Assessment of Corneal ulcer: Video, Anatomy, Definition & Function | Osmosis

Question

A 62-year-old woman comes to the physician complaining of a &#8220;gritty&#8221; sensation in the eyes for the last several months. She states her eyes have also been increasingly itchy and red, and she also needs to chew food for a longer period of time in order to swallow it properly. Past medical history is significant for rheumatoid arthritis that is well managed with methotrexate. Vital signs are within normal limits. Physical examination shows redness of both eyes. Bilateral wrist and first metacarpophalangeal joints show mild swelling and tenderness. There is nontender, diffuse parotid gland enlargement bilaterally. Oral examination reveals mucosal atrophy and multiple dental caries. Ophthalmologic examination reveals decreased visual acuity in both eyes. A strip of litmus filter paper is folded at one end and inserted in the patient's lower eyelid; after 5 minutes, there is < 5 mm (normal > 15 mm) of moisture on the filter paper. Multiple corneal punctate spots are noted on fluorescein staining. Labial salivary gland biopsy would most likely show which of the following findings? &#160;

Accepted Answer

Numerous tightly aggregated clusters of lymphocytes with interstitial fibrosis and glandular atrophy

Answer

Acinar atrophy, interstitial fibrosis, and ductal dilatation with no lymphocytic infiltrates

Answer

Well-differentiated lesions with prominent keratinization and &#8220;pearl-like&#8221; structures invading the basement membrane

Answer

Mixed cellular constitution with myoepithelial cells and chondroid tissue

Answer

Uniform hypertrophy and hyperplasia of the acinar parenchyma of salivary glands

Answer

Uncontrolled proliferation of monoclonal B-cells surrounding the ducts

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Questions or feedback?

Corneal ulcer

Pathology

Eyes, ears, nose and throat