Obata H, Yamamoto S, Horiuchi H, Machinami R
Department of Pathology, Faculty of Medicine, University of Tokyo, Japan.
Ophthalmology. 1995 Apr;102(4):678-86. doi: 10.1016/s0161-6420(95)30971-2.
Histopathologic changes in human lacrimal gland were investigated, and the relation between histopathologic parameters and patient age and sex, as well as the histopathologic differences between palpebral and orbital lobes of the lacrimal gland were analyzed.
Samples of the main human lacrimal gland that included the palpebral lobes and orbital lobes were taken in 80 autopsies. A statistical analysis was made based on light microscope observations with the following histopathologic changes as parameters: (1) fibrosis (focal, lobular, and diffuse); (2) acinar atrophy (focal, lobular, and diffuse); (3) periductal fibrosis; (4) interlobular ductal dilatation; (5) interlobular ductal proliferation; (6) lymphocytic foci; (7) periductal lymphocytic infiltration; and (8) fatty infiltration.
The incidences of these parameters in the palpebral and orbital lobes ranged from 3.8% to 35.0%. Lobular fibrosis, lobular atrophy, diffuse fibrosis, diffuse atrophy, periductal fibrosis, lymphocytic infiltration, and fatty infiltration were more frequent in the orbital lobes with statistical significance, whereas interlobular ductal dilatation was more frequent in the palpebral lobes. There were statistically significant correlations between age and diffuse fibrosis, diffuse atrophy, and periductal fibrosis in the orbital lobes of women, and periductal fibrosis in the palpebral lobes of men. Diffuse fibrosis and diffuse atrophy in the orbital lobes were observed more frequently in elderly women than in elderly men.
Various histopathologic changes were observed in the human lacrimal gland. Diffuse fibrosis, diffuse atrophy, and periductal fibrosis predominantly found in elderly women suggested a relation with keratoconjunctivitis sicca in postmenopausal women. The authors speculate the periductal fibrosis is related to the decrease in tear fluid outflow with age and that interlobular ductal dilatation in the palpebral lobes may be caused by stenosis of the excretory duct in the fornix of conjunctiva. Ductal pathologic changes may be important in lacrimal gland dysfunction.
研究人类泪腺的组织病理学变化，分析组织病理学参数与患者年龄、性别的关系，以及泪腺睑叶和眶叶之间的组织病理学差异。
在80例尸检中获取包含睑叶和眶叶的主要人类泪腺样本。基于光学显微镜观察，以以下组织病理学变化为参数进行统计分析：（1）纤维化（局灶性、小叶性和弥漫性）；（2）腺泡萎缩（局灶性、小叶性和弥漫性）；（3）导管周围纤维化；（4）小叶间导管扩张；（5）小叶间导管增生；（6）淋巴细胞灶；（7）导管周围淋巴细胞浸润；（8）脂肪浸润。
这些参数在睑叶和眶叶中的发生率在3.8%至35.0%之间。小叶纤维化、小叶萎缩、弥漫性纤维化、弥漫性萎缩、导管周围纤维化、淋巴细胞浸润和脂肪浸润在眶叶中更常见，具有统计学意义，而小叶间导管扩张在睑叶中更常见。在老年女性眶叶中的弥漫性纤维化、弥漫性萎缩和导管周围纤维化与年龄之间存在统计学显著相关性，在老年男性睑叶中的导管周围纤维化与年龄之间也存在统计学显著相关性。老年女性眶叶中的弥漫性纤维化和弥漫性萎缩比老年男性更常见。
在人类泪腺中观察到了各种组织病理学变化。主要在老年女性中发现的弥漫性纤维化、弥漫性萎缩和导管周围纤维化提示与绝经后女性的干眼性角结膜炎有关。作者推测导管周围纤维化与随着年龄增长泪液流出减少有关，睑叶中的小叶间导管扩张可能是由结膜穹窿部排泄管狭窄引起的。导管病理变化在泪腺功能障碍中可能很重要。
