What Is a Salivary Gland Biopsy?

Salivary glands are located beneath your tongue and over your jawbone near your ear. Their purpose is to secrete saliva into your mouth to begin the digestive process (while making it easier to swallow the food), while also protecting 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.

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 swelling in the salivary glands that may be caused by an obstruction or tumor
  • determine if a tumor is present
  • determine if a duct in the salivary gland has become blocked or if a malignant tumor is present and needs to be removed
  • diagnose diseases like Sjögren syndrome, a chronic autoimmune disorder in which the body attacks healthy tissue

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.

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, multiple biopsies will be taken from several salivary glands and it may require stitches at the site of the biopsy.

Normal Results

In this case, the salivary gland tissue is determined to be healthy and there will be no diseased tissue or abnormal growths.

Abnormal Results

Conditions that can cause swelling of the salivary glands include:

  • salivary gland infections
  • some forms of cancer
  • salivary duct stones
  • sarcoidosis

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. They 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, noncancerous (benign) tumor that causes the size of the gland to increase. Some tumors, however, may be cancerous (malignant). 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.

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. 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 can’t be managed by medication
  • fever
  • swelling at the site of the biopsy
  • drainage of fluid from the biopsy site
  • bleeding that you can’t 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.

Sjögren Syndrome

If you have been diagnosed with Sjögren syndrome, depending on your symptoms, your doctor will prescribe medication to help you manage the disorder.