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Beurteilung von Lippendrüsenbiopsaten beim Sjögren-Syndrom

Labial salivary gland biopsy in Sjögren’s syndrome

  • Schwerpunkt: Rheumapathologie
  • Published:
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Zusammenfassung

Die autoimmune Sialadenitis wird am häufigsten im Rahmen eines Sjögren-Syndroms angetroffen, einer systemischen Autoimmunerkrankung, bei der klinisch eine Sicca-Symptomatik mit Entwicklung einer Keratoconjunctivitis sicca sowie einer Xerostomie im Vordergrund steht. Dabei kommt es neben einer Manifestation an den großen Speicheldrüsen (SD), teilweise unter dem Bild lymphoepithelialer Läsionen, auch zu charakteristischen Veränderungen an den kleinen SD. Die histopathologische Diagnostik erfolgt daher annähernd ausschließlich an Biopsaten der labialen SD. Der Nachweis einer fokalen lymphozytären Sialadenitis mit mindestens einem Aggregat von 50 oder mehr Lymphozyten und Histiozyten bezogen auf 4 mm2 beurteiltes Speicheldrüsengewebe gilt dabei als positiver histologischer Befund. Dieser allein ist nicht beweisend für das Vorliegen eines Sjögren-Syndroms, stellt jedoch eines von 4 objektiven Kriterien dar, die die Grundlage der Klassifikation des Sjögren-Syndroms nach der American-European Consensus Group bilden.

Abstract

In the majority of cases, autoimmune sialadenitis is a feature of Sjögren’s syndrome. This systemic autoimmune disease is, therefore, clinically characterised by sicca symptoms such as xerostomia and keratoconjunctivitis sicca. Since autoimmune sialadenitis affects major as well as minor salivary glands, histopathological examination is almost always carried out using labial salivary gland biopsies. A positive histopathological result is determined as a focal lymphocytic sialadenitis with at least one aggregate of 50 or more lymphocytes and histiocytes per 4 mm2 of salivary gland tissue. As one out of four objective findings, focus scoring belongs to the classification criteria for Sjögren’s syndrome according to the American-European consensus group.

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Authors and Affiliations

  1. Institut für Pathologie, Charité Universitätsmedizin, Schumannstraße 20/21, 10117, Berlin, Deutschland

    A. Dankof & L. Morawietz

  2. Klinik für Rheumatologie und klinische Immunologie, Charité Universitätsmedizin Berlin, Berlin, Deutschland

    E. Feist

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  1. A. Dankof
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  2. L. Morawietz
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  3. E. Feist
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Correspondence to A. Dankof.

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Dankof, A., Morawietz, L. & Feist, E. Beurteilung von Lippendrüsenbiopsaten beim Sjögren-Syndrom. Pathologe 27, 416–421 (2006). https://doi.org/10.1007/s00292-006-0869-3

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  • DOI: https://doi.org/10.1007/s00292-006-0869-3

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