Lower Lip Biopsy (Labial Salivary Gland Biopsy)
In lower lip biopsy, several tiny salivary glands from the lower lip are removed and sent to a laboratory for microscopic examination. This procedure is typically performed when the results of other tests, such as antibody testing, suggest a diagnosis of Sjögren’s syndrome (an autoimmune disorder marked by dryness of the eyes and mouth) or are inconclusive.
Purpose of the Lower Lip Biopsy
- To confirm or rule out a diagnosis of Sjögren’s syndrome
- To reveal other types of glandular inflammation and help identify an alternative diagnosis, such as sarcoidosis or lymphoma
Who Performs It
- A surgeon
- Lower lip biopsy should be performed with caution in people with blood clotting disorders. Blood tests to evaluate clotting function, or coagulation studies, may be needed to ensure the biopsy can be done safely.
- The procedure may be performed in a hospital or an outpatient setting.
- The presence of mouth sores or infection may lead to false-positive results.
Before the Lower Lip Biopsy
- Tell your doctor if you regularly take anticoagulants or nonsteroidal anti-inflammatory drugs (such as aspirin, ibuprofen, or naproxen). You will be instructed to discontinue these agents for some time before the test. Also mention any other medications, herbs, or supplements that you take.
What You Experience
- You will sit in a dental chair.
- A local anesthetic (such as lidocaine) will be injected into your lower lip.
- When the anesthetic has taken effect, the doctor makes a small horizontal incision in the inner portion of the lip and removes at least 5 salivary glands. (Because they are so small, evidence of Sjögren’s syndrome may not be present in all glands.)
- The incision is sutured closed.
- The procedure usually takes about 1 hour.
Risks and Complications
Extremely rare complications include excessive bleeding or lip numbness at the biopsy site.
After the Lower Lip Biopsy
- You may leave the testing facility and return to your normal activities.
- It may be difficult to eat solid foods for several hours after the procedure.
- You may be given pain-relieving medication to allay any discomfort around the biopsy site.
- Resume taking any medications that were discontinued before the test, according to your doctor’s instructions.
- A follow-up examination may be scheduled to check the healing of the incision site.
- The tissue samples are sent to a pathology laboratory for microscopic examination. The presence of large clumps of inflammatory cells indicates Sjögren’s syndrome.
- If a diagnosis of Sjögren‘s syndrome is confirmed, treatment for the condition will be initiated.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media