Ultrastructural study of the lacrimal gland in a case of Sjögren's syndrome.

A 78-year-old woman, affected by a Gougerot-Sjögren's syndrome, had a typical keratoconjunctivitis sicca associated with xerostomia. A biopsy of lacrimal and accessory salivary glands was studied by conventional histological methods. In addition, the lacrimal gland was studied by electron microscopy. The two varieties of gland showed lesions of the same intensity with a similar decrease of lactoferrin and lysozyme. However, the ultrastructural features noted in the lacrimal gland were suggestive of an immunological reaction different from that noted in salivary glands. The attrition of ductal epithelia by lymphocytes was obvious but was never followed by regeneration and ductal ectasia. The massive infiltration of lymphocytes in the lobules and the early sclerosis of gland tissue appeared to be the main factor. Apparently, the sclerosis was not consecutive to the activity of periductal myoepithelial cells but resulted from the activity of fibroblasts in the production of basal membranes and collagen connective tissue.