A labial minor salivary gland biopsy is taken. What would you expect to find in a patient with sicca symptoms?

Correct answer: A. Focal lymphocytic infiltration of the glandular tissue

• A. Correct. Focal lymphocytic sialadenitis — dense aggregates of lymphocytes around ducts and acini — is the histologic hallmark of Sjögren syndrome, and the focus score from a lower labial biopsy is part of the classification criteria.
• B. Mucin extravasation with a granulation tissue wall describes a mucocele, a completely different lesion.
• C. Granulomas would suggest sarcoidosis, which can mimic Sjögren clinically but is histologically distinct.
• D. Fatty replacement occurs with age and with chronic obstruction, and it is not diagnostic on its own.