What is a Salivary Gland Biopsy?
Salivary glands are located beneath your tongue and over your mandible near your ear. Their purpose is to secrete saliva into your mouth to begin the digestive process and to protect your teeth from decay.
The main salivary glands (parotid glands) are located over your main chewing muscle (masseter muscle), beneath your tongue (sublingual gland), and on the floor of your mouth (sub mandibular gland).
A salivary gland biopsy involves the removal of cells or small pieces of tissue from one or more salivary glands in order to be examined in the laboratory.
What Does a Salivary Gland Biopsy Address?
If a mass is discovered in the salivary gland, your doctor may decide that a biopsy is necessary in order to determine whether you have a disease requiring treatment.
Your doctor may recommend the biopsy in order to:
- examine abnormal lumps or swellings in the salivary glands — these may be caused by an obstruction or tumor
- determine if a tumor is present — this condition will require further tests to distinguish the type of tumor and how it will be removed and treated
- determine if the gland needs to be removed — this may be necessary if a duct in the salivary gland has become blocked or if a malignant tumor is present
- diagnose diseases such as Sjögren syndrome, a chronic autoimmune disorder in which the body attacks healthy tissue namely the salivary glands.
Preparation for the Salivary Gland Biopsy
There are little or no special preparations required before a salivary gland biopsy. Your doctor may ask that you refrain from eating or drinking anything for a few hours prior to the test. You may also be asked to stop taking blood-thinning medications such as aspirin or warfarin (Coumadin) a few days before your biopsy.
How Is the Salivary Gland Biopsy Administered?
This test is usually administered in the doctor’s office. It will take the form of a needle aspiration biopsy. This enables the doctor to remove a small number of cells while barely affecting your body.
First, the skin over the selected salivary gland is sterilized with rubbing alcohol. A local anesthetic is then injected to kill the pain. Once the site is numb, a fine needle is inserted into the salivary gland and a small piece of tissue is carefully removed. The tissue is placed on microscopic slides, which are then sent to the laboratory to be examined.
If your doctor is testing for Sjögren syndrome, a biopsy will be taken from several salivary glands and may require stitches will be placed at the site of the biopsy.
Understanding the Results
In this case, the salivary gland tissue is determined to be healthy and there will be no diseased tissue or abnormal growths.
Swelling of the salivary glands: There are a number of conditions that can cause swelling of the salivary glands:
- salivary gland infections
- some forms of cancer
- salivary duct stones
Your doctor will be able to determine which condition is causing the swelling by the results of the biopsy, as well as the presence of other symptoms. He may also recommend an X-ray or CT scan, which will detect any obstruction or tumor growth.
Salivary gland tumors: Salivary gland tumors are rare. The most common form is a slow-growing, benign (noncancerous) tumor that causes the size of the gland to increase. Some tumors, however, may be malignant (cancerous). In this case, the tumor is usually a carcinoma.
Sjögren syndrome: This is an autoimmune disorder, the origin of which is unknown. It causes the body to attack healthy tissue. It is most common among women ages 40 to 50.
What Are the Risks of the Test?
Needle biopsies do carry a minimal risk of bleeding and infection at the point of insertion. You may experience mild pain for a short while after the biopsy, though this can be alleviated with over-the-counter pain medication.
If you experience any of the following symptoms, you should call your doctor:
- pain at the site of the biopsy that cannot be managed by medication
- swelling at the site of the biopsy
- drainage of fluid from the biopsy site
- bleeding that you cannot stop with mild pressure
You should seek immediate medical attention if you experience any of the following symptoms:
- dizziness or fainting
- shortness of breath
- difficulty swallowing
- numbness in your legs
Salivary Gland Tumors
If you have been diagnosed with salivary gland tumors, you will need surgery to remove them. You may also need radiation therapy or chemotherapy.
If you have been diagnosed with Sjögren syndrome, depending on your symptoms, your doctor will prescribe medication to help you manage the disorder.