PURPOSE This study aimed to examine the ultrastructural features of the lacrimal glands of patients with severe dry eye due to Stevens-Johnson syndrome (SJS). METHODS Biopsies form orbital lobes of six lacrimal glands obtained from fresh body donors (n=3) and patients with SJS (n=3; absolute tear deficiency; 2-6 months of disease duration) were examined using transmission electron microscopy (TEM). RESULTS On TEM, normal lacrimal glandular tissue shows columnar acinar epithelial cells containing basally located rounded or oval euchromatic nuclei with cytoplasmic electron dense and -moderately electron-dense secretory granules. Histologically, the lacrimal gland biopsies showed varied degree of acinar atrophy with lymphocytic infiltration in SJS patients. While on TEM, the lacrimal glands in SJS patients showed homogenous appearance of the nuclear chromatin of acinar cells with no differentiation into hetero-or euchromatin and loss of nucleoli. The cytoplasm lacked any electron dense material and showed significant loss of endoplasmic reticulum, mitochondria and Golgi bodies. The myoepithelial cells shared similar characteristics as in acinar epithelial cells along with loss of spindle shaped processes. CONCLUSION Transmission electron microscopy revealed ultrastructural changes in terms of nuclear composition, secretory vesicles, lysosomal vacuolation and myoepithelial cell distribution in the lacrimal glands of SJS patients.

中文翻译：

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史蒂文斯 - 约翰逊综合征后严重干眼病泪腺的超微结构研究。

目的 本研究旨在检查因 Stevens-Johnson 综合征 (SJS) 导致的严重干眼症患者泪腺的超微结构特征。方法 活组织检查从新鲜身体供体 (n=3) 和 SJS 患者 (n=3；绝对泪液缺乏；病程 2-6 个月) 获得的六个泪腺的眶叶使用透射电子显微镜 (TEM) 进行检查。结果 透射电镜下，正常泪腺组织呈柱状腺泡上皮细胞，含有位于基部的圆形或椭圆形常染色质核，胞质内有电子致密和中度电子致密的分泌颗粒。组织学上，SJS 患者泪腺活检显示不同程度的腺泡萎缩伴淋巴细胞浸润。在 TEM 上，SJS 患者的泪腺显示腺泡细胞的核染色质外观均一，没有分化为异染色质或常染色质，也没有核仁丢失。细胞质缺乏任何电子致密物质并且显示出内质网、线粒体和高尔基体的显着损失。肌上皮细胞具有与腺泡上皮细胞相似的特征，同时失去纺锤形突起。结论 透射电子显微镜显示 SJS 患者泪腺的核成分、分泌囊泡、溶酶体空泡化和肌上皮细胞分布的超微结构变化。细胞质缺乏任何电子致密物质并且显示出内质网、线粒体和高尔基体的显着损失。肌上皮细胞具有与腺泡上皮细胞相似的特征，同时失去纺锤形突起。结论 透射电子显微镜显示 SJS 患者泪腺的核成分、分泌囊泡、溶酶体空泡化和肌上皮细胞分布的超微结构变化。细胞质缺乏任何电子致密物质并且显示出内质网、线粒体和高尔基体的显着损失。肌上皮细胞具有与腺泡上皮细胞相似的特征，同时失去纺锤形突起。结论 透射电子显微镜显示 SJS 患者泪腺的核成分、分泌囊泡、溶酶体空泡化和肌上皮细胞分布的超微结构变化。