**6. Other histopathological features of LSGB**

There are also other histopathological features in the labial glands that are associated with SS and therefore might be indicative of this disease. Lymphoepithelial lesions (LELs) are striated ducts, which are infiltrated by lymphocytes with concurrent hyperplasia of the epithelial cells. They are found both in parotid and labial glands, and are more representative of parotid glands than labial glands.

Severity of the LELs can be classified into three stages: stage 1: a partial LEL (affecting <50% of the epithelium), stage 2: developed LELS (affecting 50–100% of the epithelium), and stage 3: occluded LELs (fully circumferentially affected epithelium without lumen).

Besides LELs, the salivary gland of SS patients also presents a relative decrease in IgA + plasma cells. Several studies showed that a relative decrease of <70% IgA + plasma cells was more sensitive and more disease specific than the FS. Both features can help assess the salivary gland biopsies for the diagnosis of SS, especially when the FS in the biopsy is <1 [7, 19–23].
