Lower Lip Biopsy Sjogren — MFDS Part 1 MCQ

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ModerateOral Surgery PrinciplesLower Lip Biopsy SjogrenMFDS Part 1

A 52-year-old woman with persistent xerostomia and dry eyes undergoes a lower labial biopsy to permit histological assessment for Sjögren's syndrome, including calculation of a lymphocytic focus score. Which tissue must the specimen contain?

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Correct answer: A — Labial minor salivary gland lobules

The correct answer is A. A lower labial biopsy for suspected Sjögren's syndrome samples the labial minor salivary gland lobules situated beneath the mucosa. Their glandular parenchyma is examined for focal lymphocytic sialadenitis and is required to calculate the focus score. A focus score of at least 1 focus per 4 mm² of glandular tissue supports classification when interpreted with the other clinical and laboratory findings; biopsy alone does not establish the diagnosis. Labial epithelium or orbicularis oris muscle without salivary tissue cannot be used for focus scoring. The submandibular and parotid glands are major salivary glands and are not the tissues targeted by a routine lower labial biopsy.

Reference: University Hospitals of North Midlands NHS Trust. Labial Gland Biopsy. Approved February 2025. https://www.uhnm.nhs.uk/our-services/oral-and-maxillofacial-surgery/patient-information-leaflets/