Histopathologic study of human lacrimal gland. Statistical analysis with special reference to aging.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.