Abnormal salivary gland function is associated with well-defined histologic alterations including clustering of lymphocytic infiltrates as a common feature of all salivary glands and other organs affected by Sjogren's syndrome (Figure 6.8). His-tologic evaluation of enlarged parotid or sub-mandibular glands usually reveals the benign lymphoepithelial lesion, with a lymphocytic infiltrate and epimyoepithelial islands. These features are not invariably noted in the major salivary glands, however (Daniels 1991). The characteristic microscopic feature of Sjogren's syndrome in the minor glands is a focal lymphocytic infiltrate, and includes focal aggregates of 50 or more lymphocytes, defined as a focus, that are adjacent to normal appearing acini and the consistent presence of these foci in all or most of the glands in the specimen (Daniels 1991). Epimyoepithelial islands occur uncommonly in minor glands of patients affected by Sjogren's syndrome.
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