽

Salivary Glands ◽

Early Period ◽

Sjögren Syndrome ◽

Biological Data ◽

Inflammatory Disorder ◽

Sjogren Syndrome ◽

Parotid Glands ◽

Submandibular Glands ◽

Left And Right

Background. Sjögren syndrome (SS) is a systemic chronic inflammatory disorder characterized by lymphocytic infiltrates in exocrine organs. Ultrasonography (US) demonstrates specificity and sensibility in major salivary glands (SG) evaluation. Recent data confirm US might be used as primary evaluation technique for its ability to show structural alterations of parenchyma (1). Objective. To assess the gray scale (GS) parenchymal inhomogeneity of major SG in patients with established primary and secondary SS and correlate with clinical and biological data. Methods. Consecutive patients with SS were recruited and SG US was performed. Inhomogeneity of glandular parenchyma was quantified binary on each gland. ESSDAI and ESSPRI scores were calculated. Statistics was performed with SPSS. Results. Twenty one (42.85% primary SS, 90.47% female) consecutive patients were included. Mean age was 53.66+/-12.99 years and disease duration 5.33+/-3.74 years. Antibody SSA/SSB presence was found in 85.7% (18/21). ESSDAI mean was 8.67+/-8.9 (0-29), ESSPRI 10.13+/-5.59(0-20). There were no differences regarding ESSDAI and ESSPRI in the two groups (primary and secondary SS). Right parotid gland showed alterations in 71.4% patients (77% with primary SS, 66% with secondary SS). Frequently inhomogeneity was found in all major SG (33%, 22% left and right submandibular, 77%, 44.4% left and right parotid glands) in primary SS. Both submandibular glands were symmetrically involved (p<0.02). Duration of disease was negatively correlated to inhomogeneity of right parotid gland (p<0.02). Conclusion. Inhomogeneity in major SG in GS US was found in the majority of patients with primary and secondary SS. The symmetrical involvement of submandibular glands was significant. The inhomogeneity appears in the early period of diagnosis. No major differences were found between two groups.

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Faculty Opinions recommendation of Latest advances in ultrasound assessment of salivary glands in sjögren syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.736461007.793564239 ◽

2019 ◽

Author(s):

William St Clair

Keyword(s):

Salivary Glands ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Ultrasound Assessment

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The Interleukin 33/ST2 Axis in Patients with Primary Sjögren Syndrome: Expression in Serum and Salivary Glands, and the Clinical Association

The Journal of Rheumatology ◽

10.3899/jrheum.140234 ◽

2014 ◽

Vol 42 (2) ◽

pp. 264-271 ◽

Cited By ~ 8

Author(s):

Seung Min Jung ◽

Jaeseon Lee ◽

Seung Ye Baek ◽

Jae Ho Lee ◽

Jennifer Lee ◽

...

Keyword(s):

Salivary Glands ◽

Activity Index ◽

Disease Activity Index ◽

Serum Levels ◽

Interferon Γ ◽

Sjögren Syndrome ◽

Epithelial Cell Line ◽

Sjogren Syndrome ◽

Interleukin 33 ◽

Primary Sjögren Syndrome

Objective.To evaluate the expression of interleukin 33 (IL-33) and its receptor in sera and salivary tissues of patients with primary Sjögren syndrome (pSS), and to investigate the association with clinical profiles.Methods.Serum IL-33 and soluble ST2 (sST2) of 55 patients with pSS and 48 controls were determined by ELISA and assessed for clinical correlation. The expression of IL-33/ST2 in salivary tissues was investigated by immunohistochemical staining and was further characterized by confocal microscopy. We also measured IL-33 production in salivary glandular epithelial cells by proinflammatory stimuli.Results.Serum levels of IL-33 and sST2 were higher in patients with pSS compared to those in controls (p = 0.018 and p < 0.0001, respectively). Among patients with pSS, sST2 concentration was associated with thrombocytopenia (p = 0.029) and correlated with disease duration (p = 0.013) and the European League Against Rheumatism Sjögren Syndrome Disease Activity Index (p = 0.042). The expression of IL-33 and ST2 was elevated in salivary glands of patients with pSS with grade 2 inflammation, and diminished in advanced inflammation. In patients with pSS, IL-33 was mainly observed in epithelial and endothelial cells of glandular tissue. The production of IL-33 mRNA by salivary gland epithelial cell line increased under stimulation with interferon-γ.Conclusion.The expression of IL-33 and its receptor was elevated in sera and salivary tissues of patients with pSS. These results suggest that the IL-33/ST2 axis might have a role in the pathogenesis of pSS.

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Evaluation of Germinal Center-like Structures and B Cell Clonality in Patients with Primary Sjögren Syndrome with and without Lymphoma

The Journal of Rheumatology ◽

10.3899/jrheum.131527 ◽

2014 ◽

Vol 41 (11) ◽

pp. 2214-2222 ◽

Cited By ~ 24

Author(s):

Svein Joar Johnsen ◽

Ellen Berget ◽

Malin Viktoria Jonsson ◽

Lars Helgeland ◽

Roald Omdal ◽

...

Keyword(s):

B Cell ◽

Germinal Center ◽

Nationwide Survey ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Immunoglobulin Gene ◽

Double Staining ◽

Minor Salivary Glands ◽

Primary Sjögren Syndrome ◽

Cell Clonality

Objective.Germinal center (GC)-like structures have previously been observed in minor salivary glands (MSG) of patients with primary Sjögren syndrome (pSS). The aim of our study was to explore the prevalence and features of GC-like structures and B cell clonality in patients with pSS with and without lymphoma.Methods.Based on a nationwide survey in Norway, we included 21 patients with pSS and with a concomitant lymphoma from whom MSG and/or lymphoma biopsies were available. Tonsil biopsies and MSG from 28 patients with pSS without lymphoma were used as controls. The presence of GC-like structures was investigated with H&E staining and double staining for CD21/IgD and CD38/IgD. B cell clonality in MSG and tumors were investigated with analysis of immunoglobulin gene rearrangements.Results.H&E labeling of MSG revealed GC-like structures in 17/40 (43%) of the patients: 4/12 (33%) with and 13/28 (46%) without lymphoma. Staining for CD21/CD38/IgD demonstrated CD21+ networks in 27/40 (68%) of the patients. CD21+/CD38– infiltrates were seen in 25/40 (63%) of the patients, and 16 of these were IgD+ within the infiltrate. Five percent (2/40) of the patients presented with CD21+/CD38+ infiltrates resembling tonsillar GC. Monoclonal B cell infiltration in MSG was present in 5/12 patients (42%) with and 5/28 patients (18%) without lymphoma (p = 0.12). In 2/10 (20%) of cases where both MSG and lymphoma biopsies were available, identical clonal rearrangements were detected.Conclusion.GC-like structures seen in H&E-stained MSG may represent various subtypes of CD21+ infiltrates. We were unable to detect a clear association between cellular infiltrates, B cell clonality, and lymphoma development.

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