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Puncture and salivary gland biopsy
Last reviewed: 23.04.2024
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Diagnostic puncture of the salivary gland refers to the morphological methods of investigation. It is made with a needle not more than 1 mm in diameter and a 20 ml syringe. After insertion of the needle into the investigated site of the body, the contents are suctioned by several movements of the piston. Then the contents of the needle are transferred to the glass and a smear is made. Staining of smears produces asurium II-eosin, according to Romanovsky. In the punctate of intact salivary glands, cells of a cubic and a cylindrical epithelium are found in a small amount. Rarely in the field of vision, cells and narrow dense filaments of mature connective tissue are found.
If, during the diagnostic puncture, there are difficulties in interpreting the cytological picture, a puncture biopsy is performed.
[How is the puncture biopsy of the salivary gland performed?
For morphological examination, take a column of tissue with a special hollow needle with a trocar. Puncture is performed with a special thick needle with a core to take a small piece of the gland tissue for subsequent pathomorphological examination. Normally, the biopsy specimen reveals lobules of the salivary gland or fat and connective tissues. After the puncture biopsy, a temporary paresis of mimic muscles may occur due to a trauma to the branches of the facial nerve.
The biopsy of the parotid glands is performed under general or local anesthesia with the help of a fringing cut of the skin and subcutaneous tissue (in the manner of GP Kovtunovich's incision) in the posterior-maxillary fossa. Dissect the capsule, expose the interesting section of the gland and excise a piece of glandular tissue to a depth of no more than 1 cm in order to avoid trauma to the branches of the facial nerve. The wound is carefully layered carefully to prevent the formation of salivary fistula. An incisional biopsy of the submaxillary glands is usually not performed, as if necessary, an extended biopsy is performed with removal of the organ.
Biopsy of the small salivary gland
A biopsy of the small salivary gland of the lower lip is used for differential diagnosis of variants of chronic sialadenitis of the large salivary glands, since the morphological changes in the ICW are largely similar to those in the large salivary glands. Basically, this method of research is used to diagnose Sjogren's syndrome or disease. A biopsy of the ICS of the lower lip is performed under infiltration analgesia. An incision is made of the mucosa of the lower lip 1 cm in length. 2-3 small salivary glands are found and removed. The wound is sutured tightly with nodular sutures. When analyzing the morphological picture, the degree of lymphoid infiltration is taken into account. Its intensity is estimated in degrees: 1st degree (focal infiltration) - cluster in focus of more than 50 lymphocytes; 2 nd degree (focal-diffuse infiltration) - next to a lobule partially replaced by a lymphoid tissue, a preserved lobe may be located; 3rd degree (diffuse infiltration) - almost all acinar tissue is replaced by a lymphoid tissue.